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应激性高血糖或血栓负荷高的 ST 段抬高型心肌梗死患者的血浆氧化高密度脂蛋白和糖化载脂蛋白 A-I 浓度。

Plasma oxidized high-density lipoprotein and glycated apolipoprotein A-I concentrations in ST-segment elevation myocardial infarction patients with stress hyperglycaemia or high thrombus burden.

机构信息

a The First Affiliated Hospital, and College of Clinical Medicine , Henan University of Science and Technology , Luoyang , P. R. China.

b Department of Cardiology, Union Hospital, Tongji Medical College , Huazhong University of Science and Technology , Wuhan , P.R. China.

出版信息

Ups J Med Sci. 2018 Sep;123(3):158-166. doi: 10.1080/03009734.2018.1494229. Epub 2018 Sep 27.

Abstract

BACKGROUND

High-density lipoprotein (HDL) particles exert many beneficial actions that may help protect against cardiovascular disease. However, recent work has demonstrated that HDL can be oxidized and glycated under certain circumstances and may become pro-atherogenic. The present study investigated the impact of oxidized high-density lipoprotein (ox-HDL) and glycated apolipoprotein A-I (gly-ApoA-I) in patients presenting with ST-elevation myocardial infarction (STEMI).

METHODS

We assessed 55 consecutive patients with STEMI. Patients were divided into: (1) a stress hyperglycaemia (SH) and a no SH group; and (2) a high thrombus burden (HTB) group and a low thrombus burden (LTB) group. Meanwhile, 48 healthy volunteers were recruited as controls. Plasma ox-HDL and gly-ApoA-I concentrations were measured on admission and 7 days after admission.

RESULTS

Higher concentrations of ox-HDL and gly-ApoA-I were found in the STEMI group than in the control group on admission and at d7. Further subgroup analysis showed that ox-HDL and gly-ApoA-I were higher in the SH group than in the no SH group at both time points; the HTB group had higher ox-HDL and ox-HDL/HDL-C levels than the LTB group on admission and at d7. However, gly-ApoA-I and the relative intensity of ApoA-I glycation showed no significant differences between the HTB and LTB groups.

CONCLUSIONS

The present data indicate that: (1) SH is associated with increased plasma concentrations of ox-HDL and gly-ApoA-I and therefore aggressive treatment is recommended; and (2) that ox-HDL and ox-HDL/HDL-C were higher in the HTB group and may be used to quantify thrombus burden.

摘要

背景

高密度脂蛋白(HDL)颗粒具有许多有益作用,可以帮助预防心血管疾病。然而,最近的研究表明,在某些情况下,HDL 可以被氧化和糖化,并且可能变得促动脉粥样硬化。本研究探讨了氧化型高密度脂蛋白(ox-HDL)和糖化载脂蛋白 A-I(gly-ApoA-I)在表现出 ST 段抬高型心肌梗死(STEMI)的患者中的影响。

方法

我们评估了 55 例连续的 STEMI 患者。患者分为:(1)应激性高血糖(SH)和非 SH 组;和(2)高血栓负荷(HTB)组和低血栓负荷(LTB)组。同时,招募了 48 名健康志愿者作为对照组。入院时和入院后 7 天测量血浆 ox-HDL 和 gly-ApoA-I 浓度。

结果

STEMI 组入院时和入院后 7 天的 ox-HDL 和 gly-ApoA-I 浓度均高于对照组。进一步的亚组分析显示,SH 组在两个时间点的 ox-HDL 和 gly-ApoA-I 浓度均高于非 SH 组;入院时和入院后 7 天 HTB 组的 ox-HDL 和 ox-HDL/HDL-C 水平均高于 LTB 组。然而,gly-ApoA-I 和 ApoA-I 糖化的相对强度在 HTB 和 LTB 组之间没有显著差异。

结论

本研究数据表明:(1)SH 与血浆 ox-HDL 和 gly-ApoA-I 浓度升高有关,因此建议积极治疗;(2)HTB 组的 ox-HDL 和 ox-HDL/HDL-C 水平较高,可能用于定量血栓负荷。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d333/6198222/f516140ee015/IUPS_A_1494229_F0001_B.jpg

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