Lehtonen A, Marniemi J, Inberg M, Maatela J, Alanen E, Niittymäki K
Atherosclerosis. 1986 Feb;59(2):215-21. doi: 10.1016/0021-9150(86)90050-x.
Serum lipids and apoproteins A-I and B were measured in 115 male patients and serum pseudocholinesterase activity (PChE) was determined in 83 patients with 3 vessel coronary artery disease (CAD). The control subjects were matched according to sex, smoking, relative weight and age and were free from heart disease. The CAD patients had significantly higher serum VLDL cholesterol and triglyceride levels and lower HDL cholesterol and apo A-I levels and lower HDL to total cholesterol ratio than the controls. The concentrations of serum total cholesterol and LDL cholesterol were only slightly (6.4% and 8.8%, on an average) higher in CAD patients than in controls. The apo B levels of CAD patients were also slightly lower in patients than in controls. The CAD patients had slightly higher PChE activities than controls. The ratios of apo A-I to PChE and HDL cholesterol to PChE were significantly (about 30%, P less than 0.001) lower in patients than in controls. In discriminant analysis between the groups HDL cholesterol and apo A-I showed the best (74% success in reclassifying the patients to correct groups), and total cholesterol, triglycerides, LDL cholesterol and apo B remarkably weak discriminating power among the single variables of serum lipids and lipoproteins. In discriminating analysis the apo A-I/PChE and HDL cholesterol/PChE ratios showed relatively high (77.1 and 71.1% success from the patients to correct groups) and serum PChE activity weak discriminating power. These results indicate that low levels of HDL cholesterol and apo A-I and the low ratio of HDL cholesterol to total cholesterol are the most potent metabolic risk factors for 3 vessel coronary artery disease in a population with relatively high serum total cholesterol level. The determinations of apo A-I/PChE and HDL cholesterol/PChE ratios may be an additional, valuable tool in discriminating the risk for CAD.
对115名男性患者进行了血清脂质、载脂蛋白A-I和B的检测，并对83例三支血管冠状动脉疾病（CAD）患者测定了血清假性胆碱酯酶活性（PChE）。对照组根据性别、吸烟情况、相对体重和年龄进行匹配，且无心脏病。CAD患者的血清极低密度脂蛋白胆固醇和甘油三酯水平显著高于对照组，高密度脂蛋白胆固醇和载脂蛋白A-I水平较低，高密度脂蛋白与总胆固醇的比值也低于对照组。CAD患者的血清总胆固醇和低密度脂蛋白胆固醇浓度仅比对照组略高（平均分别高6.4%和8.8%）。CAD患者的载脂蛋白B水平也略低于对照组。CAD患者的PChE活性略高于对照组。患者的载脂蛋白A-I与PChE的比值以及高密度脂蛋白胆固醇与PChE的比值显著低于对照组（约低30%，P<0.001）。在两组之间的判别分析中，高密度脂蛋白胆固醇和载脂蛋白A-I显示出最佳效果（将患者重新分类到正确组别的成功率为74%），而在血清脂质和脂蛋白的单一变量中，总胆固醇、甘油三酯、低密度脂蛋白胆固醇和载脂蛋白B的判别能力明显较弱。在判别分析中，载脂蛋白A-I/PChE和高密度脂蛋白胆固醇/PChE比值显示出相对较高的成功率（将患者重新分类到正确组别的成功率分别为77.1%和71.1%），而血清PChE活性的判别能力较弱。这些结果表明，在血清总胆固醇水平相对较高的人群中，低水平的高密度脂蛋白胆固醇和载脂蛋白A-I以及高密度脂蛋白胆固醇与总胆固醇的低比值是三支血管冠状动脉疾病最主要的代谢危险因素。测定载脂蛋白A-I/PChE和高密度脂蛋白胆固醇/PChE比值可能是鉴别CAD风险的一项额外的有价值工具。
