Center for Lipid Biosciences, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Lipid Science and Aging Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Lipids Health Dis. 2020 Sep 22;19(1):210. doi: 10.1186/s12944-020-01386-5.
Negatively charged very-low-density lipoprotein (VLDL-χ) in metabolic syndrome (MetS) patients exerts cytotoxic effects on endothelial cells and atrial myocytes. Atrial cardiomyopathy, manifested by atrial remodeling with a dilated diameter, contributes to atrial fibrillation pathogenesis and predicts atrial fibrillation development. The correlation of VLDL-χ with atrial remodeling is unknown. This study investigated the association between VLDL-χ and remodeling of left atrium.
Consecutively, 87 MetS and 80 non-MetS individuals between 23 and 74 years old (50.6% men) without overt cardiovascular diseases were included in the prospective cohort study. Blood samples were collected while fasting and postprandially (at 0.5, 1, 2, and 4 h after a unified meal). VLDL was isolated by ultracentrifugation; the percentile concentration of VLDL-χ (%) was determined by ultra-performance liquid chromatography. The correlations of left atrium diameter (LAD) with variables including VLDL-χ, LDL-C, HDL-C, triglycerides, glucose, and blood pressure, were analyzed by multiple linear regression models. A hierarchical linear model was conducted to test the independencies of each variable's correlation with LAD.
The mean LAD was 3.4 ± 0.5 cm in non-MetS subjects and 3.9 ± 0.5 cm in MetS patients (P < 0.01). None of the fasting lipid profiles were associated with LAD. VLDL-χ, BMI, waist circumference, hip circumference, and blood pressure were positively correlated with LAD (all P < 0.05) after adjustment for age and sex. Significant interactions between VLDL-χ and blood pressure, waist circumference, and hip circumference were observed. When adjusted for obesity- and blood pressure-related variables, 2-h postprandial VLDL-χ (mean 1.30 ± 0.61%) showed a positive correlation with LAD in MetS patients. Each 1% VLDL-χ increase was estimated to increase LAD by 0.23 cm.
Postprandial VLDL-χ is associated with atrial remodeling particularly in the MetS group. VLDL-χ is a novel biomarker and may be a therapeutic target for atrial cardiomyopathy in MetS patients.
ISRCTN 69295295 . Retrospectively registered 9 June 2020.
代谢综合征（MetS）患者中带负电荷的极低密度脂蛋白（VLDL-χ）对内皮细胞和心房肌细胞具有细胞毒性作用。心房心肌病以扩张的直径表现为心房重构，导致心房颤动的发病机制，并预测心房颤动的发展。VLDL-χ 与心房重构的相关性尚不清楚。本研究探讨了 VLDL-χ 与左心房重构之间的关系。
连续纳入 87 名 MetS 和 80 名非 MetS 患者（年龄 23-74 岁，50.6%为男性），均无明显心血管疾病。空腹和餐后（统一餐后 0.5、1、2 和 4 小时）采集血样。采用超速离心法分离 VLDL；通过超高效液相色谱法测定 VLDL-χ（%）的百分位数浓度。采用多元线性回归模型分析左心房直径（LAD）与包括 VLDL-χ、LDL-C、HDL-C、甘油三酯、血糖和血压在内的变量之间的相关性。采用分层线性模型检验每个变量与 LAD 的相关性的独立性。
非 MetS 组的平均 LAD 为 3.4±0.5cm，MetS 组为 3.9±0.5cm（P<0.01）。空腹血脂谱均与 LAD 无关。VLDL-χ、BMI、腰围、臀围和血压与 LAD 呈正相关（均 P<0.05），校正年龄和性别后。观察到 VLDL-χ 与血压、腰围和臀围之间存在显著的交互作用。在校正肥胖和血压相关变量后，MetS 患者餐后 2 小时 VLDL-χ（平均 1.30±0.61%）与 LAD 呈正相关。VLDL-χ 每增加 1%，估计 LAD 增加 0.23cm。
餐后 VLDL-χ 与心房重构相关，尤其是在 MetS 组。VLDL-χ 是一种新型生物标志物，可能是 MetS 患者心房心肌病的治疗靶点。
ISRCTN69295295。2020 年 6 月 9 日回顾性注册。
