Fernández-Cidón Bárbara, Candás-Estébanez Beatriz, Gil-Serret Miriam, Amigó Núria, Corbella Emili, Rodríguez-Sánchez M Ángeles, Padró-Miquel Ariadna, Brotons Carlos, Hernández-Mijares Antonio, Calmarza Pilar, Jarauta Estibaliz, Brea Angel J, Mauri Marta, Guijarro Carlos, Vila Àlex, Valdivielso Pedro, Corbella Xavier, Pintó Xavier
Bioquímica Especial y Biología Molecular, Laboratori Clínic, Hospital Universitario de Bellvitge, 08907 L'Hospitalet de Ll., Spain.
Clinical Laboratory, SCIAS-Hospital de Barcelona, 08034 Barcelona, Spain.
J Clin Med. 2021 Mar 29;10(7):1379. doi: 10.3390/jcm10071379.
Some lipoprotein disorders related to the residual risk of premature cardiovascular disease (PCVD) are not detected by the conventional lipid profile. In this case-control study, the predictive power of PCVD of serum sdLDL-C, measured using a lipoprotein precipitation method, and of the physicochemical properties of serum lipoproteins, analyzed by nuclear magnetic resonance (NMR) techniques, were evaluated. We studied a group of patients with a first PCVD event ( = 125) and a group of control subjects ( = 190). Conventional lipid profile, the size and number of Very Low Density Lipoproteins (VLDL), Low Density Lipoproteins (LDL), High Density Lipoproteins (HDL) particles, and the number of particles of their subclasses (large, medium, and small) were measured. Compared to controls, PCVD patients had lower concentrations of all LDL particles, and smaller and larger diameter of LDL and HDL particles, respectively. PCVD patients also showed higher concentrations of small dense LDL-cholesterol (sdLDL), and triglycerides (Tg) in LDL and HDL particles (HDL-Tg), and higher concentrations of large VLDL particles. Multivariate logistic regression showed that sdLDL-C, HDL-Tg, and large concentrations of LDL particles were the most powerful predictors of PCVD. A strong relationship was observed between increased HDL-Tg concentrations and PCVD. This study demonstrates that beyond the conventional lipid profile, PCVD patients have other atherogenic lipoprotein alterations that are detected by magnetic resonance imaging (MRI) analysis.
一些与早发性心血管疾病（PCVD）残余风险相关的脂蛋白紊乱无法通过传统血脂谱检测出来。在这项病例对照研究中，评估了使用脂蛋白沉淀法测量的血清sdLDL-C以及通过核磁共振（NMR）技术分析的血清脂蛋白物理化学性质对PCVD的预测能力。我们研究了一组首次发生PCVD事件的患者（n = 125）和一组对照受试者（n = 190）。测量了传统血脂谱、极低密度脂蛋白（VLDL）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）颗粒的大小和数量，以及它们亚类（大、中、小）颗粒的数量。与对照组相比，PCVD患者所有LDL颗粒的浓度较低，LDL和HDL颗粒的直径分别较小和较大。PCVD患者还表现出小而密LDL胆固醇（sdLDL）、LDL和HDL颗粒中的甘油三酯（Tg）（HDL-Tg）浓度较高，以及大的VLDL颗粒浓度较高。多变量逻辑回归显示，sdLDL-C、HDL-Tg和高浓度的LDL颗粒是PCVD最有力的预测指标。观察到HDL-Tg浓度升高与PCVD之间存在密切关系。这项研究表明，除了传统血脂谱外，PCVD患者还有其他通过磁共振成像（MRI）分析检测到的致动脉粥样硬化脂蛋白改变。
