Department of Neurology, Medical University of Innsbruck, Christoph-Probst-Platz 1, Innrain 52 A, 6020 Innsbruck, Austria.
Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany; German Centre for Cardiovascular Research, Partner Site Greifswald, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany.
Atherosclerosis. 2022 Jan;341:34-42. doi: 10.1016/j.atherosclerosis.2021.12.007. Epub 2021 Dec 16.
Assessment of comprehensive lipoprotein subclass profiles in adolescents and their relation to vascular disease may enhance our understanding of the development of dyslipidemia in early life and inform early vascular prevention.
Nuclear magnetic resonance was used to measure lipoprotein profiles, including lipids (cholesterol, free cholesterol, triglycerides, phospholipids) and apolipoproteins (apoB-100, apoA1, apoA2) of 17 lipoprotein subclasses (from least dense to densest: VLDL-1 to -6, IDL, LDL-1 to -6, HDL-1 to -4) in n = 1776 14- to 19-year olds (56.6% female) and n = 3027 25- to 85-year olds (51.5% female), all community-dwelling. Lipoprotein profiles were related to carotid intima-media thickness (cIMT) as ascertained by sonography.
Adolescents compared to adults had lower triglycerides, total, LDL, and non-HDL cholesterol, and apoB, and higher HDL cholesterol. They showed 26.6-59.8% lower triglyceride content of all lipoprotein subclasses and 21.9-51.4% lower VLDL lipid content. Concentrations of dense LDL-4 to LDL-6 were 36.7-40.2% lower, with also markedly lower levels of LDL-1 to LDL-3, but 24.2% higher HDL-1 ApoA1. In adolescents, only LDL-3 to LDL-5 subclasses were associated with cIMT (range of differences in cIMT for a 1-SD higher concentration, 4.8-5.9 μm). The same associations emerged in adults, with on average 97 ± 42% (mean ± SD) larger effect sizes, in addition to LDL-1 and LDL-6 (range, 6.9-11.3 μm) and HDL-2 to HDL-4, ApoA1, and ApoA2 (range, -7.0 to -17.7 μm).
Adolescents showed a markedly different and more favorable lipoprotein profile compared to adults. Dense LDL subclasses were the only subclasses associated with cIMT in adolescents, implicating them as the potential preferred therapeutic target for primary prevention of cardiovascular disease at this age. In adults, associations with cIMT were approximately twice as large as in adolescents, and HDL-related measures were additionally associated with cIMT.
评估青少年综合脂蛋白亚类谱及其与血管疾病的关系，可以增进我们对生命早期血脂异常发展的理解，并为早期血管预防提供信息。
采用核磁共振技术测量 n=1776 名 14 至 19 岁（56.6%为女性）和 n=3027 名 25 至 85 岁（51.5%为女性）的社区居住青少年和成年人的脂蛋白谱，包括脂蛋白亚类（从密度最低到最高：VLDL-1 至 -6、IDL、LDL-1 至 -6、HDL-1 至 -4）中的脂质（胆固醇、游离胆固醇、甘油三酯、磷脂）和载脂蛋白（apoB-100、apoA1、apoA2）。用超声测量颈动脉内膜-中层厚度（cIMT）来确定脂蛋白谱与 cIMT 的关系。
与成年人相比，青少年的甘油三酯、总胆固醇、LDL 胆固醇和非 HDL 胆固醇以及 apoB 水平较低，HDL 胆固醇水平较高。青少年所有脂蛋白亚类的甘油三酯含量低 26.6-59.8%，VLDL 脂质含量低 21.9-51.4%。致密 LDL-4 至 LDL-6 的浓度低 36.7-40.2%，LDL-1 至 LDL-3 的水平也明显较低，但 HDL-1 apoA1 高 24.2%。在青少年中，只有 LDL-3 至 LDL-5 亚类与 cIMT 相关（cIMT 每增加一个标准差，差异为 4.8-5.9 μm）。在成年人中也出现了同样的关联，除了 LDL-1 和 LDL-6（范围为 6.9-11.3 μm）和 HDL-2 至 HDL-4、apoA1 和 apoA2（范围为-7.0 至-17.7 μm）外，LDL-1 和 LDL-6 也有平均 97±42%（均值±标准差）更大的效应量。
与成年人相比，青少年的脂蛋白谱明显不同，更为有利。致密 LDL 亚类是青少年中唯一与 cIMT 相关的亚类，提示它们可能是这一年龄段心血管疾病一级预防的潜在首选治疗靶点。在成年人中，与 cIMT 的关联大约是青少年的两倍，而与 HDL 相关的指标也与 cIMT 相关。
