脂蛋白亚组分、止血潜能与冠状动脉粥样硬化的相关性。
Association between Lipoprotein Subfractions, Hemostatic Potentials, and Coronary Atherosclerosis.
机构信息
Institute of Radiology, University Medical Centre Ljubljana, Zaloška cesta 7/I, SI-1000 Ljubljana, Slovenia.
Department of Vascular Diseases, University Medical Centre Ljubljana, Zaloška cesta 7/VI, SI-1000 Ljubljana, Slovenia.
出版信息
Dis Markers. 2022 Aug 30;2022:2993309. doi: 10.1155/2022/2993309. eCollection 2022.
BACKGROUND
Dyslipidemias are associated with atherosclerotic plaque formation and a prothrombotic state, thus increasing the risk of both atherosclerotic vascular disease and atherothrombotic adverse events. We sought to explore the association between lipoprotein subfractions, overall hemostasis, and coronary calcifications in individuals at intermediate cardiovascular risk.
METHODS
Consecutive statin-naive individuals at intermediate cardiovascular risk referred for coronary artery calcium score (CACS) scanning were included. CACS was assessed using a 128-slice dual-source CT scanner. Traditional lipid profile, high-density lipoprotein (HDL) subfractions 2 and 3, and small dense low-density lipoproteins (sdLDL) were measured with commercially available assays. Overall hemostatic (OHP) and coagulation potentials (OCP) were measured spectrophotometrically, using fibrin aggregation curves after exposure to thrombin and recombinant tissue-type plasminogen activator, respectively. Overall fibrinolytic potential (OFP) was calculated as a difference between the two areas under curves.
RESULTS
We included 160 patients (median age 63 (interquartile range (IQR), 56-71 years, 52% women, and median CACS 8, IQR 0-173 Agatston units). HDL3 levels-but not sdLDL or hemostatic potentials-were significantly associated with CACS zero, even after adjusting for age, sex, arterial hypertension, dyslipidemia, diabetes, and smoking history (OR 0.980 (0.962-0.999), = 0.034). HDL3 was also significantly associated with OCP ( = -0.232, adjusted for age and sex 0.037).
CONCLUSIONS
In patients at intermediate cardiovascular risk, HDL3 is associated with both subclinical atherosclerosis and overall coagulation. Our findings are in line with studies reporting on an inverse relationship between HDL3 and atherosclerosis and provide one possible mechanistic explanation for the association between novel lipid biomarkers and coagulation derangements.
背景
脂代谢异常与动脉粥样硬化斑块形成和促血栓状态有关，从而增加了动脉粥样硬化性血管疾病和动脉粥样血栓不良事件的风险。我们试图探讨脂蛋白亚组分、整体止血和中等心血管风险个体冠状动脉钙化之间的关系。
方法
连续纳入中等心血管风险且他汀类药物初治的个体进行冠状动脉钙评分（CACS）扫描。使用 128 层双源 CT 扫描仪评估 CACS。采用商业试剂盒测定传统血脂谱、高密度脂蛋白（HDL）亚组分 2 和 3、小而密的低密度脂蛋白（sdLDL）。使用分别暴露于凝血酶和重组组织型纤溶酶原激活剂后的纤维蛋白聚合曲线，分光光度法测定整体止血（OHP）和凝血潜能（OCP）。总体纤维蛋白溶解潜能（OFP）计算为两条曲线下面积的差值。
结果
共纳入 160 例患者（中位年龄 63（四分位距（IQR），56-71 岁，52%为女性，中位 CACS 8，IQR 0-173 单位）。HDL3 水平——而不是 sdLDL 或止血潜能——与 CACS 为零显著相关，即使在调整年龄、性别、动脉高血压、血脂异常、糖尿病和吸烟史后（OR 0.980（0.962-0.999）， = 0.034）。HDL3 也与 OCP 显著相关（ = -0.232，调整年龄和性别后为 0.037）。
结论
在中等心血管风险患者中，HDL3 与亚临床动脉粥样硬化和整体凝血均相关。我们的研究结果与报告 HDL3 与动脉粥样硬化呈负相关的研究一致，并为新型脂质生物标志物与凝血异常之间的关联提供了一种可能的机制解释。
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