Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou 1st Rd, Kaohsiung, 807, Taiwan.
Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Sci Rep. 2023 Apr 21;13(1):6575. doi: 10.1038/s41598-023-33757-0.
Subjects with metabolic syndrome (MetS) commonly have atrial remodeling, which indicates a risk for atrial fibrillation. This study determined MetS-related changes in lipid components in very-low-density lipoprotein (VLDL), which has been shown to cause atrial remodeling, the effect of statins on these changes, and the correlation between atrial remodeling and VLDL lipid compositions. Blood samples were collected from 12 non-MetS and 27 sex- and age-matched MetS subjects. Fourteen patients with MetS (MetS-off statin) discontinued statin therapy 14 days before the study, while the remaining 13 remained on it (MetS-on statin). The VLDLs were isolated and processed for mass-based lipid profiling. Lipidomic analyses were performed and associated with atrial remodeling markers measured using standard echocardiography and electrocardiography. Compared with the VLDL components of the non-MetS group, glucosyl/galactosyl ceramide, lyso-phosphatidylcholine, lyso-phosphatidylethanolamine, and triglycerides were enriched in the MetS-off statin group. Statin therapy attenuated all abnormally abundant lipid classes in MetS, except for triglycerides. In addition, lyso-phosphatidylcholine, lyso-phosphatidylethanolamine, and triglycerides were significantly correlated with atrial dilatation, and the latter two were also correlated with the PR interval. Enrichment of double bonds, which indicate unsaturated fatty acids, was also significantly correlated with atrial remodeling and P-wave duration. This study suggests that the pathological lipid payload of MetS-VLDL may contribute to atrial remodeling in patients.
患有代谢综合征 (MetS) 的受试者通常会出现心房重构，这表明其存在心房颤动的风险。本研究旨在确定代谢综合征相关的极低密度脂蛋白 (VLDL) 脂质成分变化，因为 VLDL 已被证明会导致心房重构，同时还研究了他汀类药物对这些变化的影响，以及心房重构与 VLDL 脂质成分之间的相关性。研究共采集了 12 名非代谢综合征患者和 27 名性别和年龄匹配的代谢综合征患者的血样。14 名代谢综合征患者（停他汀治疗组）在研究前 14 天停止他汀治疗，而其余 13 名患者继续服用他汀（继续他汀治疗组）。分离和处理 VLDL 以进行基于质量的脂质分析。进行脂质组学分析，并与使用标准超声心动图和心电图测量的心房重构标志物相关联。与非代谢综合征组的 VLDL 成分相比，停他汀治疗组的葡萄糖/半乳糖神经酰胺、溶血磷脂酰胆碱、溶血磷脂酰乙醇胺和甘油三酯含量更丰富。他汀类药物治疗可减轻除甘油三酯外，代谢综合征中所有异常丰富的脂质类别。此外，溶血磷脂酰胆碱、溶血磷脂酰乙醇胺和甘油三酯与心房扩张显著相关，后两者与 PR 间期也相关。双键（表示不饱和脂肪酸）的富集也与心房重构和 P 波持续时间显著相关。本研究表明，代谢综合征 VLDL 的病理脂质负荷可能导致患者的心房重构。
