载脂蛋白作为慢性胰腺炎患者心血管风险的预测因子。

Apolipoproteins as predictors of cardiovascular risk in patients with chronic pancreatitis.

机构信息

Department of Gastroenterology, University Hospital "Tsaritsa Ioanna-ISUL", Medical University of Sofia, Sofia, Bulgaria.

出版信息

Eur Rev Med Pharmacol Sci. 2023 Dec;27(24):12043-12050. doi: 10.26355/eurrev_202312_34802.

DOI:10.26355/eurrev_202312_34802

PMID:38164866

Abstract

OBJECTIVE

Patients with pancreatic diseases are at increased risk of cardiovascular events. Investigating various apolipoprotein forms as important atherogenesis components may improve cardiovascular risk (CVR) prediction. This study aimed to investigate CVR factors in patients with chronic pancreatitis.

PATIENTS AND METHODS

The study enrolled 70 patients (40 males and 30 females, mean age 55.2 years) with chronic pancreatitis and treated pancreatic exocrine insufficiency. We assessed CVR by apolipoproteins A-I, A-II, B, and C-III, lipid profile; score systems [SCORE risk chart and Framingham Risk Score (FRS)], diabetes mellitus; chronic pancreatitis by M-ANNHEIM classification. Statistics were performed via SPSS v. 22.

RESULTS

Low apolipoprotein A-I and high apolipoprotein B levels with increased atherogenic potential were observed in 37 and 26 patients. 45.71% demonstrated a high risk of myocardial infarction with high apolipoprotein B/apolipoprotein A-I ratio. Men are at higher CVR risk. Apolipoproteins A-I and A-II correlated with the cardioprotective high-density lipoprotein (HDL) in contrast to apolipoproteins B and C-III, which correlated strongly with low-density lipoprotein (LDL), total cholesterol (TC), and triglycerides (TG). Increased CVR assessed by FRS correlated with significantly lower apolipoprotein A-I and higher apolipoprotein B and apolipoprotein B/apolipoprotein A-I ratio. With the increase in chronic pancreatitis severity, we observed decreased apolipoproteins and increased apolipoprotein B/apolipoprotein A-I ratio.

CONCLUSIONS

Apolipoproteins are valuable CVR indicators. Further studies are required to establish a CVR screening panel in this population.

摘要

目的

患有胰腺疾病的患者发生心血管事件的风险增加。研究各种载脂蛋白形式作为重要的动脉粥样硬化形成成分，可能会改善心血管风险（CVR）预测。本研究旨在探讨慢性胰腺炎患者的 CVR 因素。

方法

本研究纳入了 70 名（40 名男性，30 名女性，平均年龄 55.2 岁）患有慢性胰腺炎和胰腺外分泌功能不全的患者。我们通过载脂蛋白 A-I、A-II、B 和 C-III、血脂谱；评分系统[风险图表 SCORE 和 Framingham 风险评分（FRS）]、糖尿病；M-ANNHEIM 分类评估 CVR。统计分析使用 SPSS v. 22 进行。

结果

37 名患者存在低载脂蛋白 A-I 和高载脂蛋白 B 水平，具有增加的动脉粥样硬化形成潜力，26 名患者存在高载脂蛋白 B/载脂蛋白 A-I 比值的高心肌梗死风险。男性具有更高的 CVR 风险。载脂蛋白 A-I 和 A-II 与具有保护作用的高密度脂蛋白（HDL）相关，而载脂蛋白 B 和 C-III 则与低密度脂蛋白（LDL）、总胆固醇（TC）和甘油三酯（TG）密切相关。FRS 评估的 CVR 增加与载脂蛋白 A-I 显著降低和载脂蛋白 B 及载脂蛋白 B/载脂蛋白 A-I 比值升高相关。随着慢性胰腺炎严重程度的增加，我们观察到载脂蛋白降低和载脂蛋白 B/载脂蛋白 A-I 比值升高。