Cole Justine, Couture Patrick, Tremblay André J, Sniderman Allan D
Mike and Valeria Rosenbloom Centre for Cardiovascular Prevention, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada (Drs Cole and Sniderman).
Lipid Research Center, Laval University Medical Center, Quebec City, Quebec, Canada (Drs Couture and Tremblay).
J Clin Lipidol. 2025 Jan-Feb;19(1):72-82. doi: 10.1016/j.jacl.2024.09.009. Epub 2024 Oct 2.
The importance of any enhanced atherogenicity of triglyceride (TG)-rich lipoproteins (TRLs) will depend on the relative abundance of these particles compared with low-density lipoprotein (LDL) or total apolipoprotein (apo)B. Accordingly, we determined the contribution that TRLs make to total apoB as TG or apoB concentrations increase. We also describe compositional changes in TRLs as TG or apoB increases to assess whether very low-density lipoprotein (VLDL-[C]) is a valid proxy for VLDL-apoB.
We used sequential ultracentrifugation to separate lipoprotein fractions in plasma samples from 1940 dyslipidemic patients not on lipid-lowering medication, and measured apoB, cholesterol and TG in the plasma and in each subfraction. We analyzed these data in quartiles of TG or apoB.
There was wide variance in all parameters in all quartiles of both TG and apoB. Although VLDL-apoB accounted for almost all the increase in total apoB across TG quartiles, LDL-apoB still accounted for 80% of the total in TG quartile 4. In contrast, LDL-apoB accounted for 90% of the increase in apoB across apoB quartiles. As TG increases, the increase in VLDL-C is explained more by increased VLDL-C/apoB when TG is moderately elevated, and more by increased VLDL-apoB when TG is very high.
In conclusion, VLDL-apoB only becomes a substantial component of total apoB with extreme hypertriglyceridemia and VLDL-C is not an appropriate proxy for VLDL-apoB.
富含甘油三酯（TG）的脂蛋白（TRL）致动脉粥样硬化性增强的重要性，将取决于这些颗粒与低密度脂蛋白（LDL）或总载脂蛋白（apo）B相比的相对丰度。因此，我们确定了随着TG或apoB浓度升高，TRL对总apoB的贡献。我们还描述了随着TG或apoB升高，TRL的组成变化，以评估极低密度脂蛋白（VLDL-[C]）是否是VLDL-apoB的有效替代指标。
我们采用连续超速离心法，分离了1940例未服用降脂药物的血脂异常患者血浆样本中的脂蛋白组分，并测定了血浆及各亚组分中的apoB、胆固醇和TG。我们按TG或apoB的四分位数分析了这些数据。
TG和apoB的所有四分位数中，所有参数均存在广泛差异。尽管在TG四分位数范围内，VLDL-apoB几乎占总apoB增加量的全部，但在TG四分位数4中，LDL-apoB仍占总量的80%。相比之下，在apoB四分位数范围内，LDL-apoB占apoB增加量的90%。随着TG升高，当TG中度升高时，VLDL-C的增加更多是由VLDL-C/apoB增加所致，而当TG非常高时，则更多是由VLDL-apoB增加所致。
总之，只有在极端高甘油三酯血症时，VLDL-apoB才成为总apoB的主要成分，且VLDL-C不是VLDL-apoB的合适替代指标。
