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对伴有或不伴有亚临床动脉粥样硬化的家族性高胆固醇血症患者的代谢和先天免疫特征进行评估。

Evaluations of metabolic and innate immunity profiles in subjects with familial hypercholesterolemia with or without subclinical atherosclerosis.

作者信息

Bosco Giosiana, Di Giacomo Barbagallo Francesco, Di Marco Maurizio, Scilletta Sabrina, Miano Nicoletta, Capuccio Stefania, Musmeci Marco, Di Mauro Stefania, Filippello Agnese, Scamporrino Alessandra, Di Pino Antonino, Masana Luis, Purrello Francesco, Piro Salvatore, Scicali Roberto

机构信息

Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.

Unitat Medicina Vascular I Metabolisme. Unitat de Recerca en Lípids i Arteriosclerosi. Hospital Universitari Sant Joan. Universitat Rovira i Virgili. IISPV. Reus. Spain.

出版信息

Eur J Intern Med. 2025 Feb;132:118-126. doi: 10.1016/j.ejim.2024.12.002. Epub 2024 Dec 13.

Abstract

BACKGROUND

Familial hypercholesterolemia (FH) is a genetic condition characterized by high low-density lipoprotein cholesterol (LDL-C). The presence of risk modifiers could promote the atherosclerotic injury beyond LDL-C. Our aim was to evaluate metabolic and innate immunity profiles in FH subjects with or without subclinical atherosclerosis.

METHODS

In this cross-sectional observational study, we evaluated 211 genetically confirmed FH subjects on LDL-C target and without cardiovascular diseases. Biochemical analyses, LDL-C burden (LCB) calculation and vascular profile evaluation were obtained from all subjects. Study population was divided into two groups according to subclinical atherosclerosis: the subclinical atherosclerosis (SA) group and non-subclinical atherosclerosis (NSA) group.

RESULTS

SA group had higher LDL-C at diagnosis (288.35 ± 24.52 vs 267.92 ± 23.86, p < 0.05) and LCB (13,465.84 ± 3617.46 vs 10,872.63 ± 3594.7, p < 0.001) than NSA group. SA group had higher white blood cell count (WBCC, 6.9 ± 1.66 vs 6.1 ± 1.16), neutrophil count (NC, 4.2 ± 1.3 vs 3.6 ± 1.11), monocyte count (MC, 0.8 ± 0.2 vs 0.4 ± 0.1), triglyceride to high-density lipoprotein ratio (TG/HDL, 1.73 ± 0.72 vs 1.45 ± 0.69), triglyceride-glucose index (TyG, 8.29 ± 0.35 vs 8.01 ± 0.33) than NSA group (p value for all < 0.01). Multivariate logistic regression analysis showed that LCB (p < 0.01), WBCC (p < 0.01), NC (p < 0.05), MC (p < 0.05) were associated with subclinical atherosclerosis. Simple linear regression analyses showed that LCB was associated with WBCC, NC, MC (p value for all < 0.01).

CONCLUSION

An increased LCB and an impaired innate immunity profile were found in FH subjects with subclinical atherosclerosis and they were independently associated with atherosclerotic injury. LCB could modulate the innate immunity profile.

摘要

背景

家族性高胆固醇血症(FH)是一种以低密度脂蛋白胆固醇(LDL-C)水平升高为特征的遗传性疾病。风险修饰因素的存在可能会促进超出LDL-C水平的动脉粥样硬化损伤。我们的目的是评估有无亚临床动脉粥样硬化的FH患者的代谢和固有免疫特征。

方法

在这项横断面观察性研究中,我们评估了211名经基因确诊的FH患者,这些患者LDL-C水平达标且无心血管疾病。对所有患者进行了生化分析、LDL-C负荷(LCB)计算和血管特征评估。根据亚临床动脉粥样硬化情况将研究人群分为两组:亚临床动脉粥样硬化(SA)组和非亚临床动脉粥样硬化(NSA)组。

结果

SA组诊断时的LDL-C水平(288.35±24.52 vs 267.92±23.86,p<0.05)和LCB(13465.84±3617.46 vs 10872.63±3594.7,p<0.001)均高于NSA组。SA组的白细胞计数(WBCC,6.9±1.66 vs 6.1±1.16)、中性粒细胞计数(NC,4.2±1.3 vs 3.6±1.11)、单核细胞计数(MC,0.8±0.2 vs 0.4±0.1)、甘油三酯与高密度脂蛋白比值(TG/HDL,1.73±0.72 vs 1.45±0.69)、甘油三酯-葡萄糖指数(TyG,8.29±0.35 vs 8.01±0.33)均高于NSA组(所有p值均<0.01)。多因素logistic回归分析显示,LCB(p<0.01)、WBCC(p<0.01)、NC(p<0.05)、MC(p<0.05)与亚临床动脉粥样硬化相关。简单线性回归分析显示,LCB与WBCC、NC、MC相关(所有p值均<0.01)。

结论

在有亚临床动脉粥样硬化的FH患者中发现LCB升高和固有免疫特征受损,且它们与动脉粥样硬化损伤独立相关。LCB可调节固有免疫特征。

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