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家族性高胆固醇血症基因变异携带者患者的新型心血管疾病标志物。

New cardiovascular disease markers in patients with familial hypercholesterolemia carriers of genetic variants.

作者信息

de Paiva Silvino Júnea Paolucci, Jannes Cinthia Elim, Pestana Rodrigo Mendonça Cardoso, de Paiva Silvino Lucas Paolucci, Silva Iêda de Fátima Oliveira, Gomes Karina Braga

机构信息

Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerias Brazil.

Laboratório de Genética do Instituto do Coração (INCOR), Universidade de São Paulo, São Paulo, Brazil.

出版信息

J Diabetes Metab Disord. 2024 Dec 16;24(1):13. doi: 10.1007/s40200-024-01537-w. eCollection 2025 Jun.

Abstract

OBJECTIVES

Familial hypercholesterolemia (FH) is an autosomal dominant genetic disease characterized by elevated levels of low-density lipoprotein cholesterol (LDLc). The early diagnosis of FH can reduce unfavorable outcomes in this population, but genetic study is not available in all populations. This study aimed to evaluate new cardiovascular plasma markers (GDF-15, CXCL16, FABP3, FABP4, LIGHT, sCD14, ucMGP), as well as Lp(a) levels, in individuals genetically characterized for FH, classified according to treatment with statins.

METHODS

Sequencing was performed by next generation sequencing (NGS) for 17 ICs and by the Sanger method for 120 relatives. Lp(a) was measured by turbidimetry and the other cardiovascular markers by the multiplex method for Luminex. Statistical analyses were performed using the R Platform version 4.2.2 program.

RESULTS

86 individuals carrying FH genetic variants and 51 non-carrier family members were identified. Lp(a) showed higher levels in the group with variants and was correlated to LDLc levels. FABP3 levels were higher in the group carrying variants using statins compared to the group without statins. The non-carrier group using statins showed higher levels of FABP4 compared to the carrier group using statins. The markers GDF-15, CXCL16, LGHT, sCD14 and ucMGP did not show a significant difference between groups, but GDF-15 and sCD14 were correlated to LDLc levels.

CONCLUSIONS

Lp(a) and the new markers FABP3 e FABP4 are associated with FH, their levels are modulated by the use of statins, and they could be potential markers to assess the disease when genetic testing is not available.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40200-024-01537-w.

摘要

目的

家族性高胆固醇血症(FH)是一种常染色体显性遗传病,其特征为低密度脂蛋白胆固醇(LDLc)水平升高。FH的早期诊断可减少该人群的不良结局,但并非所有人群都能进行基因研究。本研究旨在评估新的心血管血浆标志物(生长分化因子15、CXC趋化因子配体16、脂肪酸结合蛋白3、脂肪酸结合蛋白4、肿瘤坏死因子配体超家族成员14、可溶性CD14、未羧化基质Gla蛋白)以及脂蛋白(a)[Lp(a)]水平,这些评估对象为经基因鉴定的FH患者,并根据他汀类药物治疗情况进行分类。

方法

对17名先证者采用二代测序(NGS)进行测序,对120名亲属采用桑格法进行测序。采用比浊法测定Lp(a),采用Luminex多重方法测定其他心血管标志物。使用R平台4.2.2版程序进行统计分析。

结果

共鉴定出86名携带FH基因变异的个体和51名非携带者家庭成员。携带变异的组中Lp(a)水平较高,且与LDLc水平相关。与未使用他汀类药物的组相比,使用他汀类药物的携带变异组中脂肪酸结合蛋白3水平较高。使用他汀类药物的非携带者组中脂肪酸结合蛋白4水平高于使用他汀类药物的携带者组。生长分化因子15、CXC趋化因子配体16、肿瘤坏死因子配体超家族成员14、可溶性CD14和未羧化基质Gla蛋白在各组之间未显示出显著差异,但生长分化因子15和可溶性CD14与LDLc水平相关。

结论

Lp(a)以及新标志物脂肪酸结合蛋白3和脂肪酸结合蛋白4与FH相关,它们的水平受他汀类药物使用的调节,并且在无法进行基因检测时,它们可能是评估该疾病的潜在标志物。

补充信息

在线版本包含可在10.1007/s40200-024-01537-w获取的补充材料。

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Statins for children with familial hypercholesterolemia.用于患有家族性高胆固醇血症儿童的他汀类药物。
Cochrane Database Syst Rev. 2017 Jul 7;7(7):CD006401. doi: 10.1002/14651858.CD006401.pub4.

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