Kesaniemi Y A, Grundy S M
Arteriosclerosis. 1983 Mar-Apr;3(2):170-7. doi: 10.1161/01.atv.3.2.170.
Turnover rates of the apolipoprotein of low density lipoproteins (apoLDL) and cholesterol balance were determined in six obese men and six control men. The two groups were of similar age and matched for apoLDL concentrations. Levels of plasma total cholesterol in obese patients (209 +/- 14 SEM mg/dl) were similar to controls (225 +/- 17 mg/dl). LDL-cholesterol was numerically but not statistically lower in obese subjects (111 +/- 18 mg/dl) compared to controls (145 +/- 13 mg/dl). Synthetic rates of apoLDL in contrast were higher in obese patients (1450 mg/day) than in controls (934 mg/day) (p less than 0.002). Three factors could explain the similar concentrations of LDL-cholesterol in obese and control subjects, despite overproduction of apoLDL in the obese. First, LDL was diluted into a larger plasma pool in obese patients; second, fractional catabolic rates of apoLDL were somewhat greater in obese men than in controls; and third, obese patients had higher ratios of protein-to-cholesterol in LDL. The production of apoLDL for all patients was not correlated with total body synthesis of cholesterol. The major finding of this study was that obese patients have increased turnover of apoLDL, not necessarily reflected by high concentrations of LDL-cholesterol. This high turnover rate itself may raise the risk for coronary heart disease in obese patients.
在六名肥胖男性和六名对照男性中测定了低密度脂蛋白载脂蛋白（apoLDL）的周转率和胆固醇平衡。两组年龄相似，apoLDL浓度匹配。肥胖患者的血浆总胆固醇水平（209±14 SEM毫克/分升）与对照组（225±17毫克/分升）相似。与对照组（145±13毫克/分升）相比，肥胖受试者的低密度脂蛋白胆固醇在数值上较低，但无统计学差异（111±18毫克/分升）。相比之下，肥胖患者的apoLDL合成率（1450毫克/天）高于对照组（934毫克/天）（p＜0.002）。尽管肥胖患者apoLDL产生过多，但有三个因素可以解释肥胖和对照受试者中低密度脂蛋白胆固醇浓度相似的现象。首先，肥胖患者的低密度脂蛋白被稀释到更大的血浆池中；其次，肥胖男性的apoLDL分解代谢率略高于对照组；第三，肥胖患者的低密度脂蛋白中蛋白质与胆固醇的比例更高。所有患者的apoLDL产生与全身胆固醇合成无关。本研究的主要发现是，肥胖患者的apoLDL周转率增加，不一定反映为高浓度的低密度脂蛋白胆固醇。这种高周转率本身可能会增加肥胖患者患冠心病的风险。
