Stiel G M, Reblin T, Bührlen M, Lattermann A, Nienaber C A
Division of Cardiology, University Hospital Eppendorf, Hamburg, Germany.
Coron Artery Dis. 1995 Apr;6(4):347-50. doi: 10.1097/00019501-199504000-00013.
This study was designed to evaluate whether differences between sexes exist in serum-lipoprotein (a) [Lp(a)] and arterial-wall-apolipoprotein (a) [Apo(a)] levels in patients with advanced coronary artery disease.
The concentrations of Lp(a) in serum and Apo(a) in aortic biopsies were studied in 76 men and 20 women undergoing coronary artery bypass graft surgery. The severity of coronary artery disease was determined by a coronary atherosclerosis score that used quantitative coronary angiography.
Serum-Lp(a) and tissue-Apo(a) do not correlate with the severity of coronary artery disease as expressed by the coronary atherosclerosis score (r = 0.09 and r = 0.14, respectively). Women were older (65 +/- 8 versus 57 +/- 8 years, P < 0.001) and had higher mean Lp(a) and higher mean Apo(a) levels (47 +/- 41 versus 32 +/- 40 mg/dl and 33 +/- 34 versus 19 +/- 24 micrograms/g wet weight, P < 0.05) than men with identical coronary atherosclerosis score (35 +/- 8 versus 33 +/- 8, P > 0.05). The serum levels of cholesterol, triglycerides, and high-density lipoprotein were similar in both groups.
Men and women undergoing coronary artery bypass graft surgery had very similar severity of coronary artery disease as expressed by the coronary atherosclerosis score. Women were 8 years older and had 1.5 times higher mean serum-Lp(a) levels and 1.75 times higher mean tissue Apo(a) levels higher than the men. Sixty per cent of the women but only 39% of the men had serum Lp(a) levels higher than 25 mg/dl. Lp(a) level seems to be an additional risk factor for coronary artery disease confined to postmenopausal women.
本研究旨在评估晚期冠状动脉疾病患者血清脂蛋白（a）[Lp（a）]和动脉壁载脂蛋白（a）[Apo（a）]水平是否存在性别差异。
对76名男性和20名女性进行冠状动脉搭桥手术，研究血清中Lp（a）浓度和主动脉活检中Apo（a）浓度。冠状动脉疾病的严重程度通过使用定量冠状动脉造影的冠状动脉粥样硬化评分来确定。
血清Lp（a）和组织Apo（a）与冠状动脉粥样硬化评分所表示的冠状动脉疾病严重程度无关（分别为r = 0.09和r = 0.14）。与具有相同冠状动脉粥样硬化评分（35±8对33±8，P>0.05）的男性相比，女性年龄更大（65±8岁对57±8岁，P<0.001），平均Lp（a）和平均Apo（a）水平更高（47±41对32±40mg/dl和33±34对19±24μg/g湿重，P<0.05）。两组的胆固醇、甘油三酯和高密度脂蛋白血清水平相似。
接受冠状动脉搭桥手术的男性和女性，以冠状动脉粥样硬化评分表示的冠状动脉疾病严重程度非常相似。女性比男性大8岁，平均血清Lp（a）水平高1.5倍，平均组织Apo（a）水平高1.75倍。60%的女性血清Lp（a）水平高于25mg/dl，而男性仅为39%。Lp（a）水平似乎是仅限于绝经后女性的冠状动脉疾病的一个额外危险因素。
