Amouyel P, Isorez D, Bard J M, Goldman M, Lebel P, Zylberberg G, Fruchart J C
Faculté de Médecine de Lille II, France.
Arterioscler Thromb. 1993 Nov;13(11):1640-4. doi: 10.1161/01.atv.13.11.1640.
A family history of coronary heart disease (CHD) is a known risk factor for CHD. To investigate the possible role of lipoprotein particles in the relationship between family history of CHD and risk of CHD, we performed a case-control study in a sample of adolescents. The case group consisted of 97 adolescents whose parents had suffered a verified myocardial infarction before the age of 55 years. The control group was composed of 194 subjects without any family history of CHD. One case patient was matched to two control subjects for gender, age, and body mass index. In both groups, plasma lipid variables were measured, including total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C) low-density lipoprotein cholesterol, apolipoprotein (apo)AI, apoB, apoAI-containing lipoprotein particles without apoAII (LpAI) and with apoAII, and apoB-containing lipoprotein particles with apoE and with apoCIII. Adolescents with a family history of early myocardial infarction had lower plasma levels of HDL-C (P < .0001), apoAI (P < .01), and LpAI (P < .0001) than control subjects (adjusted for gender, age, body mass index, smoking habits, and oral contraceptive use). No other differences were statistically significant between case and control subjects. The analysis was repeated separately for male and female subjects. In young men, the best predictor of family history of early myocardial infarction was the LpAI plasma level, whereas in young women it was the HDL-C plasma level. Decreased levels of HDL-C and LpAI lipoprotein particles explain part of the relationship between parental history of early myocardial infarction and CHD risk.
冠心病(CHD)家族史是已知的冠心病风险因素。为了研究脂蛋白颗粒在冠心病家族史与冠心病风险关系中可能发挥的作用,我们在青少年样本中开展了一项病例对照研究。病例组由97名青少年组成,他们的父母在55岁之前曾发生过经证实的心肌梗死。对照组由194名无冠心病家族史的受试者组成。一名病例患者与两名对照受试者按性别、年龄和体重指数进行匹配。在两组中,均测量了血浆脂质变量,包括总胆固醇、甘油三酯、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇、载脂蛋白(apo)AI、apoB、不含apoAII的含apoAI脂蛋白颗粒(LpAI)和含apoAII的LpAI,以及含apoE和含apoCIII的含apoB脂蛋白颗粒。有早期心肌梗死家族史的青少年的HDL-C(P <.0001)、apoAI(P <.01)和LpAI(P <.0001)血浆水平低于对照受试者(根据性别、年龄、体重指数、吸烟习惯和口服避孕药使用情况进行了调整)。病例组和对照组之间的其他差异均无统计学意义。分别对男性和女性受试者重复进行了分析。在年轻男性中,早期心肌梗死家族史的最佳预测指标是LpAI血浆水平,而在年轻女性中则是HDL-C血浆水平。HDL-C和LpAI脂蛋白颗粒水平降低解释了早期心肌梗死家族史与冠心病风险之间的部分关系。