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严重高甘油三酯血症患者的脂蛋白脂肪酶质量与活性

Lipoprotein lipase mass and activity in severe hypertriglyceridemia.

作者信息

Kobayashi J, Hashimoto H, Fukamachi I, Tashiro J, Shirai K, Saito Y, Yoshida S

机构信息

Second Department of Internal Medicine, School of Medicine, Chiba University, Japan.

出版信息

Clin Chim Acta. 1993 Jul 16;216(1-2):113-23. doi: 10.1016/0009-8981(93)90144-s.

Abstract

To clarify the role of defective lipoprotein lipase (LPL) in hypertriglyceridemia, the LPL masses and LPL activities in post-heparin plasma (PHP) were studied in severe hypertriglyceridemias. The developed sandwich enzyme immunoassay for the LPL was sensitive from 0.5 to 20 ng/ml of LPL in human PHP. The plasma LPL mass increased by heparin injection (30 USP units/kg) and was found to positively correlate with LPL activity. The mean LPL activity from PHP of normal controls was 2,960 +/- 1,057 nmol/ml/h. The mean LPL masses from human pre- and 15-min post-heparin plasma from normal subjects were 25 +/- 5 ng/ml and 224 +/- 60 ng/ml, respectively. Thus the specific activity of LPL from PHP of normal controls was calculated to be 13.3 mumol FFA released/h/microgram LPL. Among hypertriglyceridemic patients with over 1,000 mg/dl of serum triglyceride, the incidence of patients with LPL masses less than -2 standard deviations (S.D.) of those of average normal control subjects was found to be 27%. Seventy percent of patients showed specific activities within + 2 S.D. of those of average control LPL, and 30% showed significantly low specific activities less than -2 S.D. despite the fact that LPL masses were not less than -2 S.D. of the average normal controls. These results suggest that the evaluation of LPL masses in PHP would be useful for finding functionally defective LPL in patients with hypertriglyceridemia, and that up to 30% severe hypertriglyceridemias may have functionally defective LPL.

摘要

为阐明脂蛋白脂肪酶(LPL)缺陷在高甘油三酯血症中的作用,我们研究了重度高甘油三酯血症患者肝素后血浆(PHP)中的LPL质量和LPL活性。所开发的用于LPL的夹心酶免疫测定法对人PHP中0.5至20 ng/ml的LPL敏感。注射肝素(30 USP单位/千克)后血浆LPL质量增加,且发现其与LPL活性呈正相关。正常对照组PHP的平均LPL活性为2,960±1,057 nmol/ml/h。正常受试者肝素前和肝素后15分钟血浆的平均LPL质量分别为25±5 ng/ml和224±60 ng/ml。因此,正常对照组PHP中LPL的比活性经计算为每微克LPL每小时释放13.3 μmol游离脂肪酸(FFA)。在血清甘油三酯超过1,000 mg/dl的高甘油三酯血症患者中,发现LPL质量低于正常对照受试者平均值-2个标准差(S.D.)的患者发生率为27%。70%的患者显示比活性在对照LPL平均值的+2 S.D.范围内,30%的患者显示比活性显著降低,低于-2 S.D.,尽管LPL质量不低于正常对照平均值的-2 S.D.。这些结果表明,评估PHP中的LPL质量有助于发现高甘油三酯血症患者中功能缺陷的LPL,且高达30%的重度高甘油三酯血症可能存在功能缺陷的LPL。

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