Glueck C J, Glueck H I, Tracy T, Speirs J, Stroop D
Cholesterol Center, Jewish Hospital, Cincinnati, OH 45229.
Metabolism. 1993 Nov;42(11):1410-9. doi: 10.1016/0026-0495(93)90191-p.
Our specific aim was to assess within-family relationships of basal fibrinolytic activity and its determinants in hyperlipidemic probands (n = 34) with high lipoprotein (a) [Lp(a)] levels (> 35 mg/dL) and their first-degree relatives (n = 74) and in hyperlipidemic probands (n = 19) with Lp(a) < 35 and their first-degree relatives (n = 23). Probands' plasminogen activator inhibitor activity (PAI-Fx), the major fibrinolysis inhibitor, correlated with first-degree relatives' PAI-Fx in high-Lp(a) kindreds (r = .30, P = .06) and in Lp(a) < 35 kindreds (r = .43, P < or = .05). Probands' tissue plasminogen activator activity (tPA-Fx), the major fibrinolysis activator, was inversely associated with first-degree relatives' PAI-Fx in high-Lp(a) kindreds (r = -.30, P = .06) and in Lp(a) < 35 kindreds (r = -.49, P < or = .025). These correlations [irrespective of probands' Lp(a)] pointed to within-family heritability of the major fibrinolysis inhibitor, PAI-Fx, and the fibrinolysis stimulator, tPA-Fx. There were many other within-family correlations. High-Lp(a) probands' tPA-Fx, the stimulator of fibrinolysis, correlated with first-degree relatives' tPA-Fx (r = .32, P < or = .05). High-Lp(a) probands' plasminogen was inversely correlated with first-degree relatives' alpha 2-antiplasmin, a major fibrinolytic inhibitor (r = -.41, P < or = .01), and with their Lp(a) [r = -.24, P < or = .05]. High-Lp(a) probands' tPA-Fx correlated inversely with first-degree relatives' apolipoprotein (apo) B (r = -.28) and triglyceride ([TG] r = -.41), and positively with their high-density lipoprotein cholesterol ([HDLC] r = .40) and apo A-1 (r = .33; all P < or = .025). High-Lp(a) probands' PAI-Fx correlated positively with first-degree relatives' apo B (r = .34) and TG (r = .47), and inversely with HDLC (r = -.34) and apo A-1 (r = -.30; all P < or = .01). By stepwise regression, the Quetelet index (a measure of relative ponderosity) was independently inversely associated with tPA-Fx (P < or = .05) and positively associated with tPA-Ag and PAI-Fx (P < or = .05). TG was a positive independent determinant of PAI-Fx (P < or = .05), alpha 2-antiplasmin (P < or = .05), and plasminogen (P < or = .05). Lp(a) was a positive, independent determinant of fibrinogen (P < or = .05).(ABSTRACT TRUNCATED AT 400 WORDS)
我们的具体目标是评估高脂蛋白（a）[Lp（a）]水平（>35mg/dL）的高脂血症先证者（n = 34）及其一级亲属（n = 74），以及Lp（a）<35的高脂血症先证者（n = 19）及其一级亲属（n = 23）中基础纤溶活性及其决定因素的家庭内部关系。先证者的纤溶酶原激活物抑制剂活性（PAI-Fx），即主要的纤溶抑制物，在高Lp（a）家族（r = 0.30，P = 0.06）和Lp（a）<35的家族（r = 0.43，P≤0.05）中与一级亲属的PAI-Fx相关。先证者的组织纤溶酶原激活物活性（tPA-Fx），即主要的纤溶激活物，在高Lp（a）家族（r = -0.30，P = 0.06）和Lp（a）<35的家族（r = -0.49，P≤0.025）中与一级亲属的PAI-Fx呈负相关。这些相关性[与先证者的Lp（a）无关]表明主要纤溶抑制物PAI-Fx和纤溶刺激物tPA-Fx存在家庭内部遗传性。还有许多其他家庭内部相关性。高Lp（a）先证者的tPA-Fx，即纤溶刺激物，与一级亲属的tPA-Fx相关（r = 0.32，P≤0.05）。高Lp（a）先证者的纤溶酶原与一级亲属的α2-抗纤溶酶呈负相关，α2-抗纤溶酶是一种主要的纤溶抑制物（r = -0.41，P≤0.01），且与他们的Lp（a）呈负相关[r = -0.24，P≤0.05]。高Lp（a）先证者的tPA-Fx与一级亲属的载脂蛋白（apo）B呈负相关（r = -0.28）和甘油三酯（[TG] r = -0.41），与他们的高密度脂蛋白胆固醇（[HDLC] r = 0.40）和apo A-1呈正相关（r = 0.33；所有P≤0.025）。高Lp（a）先证者的PAI-Fx与一级亲属的apo B呈正相关（r = 0.34）和TG呈正相关（r = +0.47），与HDLC呈负相关（r = -0.34）和apo A-1呈负相关（r = -0.30；所有P≤0.01）。通过逐步回归分析，克托莱指数（相对肥胖的一种度量）与tPA-Fx呈独立负相关（P≤0.05），与tPA-Ag和PAI-Fx呈正相关（P≤0.05）。TG是PAI-Fx（P≤0.05）、α2-抗纤溶酶（P≤0.05）和纤溶酶原（P≤0.05）的正性独立决定因素。Lp（a）是纤维蛋白原的正性独立决定因素（P≤0.
