Halle M, Berg A, Keul J, Baumstark M W
Department of Rehabilitation, Prevention and Sports Medicine, Freiburg University Hospital, Germany.
Arterioscler Thromb Vasc Biol. 1996 Jan;16(1):144-8. doi: 10.1161/01.atv.16.1.144.
Hyperfibrinogenemia and a dyslipoproteinemia characterized by reduced HDL2 cholesterol and elevated levels of small, dense LDL particles are risk factors for coronary artery disease. However, the relationship between fibrinogen and lipoproteins, in particular LDL subfractions, is uncertain. We therefore measured serum fibrinogen levels and serum concentrations of cholesterol and apolipoproteins of VLDL, IDL, six LDL, and two HDL subfractions by using the technique of density-gradient ultracentrifugation in 132 nonsmoking men without evidence of coronary artery disease or infection. Dividing the individuals into quartiles according to their fibrinogen values showed that men within the highest fibrinogen quartile (fibrinogen 2.90 to 4.34 g/L) had significantly higher concentrations of small, dense LDL (d > 1.044 g/mL) apolipoprotein B and cholesterol and lower concentrations of HDL2 cholesterol than men within the lower fibrinogen quartiles (fibrinogen < 2.55 g/L). Multivariate regression analysis revealed that the association between fibrinogen and small, dense LDL particles was independent of serum triglycerides, cholesterol, body mass index, and age. In contrast, the relationship between fibrinogen and HDL2 cholesterol was primarily influenced by triglycerides and cholesterol and not independently influenced by fibrinogen. There were no significant differences between the quartiles in terms of insulin, glucose, insulin resistance, free fatty acids, lipoprotein(a), and blood pressure. This study showed that fibrinogen is associated with the expression of a more atherogenic LDL subfraction phenotype independent of body mass index, age, other serum lipids, and insulin resistance in a healthy male nonsmoking population. The reason for this association is uncertain. These findings reinforce the evidence that fibrinogen should be determined when assessing coronary risk.
高纤维蛋白原血症以及以高密度脂蛋白2胆固醇降低和小而密的低密度脂蛋白颗粒水平升高为特征的血脂蛋白异常是冠状动脉疾病的危险因素。然而，纤维蛋白原与脂蛋白尤其是低密度脂蛋白亚组分之间的关系尚不确定。因此，我们采用密度梯度超速离心技术，对132名无冠状动脉疾病或感染证据的不吸烟男性的血清纤维蛋白原水平以及极低密度脂蛋白、中间密度脂蛋白、六种低密度脂蛋白和两种高密度脂蛋白亚组分的胆固醇及载脂蛋白的血清浓度进行了测量。根据纤维蛋白原值将个体分为四分位数，结果显示，纤维蛋白原处于最高四分位数（纤维蛋白原2.90至4.34 g/L）的男性，其小而密的低密度脂蛋白（d>1.044 g/mL）、载脂蛋白B和胆固醇的浓度显著高于纤维蛋白原处于较低四分位数（纤维蛋白原<2.55 g/L）的男性，而高密度脂蛋白2胆固醇的浓度则较低。多变量回归分析显示，纤维蛋白原与小而密的低密度脂蛋白颗粒之间的关联独立于血清甘油三酯、胆固醇、体重指数和年龄。相比之下，纤维蛋白原与高密度脂蛋白2胆固醇之间的关系主要受甘油三酯和胆固醇的影响，而非纤维蛋白原的独立影响。在胰岛素、葡萄糖、胰岛素抵抗、游离脂肪酸、脂蛋白(a)和血压方面，四分位数之间没有显著差异。这项研究表明，在健康的男性不吸烟人群中，纤维蛋白原与更具动脉粥样硬化性的低密度脂蛋白亚组分表型的表达相关，且独立于体重指数、年龄、其他血脂和胰岛素抵抗。这种关联的原因尚不确定。这些发现进一步证明，在评估冠状动脉风险时应测定纤维蛋白原。
