Denti L, Marchini L, Pasolini G, Baffoni M T, Ablondi F, Valenti G
Chair of Gerontology and Geriatrics, University of Parma, Italy.
Acta Biomed Ateneo Parmense. 1995;66(3-4):175-83.
High levels of lipoprotein Lp(a) are related to cerebrovascular disease clinical manifestations, as well as to the severity of extracranial carotid atherosclerosis assessed by ultrasonography. In order to investigate the relationship of Lp(a) to the severity of carotid atherosclerosis in the elderly, 100 subjects, aged 78.5 +/- 0.6 yrs underwent an echo-color-doppler scanning of carotids; atherosclerosis severity, assessed as maximum percentage stenosis, presence of complicated plaque and Intima-Media Thickness (IMT), was related to Lp(a) levels, assayed by an immunoenzymatic procedure. A slight association between Lp(a) and CVD clinical manifestations was apparent only in subjects under 78 yrs and for Lp(a) values above 25 mg/dL. Lp(a) levels were not related either to the degree of stenosis, the presence of complicated plaque, or IMT. As for other selected risk factors, while no relationship was found for clinical CVD and IMT, the maximum percentage of stenosis and the presence of complicated plaques were positively related to LDL-cholesterol in subjects under 78 yrs. We can conclude that Lp(a), albeit unrelated to the severity of extracranial vessel atherosclerosis, maintains a role as cerebrovascular risk factor in the elderly, being slightly related to clinical manifestations; however its discriminant power is lower than in middle-aged people and further decreases throughout ageing.
高水平的脂蛋白Lp(a)与脑血管疾病的临床表现以及通过超声评估的颅外颈动脉粥样硬化的严重程度相关。为了研究Lp(a)与老年人颈动脉粥样硬化严重程度的关系，100名年龄为78.5±0.6岁的受试者接受了颈动脉超声彩色多普勒扫描；通过免疫酶法检测的Lp(a)水平与以最大狭窄百分比、复杂斑块的存在以及内膜中层厚度（IMT）评估的动脉粥样硬化严重程度相关。Lp(a)与心血管疾病（CVD）临床表现之间的轻微关联仅在78岁以下且Lp(a)值高于25mg/dL的受试者中明显。Lp(a)水平与狭窄程度、复杂斑块的存在或IMT均无关。至于其他选定的危险因素，虽然未发现临床CVD与IMT之间存在关联，但在78岁以下的受试者中，最大狭窄百分比和复杂斑块的存在与低密度脂蛋白胆固醇呈正相关。我们可以得出结论，Lp(a)虽然与颅外血管动脉粥样硬化的严重程度无关，但在老年人中仍作为脑血管危险因素发挥作用，与临床表现略有相关；然而，其判别能力低于中年人，并且随着年龄增长进一步下降。
