Nikkilä M, Pitkäjärvi T, Koivula T, Solakivi T, Lehtimäki T, Laippala P, Jokela H, Lehtomäki E, Seppä K, Sillanaukee P
Department of Internal Medicine, City Hospital of Tampere, Finland.
Atherosclerosis. 1996 Jan 26;119(2):181-90. doi: 10.1016/0021-9150(95)05645-9.
Some epidemiological studies have shown that serum total cholesterol increases with age. especially in women. On the other hand, the risk of coronary artery disease is smaller in women than in men. Earlier studies have shown that a small dense low density lipoprotein (LDL) is more atherogenic than a large LDL. We studied LDL size and apolipoprotein E (apo E) phenotypes in premenopausal and postmenopausal women and in men at the same age. In this study 342 subjects participating in a health screening study were examined. There were four subgroups: 40-year-old men (n = 85), 40-year-old women (n = 80), 70-year old men (n = 88) and 70-year-old women (n = 89). In the present study LDL size was larger (P < 0.01) in women (26.39 +/- 0.07 nm) than in men (25.95 +/- 0.07 nm). We found that LDL size correlated highly positively (r = 0.606; P < 0.001) with serum high density lipoprotein (HDL) concentration and inversely with serum triglyceride concentration (r = -0.627; P < 0.001). Measuring serum HDL cholesterol and triglycerides in health screening studies gives information indirectly about LDL size and its atherogenicity. Apo E phenotype was not significantly associated with serum triglycerides, but was associated with LDL size, LDL cholesterol, total cholesterol and HDL cholesterol. In our sample LDL size decreased and LDL cholesterol and total cholesterol increased according to the most prevalent apo E phenotypes in the order E2/3, E3/3, E3/4 and E4/4. Subjects with phenotype apo E4/4 had the smallest LDL size (25.70 +/- 0.19 nm), the highest total cholesterol (6.53 +/- 0.35 mmol/l) and the lowest HDL cholesterol values (1.28 +/- 0.04 mmol/l). We conclude that there was a significant interaction between sex and age in serum total cholesterol which was highest in older women. However, their LDL size was larger and their LDL is less atherogenic. Apo E phenotype had a significant influence on LDL size.
一些流行病学研究表明，血清总胆固醇随年龄增长而升高，尤其是在女性中。另一方面，女性患冠状动脉疾病的风险低于男性。早期研究表明，小而密的低密度脂蛋白（LDL）比大的LDL更具致动脉粥样硬化性。我们研究了绝经前和绝经后女性以及同年龄段男性的LDL大小和载脂蛋白E（apo E）表型。在这项研究中，对342名参与健康筛查研究的受试者进行了检查。有四个亚组：40岁男性（n = 85）、40岁女性（n = 80）、70岁男性（n = 88）和70岁女性（n = 89）。在本研究中，女性的LDL大小（26.39 +/- 0.07 nm）大于男性（25.95 +/- 0.07 nm）（P < 0.01）。我们发现LDL大小与血清高密度脂蛋白（HDL）浓度高度正相关（r = 0.606；P < 0.001），与血清甘油三酯浓度呈负相关（r = -0.627；P < 0.001）。在健康筛查研究中测量血清HDL胆固醇和甘油三酯可间接提供有关LDL大小及其致动脉粥样硬化性的信息。Apo E表型与血清甘油三酯无显著相关性，但与LDL大小、LDL胆固醇、总胆固醇和HDL胆固醇相关。在我们的样本中，根据最常见的apo E表型，LDL大小按E2/3、E3/3、E3/4和E4/4的顺序减小，LDL胆固醇和总胆固醇升高。具有apo E4/4表型的受试者LDL大小最小（25.70 +/- 0.19 nm），总胆固醇最高（6.53 +/- 0.35 mmol/l），HDL胆固醇值最低（1.28 +/- 0.04 mmol/l）。我们得出结论：血清总胆固醇在性别和年龄之间存在显著相互作用，在老年女性中最高。然而，她们的LDL大小较大，其LDL致动脉粥样硬化性较低。Apo E表型对LDL大小有显著影响。
