Karmansky I, Shnaider H, Palant A, Gruener N
Department of Biochemistry and Coronary Care Unit, Lady Davis Carmel Hospital, Haifa, Israel.
Clin Biochem. 1996 Dec;29(6):573-9. doi: 10.1016/s0009-9120(96)00072-0.
Oxidative modifications of low-density lipoproteins (LDL) are considered to be important in the pathogenesis of atherosclerosis. However, the data on the association between LDL oxidation and severity of clinical manifestations of coronary artery disease (CAD) are contradictory. Previous reports were concerned mostly with unstable angina patients. The present study was undertaken to evaluate plasma lipid oxidation status in patients with stable CAD.
37 male patients with angiographically confirmed CAD (asymptomatic or suffering from stable angina pectoris) and 32 control subjects were used in the study. Plasma levels of vitamin E and products of lipid peroxidation, as well as parameters of the test for oxidizability of LDL in vitro were measured.
We did not find differences between 2 groups of individuals regarding the levels of products of lipid peroxidation, vitamin E levels, lag time, maximal rate of oxidation, and total amount of conjugated dienes in the test for oxidizability of LDL.
The results of our study challenge, but do not disprove, the oxidative hypothesis of atherosclerosis. Real atherosclerotic modifications of plasma LDL occur apparently in the vascular wall after trapping of LDL by the interstitial matrix. The rise in oxidative parameters in unstable angina reported in the literature may not be the cause of the disease but, rather, the consequence of the multiple brief episodes of ischemia-reperfusion.
低密度脂蛋白（LDL）的氧化修饰被认为在动脉粥样硬化的发病机制中起重要作用。然而，关于LDL氧化与冠状动脉疾病（CAD）临床表现严重程度之间关联的数据相互矛盾。以往的报告主要关注不稳定型心绞痛患者。本研究旨在评估稳定型CAD患者的血浆脂质氧化状态。
本研究纳入了37例经血管造影证实患有CAD（无症状或患有稳定型心绞痛）的男性患者和32名对照受试者。测量了血浆维生素E水平、脂质过氧化产物水平以及LDL体外氧化试验的参数。
在LDL氧化试验中，两组个体在脂质过氧化产物水平、维生素E水平、延迟时间、最大氧化速率和共轭二烯总量方面未发现差异。
我们的研究结果对动脉粥样硬化的氧化假说提出了挑战，但并未予以否定。血浆LDL的真正动脉粥样硬化修饰显然发生在LDL被间质基质捕获后在血管壁中。文献中报道的不稳定型心绞痛中氧化参数的升高可能不是疾病的原因，而是多次短暂缺血再灌注的结果。
