Guazzelli R, Fatini C, Piazzini M, Lazzeri C
Dipartimento di Fisiopatologia Clinica, Università degli Studi di Firenze.
Ann Ital Med Int. 1996 Apr-Jun;11(2):90-4.
Since an elevated serum concentration of lipoprotein(a) [Lp(a)] associated with a positive family history of premature myocardial infarction (PMI), would support the hypothesis that Lp(a) is a genetic risk factor for atherosclerosis, we measured serum levels in subjects from families with a history of PMI and compared them to those in a group of healthy control subjects. Twenty-five males (average age 39 +/- 16 years) and 9 females (average age 42 +/- 14 years) who had at least one blood relative affected by PMI were included in the study; 20 males (average age 41 +/- 11 years) and 10 females (average age 37 +/- 13 years) served as control subjects. Serum cholesterol, triglyceride, HDL-cholesterol, apo A1, apo B100 and Lp(a) concentrations were measured in both groups. The statistically significant higher prevalence of elevated Lp(a) levels (> 30 mg/dL) in the PMI group (p < 0.05) is attributable to the higher prevalence of PMI males with elevated Lp(a) levels. Pedigree studies disclosed a family distribution of coronary heart disease compatible with the hypothesis of a segregation of a dominant character for PMI risk. Because serum Lp(a) concentration is inherited with a Mendelian codominant pattern, we conclude that our data strongly support the hypothesis of a correlation between excess Lp(a) and coronary atherosclerosis.
由于血清脂蛋白(a)[Lp(a)]浓度升高与早发心肌梗死(PMI)的阳性家族史相关，这将支持Lp(a)是动脉粥样硬化遗传危险因素的假说，我们测量了有PMI病史家庭中受试者的血清水平，并将其与一组健康对照受试者的血清水平进行比较。本研究纳入了25名男性(平均年龄39±16岁)和9名女性(平均年龄42±14岁)，他们至少有一名受PMI影响的血亲；20名男性(平均年龄41±11岁)和10名女性(平均年龄37±13岁)作为对照受试者。两组均测量了血清胆固醇、甘油三酯、高密度脂蛋白胆固醇、载脂蛋白A1、载脂蛋白B100和Lp(a)浓度。PMI组中Lp(a)水平升高(>30mg/dL)的患病率在统计学上显著更高(p<0.05)，这归因于Lp(a)水平升高的PMI男性患病率更高。系谱研究揭示了冠心病的家族分布与PMI风险显性性状分离的假说相符。由于血清Lp(a)浓度以孟德尔共显性模式遗传，我们得出结论，我们的数据有力地支持了Lp(a)过量与冠状动脉粥样硬化之间存在相关性的假说。
