Syvänne M, Talmud P J, Humphries S E, Fisher R M, Rosseneu M, Hilden H, Taskinen M R
Department of Medicine, University of Helsinki, Finland.
J Lipid Res. 1997 Jul;38(7):1463-72.
We studied the determinants of postprandial lipemia in 49 post-coronary-bypass men with low HDL cholesterol (< or = 1.1 mmol/l at screening). The subjects were given a mixed meal containing 63 g fat and 150,000 IU vitamin A. Serum was obtained before and 3, 4, 5, 6, and 8 h after the meal. S(f) > 400 and S(f) 12-400 lipoproteins, LDL, and HDL were separated by ultracentrifugation; and triglyceride (TG), retinyl ester (RE), and apolipoprotein (apo)E concentrations were measured. The associations of 15 potential predictor variables with measures of postprandial lipemia were evaluated in univariate and multivariate models. Fasting TG concentration was the most important determinant of postprandial lipid and apoE concentrations. In univariate analyses, neither apoE phenotype nor common genetic polymorphisms in the apoB gene (XbaI and apoB signal peptide length polymorphisms), lipoprotein lipase gene (Hind III polymorphism), or apoC-III gene (C[1100] to T sequence change) significantly predicted the magnitude of postprandial lipemia. In multivariate linear regression analyses, fasting TG concentration (P< 0.001) and postheparin plasma hepatic lipase activity (P = 0.023) were directly, and body mass index (P = 0.007) and the presence of apoE2 (P = 0.029) allele inversely related to the TG increment in S(f) >400 lipoproteins. Fasting TG was associated with a high (P < 0.001) and presence of the SP24 allele of the apoB signal peptide gene with a low (P = 0.014) S(f) 12-400 TG response. Fasting TG concentrations alone predicted 35%, 10%, and 34% of the variability in postprandial S(f) >400 responses of TG, RE, and apoE; multivariate models improved this predictive power to 40-50%. Even multivariate models were poor predictors of postprandial responses in S(f) 12-400 lipoproteins (0-26%). Much of the interindividual variation in the magnitude of postprandial lipemia remained unexplained in the present study.
我们研究了49名冠状动脉搭桥术后男性患者餐后血脂异常的决定因素，这些患者高密度脂蛋白胆固醇水平较低（筛查时≤1.1 mmol/l）。给这些受试者提供一顿含有63 g脂肪和150,000 IU维生素A的混合餐。在进餐前以及进餐后3、4、5、6和8小时采集血清。通过超速离心分离S(f)>400和S(f) 12 - 400的脂蛋白、低密度脂蛋白（LDL）和高密度脂蛋白（HDL）；并测量甘油三酯（TG）、视黄酯（RE）和载脂蛋白（apo）E的浓度。在单变量和多变量模型中评估了15个潜在预测变量与餐后血脂异常指标之间的关联。空腹TG浓度是餐后脂质和apoE浓度的最重要决定因素。在单变量分析中，apoE表型以及apoB基因（XbaI和apoB信号肽长度多态性）、脂蛋白脂肪酶基因（Hind III多态性）或apoC-III基因（C[1100]到T序列改变）中的常见基因多态性均未显著预测餐后血脂异常的程度。在多变量线性回归分析中，空腹TG浓度（P<0.001）和肝素后血浆肝脂酶活性（P = 0.023）与S(f)>400脂蛋白中TG的升高呈正相关，而体重指数（P = 0.007）和apoE2等位基因的存在（P = 0.029）与S(f)>400脂蛋白中TG的升高呈负相关。空腹TG与高的S(f) 12 - 400 TG反应相关（P < 0.001），而apoB信号肽基因的SP24等位基因的存在与低的S(f) 12 - 400 TG反应相关（P = 0.014）。仅空腹TG浓度就能预测餐后S(f)>400的TG、RE和apoE反应变异性的35%、10%和34%；多变量模型将这种预测能力提高到了40% - 50%。即使是多变量模型，对S(f) 12 - 400脂蛋白餐后反应的预测能力也很差（0 - 26%）。在本研究中，餐后血脂异常程度的个体间差异仍有很大一部分无法解释。
