Pintó X, Fiol C, Simeón J M, Capdevila J M, Barjau E, Argimón J M, Moga I, Pujol R
Unidad de Arteriosclerosis, Universitaria de Bellvitge, L'Hospitalet de Llobregat, Barcelona.
Med Clin (Barc). 1997 Jun 7;109(2):41-4.
The role of lipoproteins as markers of peripheral arterial disease (PAD) is not well defined.
We measured both lipid and non-lipid risk factors in 51 male patients with angiographically proven PAD and in 56 control subjects. The independent association of risk factors with PAD was evaluated by means of a multiple logistic regression analysis.
The levels of cholesterol bound to high density lipoprotein (HDLc) and to its subfraction HDL2 were lower and triglycerides were higher in patients than in control subjects (1.0 +/- 0.3 vs 1.2 +/- 0.3, p < 0.003; 0.4 +/- 0.2 vs 0.5 +/- 0.3, p < 0.03; and 1.8 +/- 1.2 vs 1.3 +/- 0.7, p < 0.02, respectively). Total cholesterol and LDLc levels were similar in both groups. In the multiple logistic regression analysis that was done with lipid parameters, a statistically significant association of triglycerides (OR = 1.73; CI95% = 1.06-2.80) and HDLc (OR = 0.15; CI95% = 0.05-0.50) with PAD was observed, while HDL subfractions and apolipoproteins were not significantly associated. In the multiple logistic regression analysis that was done with non-lipid parameters, hypertension (OR = 5.35; CI95% = 1.86-15.4) and smoking (packs-year) (OR = 1.04; CI95% = 1.10-1.06) were the only significantly associated with PAD. When lipid and non-lipid parameters were included in the regression analysis, a statistically significant association between hypertension, smoking and HDLc with PAD was observed.
Among lipid risk factors, a low HDLc and high triglycerides, and among non-lipid risk factors hypertension and smoking, are significantly and independently associated with lower limb arteriopathy.
脂蛋白作为外周动脉疾病(PAD)标志物的作用尚未明确界定。
我们测量了51例经血管造影证实患有PAD的男性患者以及56例对照受试者的脂质和非脂质风险因素。通过多因素逻辑回归分析评估风险因素与PAD的独立关联。
与对照受试者相比,患者中与高密度脂蛋白(HDLc)及其亚组分HDL2结合的胆固醇水平较低,甘油三酯水平较高(分别为1.0±0.3对1.2±0.3,p<0.003;0.4±0.2对0.5±0.3,p<0.03;以及1.8±1.2对1.3±0.7,p<0.02)。两组的总胆固醇和低密度脂蛋白胆固醇(LDLc)水平相似。在对脂质参数进行的多因素逻辑回归分析中,观察到甘油三酯(OR = 1.73;95%置信区间= 1.06 - 2.80)和HDLc(OR = 0.15;95%置信区间= 0.05 - 0.50)与PAD存在统计学显著关联,而HDL亚组分和载脂蛋白无显著关联。在对非脂质参数进行的多因素逻辑回归分析中,高血压(OR = 5.35;95%置信区间= 1.86 - 15.4)和吸烟(包年)(OR = 1.04;95%置信区间= 1.10 - 1.06)是与PAD仅有的显著相关因素。当将脂质和非脂质参数纳入回归分析时,观察到高血压、吸烟和HDLc与PAD之间存在统计学显著关联。
在脂质风险因素中,低HDLc和高甘油三酯,以及在非脂质风险因素中高血压和吸烟,与下肢动脉病变显著且独立相关。