Bigot E, Robert B, Bard J M, Mainard F
UFR de Phamacie, Laboratoire de Biochimie et EA1160 Fonctions digestives et nutrition, Nantes, France.
Clin Chim Acta. 1997 Sep 8;265(1):99-111. doi: 10.1016/s0009-8981(97)00107-1.
A case control study was undertaken to compare the distribution of apolipoprotein (a) phenotypes in patients suffering from atherosclerosis and undergoing coronary bypass surgery with the distribution observed in adequately selected controls. Cases differed from controls for triglycerides (1.90 +/- 0.88 mmol l-1 and 1.16 +/- 0.79 mmol l-1, P < 0.0001, respectively), HDL cholesterol (1.15 +/- 0.34 mmol l-1 and 1.69 +/- 0.42 mmol l-1, P < 0.0001, respectively), apolipoprotein AI (1.31 +/- 0.24 g l-1 and 1.70 +/- 0.29 g l-1, P < 0.0001, respectively) and lipoprotein a (Lp(a)) (0.32 +/- 0.30 g l-1 and 0.19 +/- 0.20 g l-1, P < 0.0001, respectively). The apolipoprotein (a) phenotypes were distributed differently in cases and controls (chi 2 = 25.26, P < 0.0001) with a lower percentage of isoforms of larger size and a higher percentage of isoforms of smaller size in patients. The Lp(a) concentration remained significantly higher in patients than in controls for most of the phenotypes, suggesting that both a high Lp(a) concentration and a different apolipoprotein (a) size distribution could be involved in the development of atherosclerosis in this population. In addition, patients exhibiting the highest Lp(a) concentrations had higher levels of LDL cholesterol and apolipoprotein B than patients exhibiting the lowest Lp(a) concentrations. This feature was not observed in controls. By contrast, controls with the highest Lp(a) concentration had significantly higher triglyceride levels than controls with the lowest Lp(a) concentration. This feature was not observed in patients. Our results indicate that patients undergoing bypass surgery have higher Lp(a) concentrations than controls, this increase being not completely explained by the difference in apolipoprotein (a) phenotype distribution. The high Lp(a) concentration seems to be associated with different lipid profiles in patients than in controls.
开展了一项病例对照研究，以比较患有动脉粥样硬化并接受冠状动脉搭桥手术的患者与经过适当挑选的对照组中载脂蛋白(a)表型的分布情况。病例组与对照组在甘油三酯（分别为1.90±0.88 mmol/L和1.16±0.79 mmol/L，P<0.0001）、高密度脂蛋白胆固醇（分别为1.15±0.34 mmol/L和1.69±0.42 mmol/L，P<0.0001）、载脂蛋白AI（分别为1.31±0.24 g/L和1.70±0.29 g/L，P<0.0001）和脂蛋白a（Lp(a)）（分别为0.32±0.30 g/L和0.19±0.20 g/L，P<0.0001）方面存在差异。病例组和对照组的载脂蛋白(a)表型分布不同（χ2=25.26，P<0.0001），患者中较大尺寸异构体的百分比更低，较小尺寸异构体的百分比更高。对于大多数表型，患者的Lp(a)浓度仍显著高于对照组，这表明高Lp(a)浓度和不同的载脂蛋白(a)大小分布可能都与该人群动脉粥样硬化的发生有关。此外，Lp(a)浓度最高的患者的低密度脂蛋白胆固醇和载脂蛋白B水平高于Lp(a)浓度最低患者。在对照组中未观察到这一特征。相比之下，Lp(a)浓度最高的对照组的甘油三酯水平显著高于Lp(a)浓度最低的对照组。在患者中未观察到这一特征。我们的结果表明，接受搭桥手术的患者的Lp(a)浓度高于对照组，这种升高不能完全由载脂蛋白(a)表型分布的差异来解释。高Lp(a)浓度似乎与患者而非对照组的不同血脂谱相关。
