Cohn J S, Giroux L M, Fortin L J, Davignon J
Hyperlipidemia and Atherosclerosis Research Group, Clinical Research Institute of Montreal, Quebec, Canada.
Arterioscler Thromb Vasc Biol. 1997 Nov;17(11):2630-7. doi: 10.1161/01.atv.17.11.2630.
Double pre-beta lipoproteinemia (DPBL) is a plasma lipoprotein phenotype characterized by the presence of two agarose gel electrophoretic populations of very low density lipoproteins (VLDLs, d < 1.006 g/mL), i.e., normal pre-beta-migrating VLDL and slow pre-beta VLDL. Slow pre-beta VLDL represents remnant lipoproteins derived from the hydrolysis of triglyceride (TG)-rich lipoproteins (TRLs), and thus DPBL is a characteristic of plasma remnant lipoprotein accumulation. To determine the prevalence of DPBL in our lipid clinic population, patients (n = 2501) were selected who (1) had an unambiguous VLDL electrophoretic phenotype and could be classified as having either DPBL (DPBL+), beta-migrating VLDL (beta-VLDL +), or an absence of both (DPBL/beta-VLDL-/-) and (2) had hypercholesterolemia (HC: plasma cholesterol > or = 6.2 mmol/L, n = 1017), hypertriglyceridemia (HTG: plasma TG > or = 2.3 mmol/L but < 15 mmol/L, n = 554) or combined hyperlipidemia (HC + HTG, n = 930). Patients with TG < 2.3 mmol/L and cholesterol < 5.2 mmol/L acted as control subjects (n = 343). Using a commercially available agarose gel electrophoresis system, we identified 220 hyperlipidemic patients (8.8%) with DPBL (versus < 1% of control). The prevalence of DPBL was higher in (1) male than in female patients (10.7% versus 6.7%), (2) postmenopausal than in premenopausal females (7.3% versus 4.1%), and (3) patients with HC + HTG than in those with HTG or HC alone (15.8% versus 8.3% versus 2.7%, respectively). Patients with an epsilon 2 allele had a higher prevalence of DPBL; i.e., 26.9% of apoE 3/2 and 26.2% of apoE 4/2 patients had DPBL compared with 6.5%, 6.8%, and 7.4% of apoE 3/3, 4/3, and 4/4 patients, respectively. DPBL patients consistently had increased levels of VLDL-C and (LDL + HDL)-TG and decreased levels of LDL-C, and their plasma lipid profiles were intermediate between those of beta-VLDL+ and DPBL/beta-VLDL -/- patients. These results demonstrate that male sex, postmenopausal status in women, and the presence of an apoE 3/2 or apoE 4/2 phenotype are associated with an increased incidence of DPBL in hyperlipidemic patients.
双前β脂蛋白血症（DPBL）是一种血浆脂蛋白表型，其特征是存在两种琼脂糖凝胶电泳的极低密度脂蛋白（VLDL，d<1.006 g/mL）群体，即正常前β迁移的VLDL和缓慢前βVLDL。缓慢前βVLDL代表富含甘油三酯（TG）的脂蛋白（TRL）水解产生的残余脂蛋白，因此DPBL是血浆残余脂蛋白积累的一个特征。为了确定我们脂质门诊人群中DPBL的患病率，选择了（n = 2501）名患者，他们（1）具有明确的VLDL电泳表型，可被分类为患有DPBL（DPBL+）、β迁移VLDL（β-VLDL+）或两者均无（DPBL/β-VLDL-/-），并且（2）患有高胆固醇血症（HC：血浆胆固醇≥6.2 mmol/L，n = 1017）、高甘油三酯血症（HTG：血浆TG≥2.3 mmol/L但<15 mmol/L，n = 554）或混合性高脂血症（HC + HTG，n = 930）。TG<2.3 mmol/L且胆固醇<5.2 mmol/L的患者作为对照（n = 343）。使用市售的琼脂糖凝胶电泳系统，我们鉴定出220例高脂血症患者（8.8%）患有DPBL（对照组<1%）。DPBL的患病率在（1）男性患者中高于女性患者（10.7%对6.7%），（2）绝经后女性高于绝经前女性（7.3%对4.1%），以及（3）HC + HTG患者高于单独患有HTG或HC的患者（分别为15.8%对8.3%对2.7%）。携带ε2等位基因的患者DPBL患病率更高；即，apoE 3/2患者中有26.9%和apoE 4/2患者中有26.2%患有DPBL，而apoE 3/3、4/3和4/4患者的患病率分别为6.5%、6.8%和7.4%。DPBL患者的VLDL-C和（LDL + HDL）-TG水平持续升高，LDL-C水平降低，并且他们的血浆脂质谱介于β-VLDL+和DPBL/β-VLDL-/-患者之间。这些结果表明，男性、女性绝经后状态以及apoE 3/2或apoE 4/2表型的存在与高脂血症患者中DPBL的发病率增加有关。
