动脉粥样硬化斑块反映血清总胆固醇水平：对从印度南部患者和加拿大渥太华白种人身上切除的冠状动脉粥样硬化斑块进行的比较形态学研究。

Atheromatous plaque reflects serum total cholesterol levels: a comparative morphologic study of endarterectomy coronary atherosclerotic plaques removed from patients from the southern part of India and Caucasians from Ottawa, Canada.

作者信息

Varghese P J, Arumugam S B, Cherian K M, Walley V, Farb A, Virmani R

机构信息

Division of Cardiology, George Washington University Medical Center, Washington, D.C. 20037, USA.

出版信息

Clin Cardiol. 1998 May;21(5):335-40. doi: 10.1002/clc.4960210507.

DOI:10.1002/clc.4960210507

PMID:9595216

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6655646/

Abstract

BACKGROUND

Natives of South India have a very high incidence of coronary artery disease, despite low calorie and fat intake.

HYPOTHESIS

This study was undertaken to determine whether morphologic features of atheromatous plaque reflect the serum total cholesterol.

METHODS

Fifty-three endarterectomy specimens from patients (mean age 47 +/- 9 years, mean cholesterol 203 +/- 47 mg/dl) obtained from one cardiac surgeon working in a single institution in South India were evaluated. Morphologic findings were compared with 40 endoarterectomy specimens obtained from age-matched Caucasians from Ottawa, Canada, with a reported mean cholesterol of 262 +/- 47 mg/dl. Morphometric measurements of the vessel size, percent stenosis, and the various components of the atherosclerotic plaque were determined by computerized planimetry.

RESULTS

The vessel size was smaller in the Indian than in the Canadian population (4.6 +/- 2.9 vs. 5.6 +/- 3.0 mm2, p = 0.07), the plaque area was less (4.3 +/- 2.3 vs. 5.3 +/- 2.8 mm2, p = 0.055) and the calculated percent stenosis was significantly less (93 vs. 96%, p = 0.028). Of all the parameters evaluated, only necrotic core in the Indian population (7.1 +/- 10.9% vs. Canadian 16.7 +/- 19.7%, p < 0.001) and proteoglycan deposition (7.9 +/- 11.2% vs. Canadian 3.7 +/- 5.3%, p < 0.023) were significantly different. Despite the Indians having low total cholesterol, there was greater diffuse double and triple-vessel disease and at a younger age than in the Caucasians.

CONCLUSIONS

From our data, it appears that the mechanism of development of atherosclerotic disease in the Indians may be different because they have smaller vessels, smaller necrotic core, and greater proteoglycan deposition. Other etiologies, especially those related to a high carbohydrate diet (which is typical for South Indians), should be considered.

摘要

背景

尽管南印度人的热量和脂肪摄入量较低，但他们的冠状动脉疾病发病率却非常高。

假设

本研究旨在确定动脉粥样硬化斑块的形态学特征是否反映血清总胆固醇水平。

方法

对一位在南印度单一机构工作的心脏外科医生获取的53例患者（平均年龄47±9岁，平均胆固醇水平203±47mg/dl）的动脉内膜切除术标本进行评估。将形态学结果与从加拿大渥太华年龄匹配的白种人获取的40例动脉内膜切除术标本进行比较，报告的平均胆固醇水平为262±47mg/dl。通过计算机图像分析测定血管大小、狭窄百分比以及动脉粥样硬化斑块的各种成分的形态学测量值。

结果

印度人群的血管尺寸小于加拿大人群（4.6±2.9 vs. 5.6±3.0mm²，p = 0.07），斑块面积较小（4.3±2.3 vs. 5.3±2.8mm²，p = 0.055），计算得出的狭窄百分比显著更低（93% vs. 96%，p = 0.028）。在所有评估参数中，只有印度人群的坏死核心（7.1±10.9% vs. 加拿大人群16.7±19.7%，p < 0.001）和蛋白聚糖沉积（7.9±11.2% vs. 加拿大人群3.7±5.3%，p < 0.023）存在显著差异。尽管印度人的总胆固醇水平较低，但与白种人相比，他们的弥漫性双支和三支血管疾病更为严重，且发病年龄更小。