Smaller LDL size as a possible risk factor for the prevalence of coronary artery diseases in hemodialysis patients-Associations of CETP and the hepatic lipase gene polymorphism with LDL size
Smaller LDL size as a possible risk factor for the prevalence of coronary artery diseases in hemodialysis patients-Associations of CETP and the hepatic lipase gene polymorphism with LDL size
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较小的LDL大小可能是血液透析患者冠状动脉疾病患病的危险因素-CETP和肝脂肪酶基因多态性与LDL大小的关联
DOI：
10.1111/j.1440-1797.2011.01454.x
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Yoshida H
中科院分区：
文献类型：
--
作者：
Kimura H;Miyazaki R;Imura T;Masunaga S;Shimada A;Mikami D;Kasuno K;Takahashi N;Hirano T;Yoshida H
目的：较小的低密度脂蛋白（LDL）大小最近被报道为冠状动脉疾病（CAD）的非传统脂质危险因素。胆固醇酯转移蛋白（CETP）和C/肝脂肪酶（HL）基因多态性可能通过CETP介导的CE与甘油三酯（TG）的交换以及随后HL介导的LDL中TG的水解来促进LDL大小的减小。然而，对于动脉粥样硬化高危血液透析（HD）患者的LDL大小状态及其与冠心病患病率的关系知之甚少。方法：对30岁以上HD患者（236例）的CETP水平、HLgenotypes和LDL大小进行测定，并研究LDL大小的决定因素及其与CAD患病率的关系。结果：HD患者LDL大小与健康人相近。在HD组中，高密度脂蛋白胆固醇是LDL大小的独立阳性决定因素，而在高CETP组（≥2.1µg/mL）而非低CETP组（<2.1µg/mL）中，log10（TG）是独立负决定因素。在高甘油三酯血症患者中，高CETP组的LDL大小明显小于低CETP组。在TG水平高于中位数的患者中，ccgene型和CETP是LDL大小的独立阴性决定因素。在整个组和高CETP组中，CAD患者的LDL大小明显小于非CAD患者。最后，DM和较小的LDL大小被确定为CAD患病率的独立危险因素。结论：这些结果表明，较小的LDL大小与较高的TG和CETP水平以及hl / cc基因型相关，可能是HD患者CAD的危险因素。
Aim:Smaller low‐density lipoprotein (LDL) size has recently been reported as a non‐traditional lipid risk factor for coronary artery disease (CAD). Cholesteryl ester transfer protein (CETP) and the C/Thepatic lipase (HL)gene polymorphism may promote LDL size reduction via the CETP‐mediated exchange of CE for triglyceride (TG) and subsequent HL‐mediated TG hydrolysis in LDL. However, little is known about LDL size status and its relationship with CAD prevalence in haemodialysis (HD) patients who are at high risk for atherosclerosis.Methods:CETP levels,HLgenotypes and LDL size were determined, and the determinants of LDL size and its association with CAD prevalence in HD patients (n= 236) aged over 30 years were investigated.Results:The HD patients had a similar LDL size to the healthy subjects. In the HD group, high‐density lipoprotein cholesterol was an independent positive determinant of LDL size, while log10(TG) was an independent negative determinant in the high (≥2.1 µg/mL) but not low (<2.1 µg/mL) CETP group. In the patients with hypertriglyceridemia, the high CETP group had a significantly smaller LDL size than the low CETP group. Among the patients with above‐median TG levels, theCCgenotype and CETP were independent negative determinants of LDL size. In the whole group and the high CETP group, the patients with CAD had a significantly smaller LDL size than those without CAD. Finally, DM and smaller LDL size were identified as independent risk factors for CAD prevalence.Conclusion:These suggest that a smaller LDL size, which is associated with higher levels of TG and CETP and theHL/CCgenotype, may serve as a risk factor for CAD in HD patients.