Remnant lipoproteinemia is a risk factor for endothelial vasomotor dysfunction and coronary artery disease in metabolic syndrome
Remnant lipoproteinemia is a risk factor for endothelial vasomotor dysfunction and coronary artery disease in metabolic syndrome
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DOI：
10.1016/j.atherosclerosis.2005.01.012
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发表时间：
2005-08-01
期刊：
影响因子：
5.3
通讯作者：
Kugiyama, K
中科院分区：
文献类型：
--
作者：
Nakamura, T;Takano, H;Kugiyama, K
本研究旨在确定残余脂蛋白(一种富含甘油三酯的致动脉粥样硬化脂蛋白)水平升高是否与代谢综合征中的冠状动脉疾病(CAD)和内皮血管运动功能障碍有关。用免疫分离法测定了210例符合ATPIII标准的代谢综合征患者的空腹血清残余脂蛋白(残留样脂蛋白颗粒胆固醇；RLP-C)水平。应用高分辨率超声技术检测反应性充血时肱动脉血流介导的内皮依赖性扩张(FMD)。这项研究发现，RLP-C水平升高是FMD受损和经血管造影证实的冠状动脉疾病(CAD)的一个重要和独立的危险因素。苯扎贝特(n=20)或阿托伐他汀(n=20)治疗4周可显著降低RLP-C水平，并伴随FMD的改善。治疗后RLP-C水平较基线水平下降的百分比与调整甘油三酯、hsCRP和IL-6水平以及HOMA指数的百分比变化后FMD的改善程度独立相关。因此，RLP-C水平升高是代谢综合征中冠心病和内皮血管运动功能障碍的危险因素，而内皮血管运动功能障碍是冠状动脉事件的预测因子。测定RLP-C有助于评估代谢综合征的冠心病风险和治疗效果。(C)2005爱思唯尔爱尔兰有限公司。保留所有权利。
This study aimed to determine whether elevated levels of remnant lipoprotein, an atherogenic triglyceride-rich lipoprotein, might be associated with coronary artery disease (CAD) and endothelial vasomotor dysfunction in metabolic syndrome. The fasting serum levels of remnant lipoproteins (remnant-like lipoprotein particles cholesterol; RLP-C) were measured by an immunoseparation method in 210 patients with metabolic syndrome meeting ATP III criteria. Flow-mediated endothelium-dependent dilatation (FMD) in the brachial artery during reactive hyperemia was examined by high-resolution ultrasound technique. This study found that elevated RLP-C levels were a significant and independent risk factor for impaired FMD and angiographically proven coronary artery disease (CAD). Treatment with bezafibrate (n = 20) or atorvastatin (n = 20) for 4 weeks significantly reduced RLP-C levels, with a concomitant improvement in FMD. The % reduction in RLP-C levels from baseline after the treatment was independently correlated with the magnitude of improvement in FMD after adjustment for the % changes in levels of triglyceride, hsCRP, and IL-6, and HOMA index. Thus, elevated levels of RLP-C are a risk factor for CAD and endothelial vasomotor dysfunction, a predictor of coronary events, in metabolic syndrome. Measurement of RLP-C is useful for assessment of CAD risk and therapeutic effects in metabolic syndrome. (c) 2005 Elsevier Ireland Ltd. All rights reserved.