Serum plasma pregnancy-associated protein A - A potential marker of echogenic carotid atherosclerotic plaques in asymptomatic hyperlipidemic subjects at high cardiovascular risk
Serum plasma pregnancy-associated protein A - A potential marker of echogenic carotid atherosclerotic plaques in asymptomatic hyperlipidemic subjects at high cardiovascular risk
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DOI：
10.1161/01.atv.0000047448.76485.b8
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发表时间：
2003-01-01
影响因子：
8.7
通讯作者：
Chapman, MJ
中科院分区：
文献类型：
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作者：
Beaudeux, JL;Burc, L;Chapman, MJ
目的：金属蛋白酶（降解细胞外基质的促炎酶）的蛋白水解活性在富含脂质的动脉粥样硬化斑块中升高，从而导致斑块脆性和破裂。妊娠相关血浆蛋白（PAPP-A）是一种金属蛋白酶，在不稳定的动脉粥样硬化斑块中表达，其循环水平在急性冠状动脉综合征中升高。我们评估了血清PAPP-A水平作为高脂血症患者心血管风险升高时动脉粥样硬化过早发展的标志。方法与结果：检测无症状高脂血症男性受试者（n=64，平均+/-SD年龄，51+/-7岁）的血清PAPP-A水平，通过无创超声检查评估颈动脉内膜-中膜厚度（IMT）和病变状态，并与正常血脂对照组（n=25）进行比较。在高脂血症患者和对照组之间（分别为8.99+/-2.93和8.03+/-2.75 mIU/L；平均值+/-SD），以及出现颈动脉腔梗阻的高脂血症患者（9.26+/-2.53 mIU/L）和没有出现颈动脉腔梗阻的高脂血症患者（8.85+/-3.29 mIU/L）之间的循环pap - a水平无差异。相比之下，在颈动脉粥样斑块患者中，观察到血清中PAPP-A和c反应蛋白水平呈正相关(P
Objective-The proteolytic activity of metalloproteinases, proinflammatory enzymes that degrade extracellular matrix, is elevated in lipid-rich atherosclerotic plaques, thereby contributing to plaque fragility and rupture. Pregnancy-associated plasma protein (PAPP-A) is a metalloproteinase, expressed in unstable atherosclerotic plaques, whose circulating levels are elevated in acute coronary syndromes. We evaluated serum PAPP-A levels as a marker of the premature development of atherosclerosis in hyperlipidemic subjects at elevated cardiovascular risk.Methods and Results-Serum PAPP-A levels were determined in asymptomatic hyperlipidemic male subjects (n=64; mean+/-SD age, 51+/-7 years) in whom intima-media thickness (IMT) and lesion status in the carotid artery were evaluated by noninvasive ultrasonography and compared with those of a normolipidemic control group (n=25). No difference was observed in circulating PAPP-A levels between hyperlipidemic subjects and controls (8.99+/-2.93 and 8.03+/-2.75 mIU/L, respectively; mean+/-SD) nor between hyperlipidemic subjects who presented with a luminal obstruction of the carotid artery (9.26+/-2.53 mIU/L) and those who did not (8.85+/-3.29 mIU/L). By contrast, in patients with atheromatous carotid plaques, a positive association between serum levels of PAPP-A and C-reactive protein was observed (P