Determinants of plasma HDL-cholesterol in hypertriglyceridemic patients. Role of cholesterol-ester transfer protein and lecithin cholesteryl acyl transferase.
Determinants of plasma HDL-cholesterol in hypertriglyceridemic patients. Role of cholesterol-ester transfer protein and lecithin cholesteryl acyl transferase.
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高甘油三酯血症患者血浆高密度脂蛋白胆固醇的决定因素。
DOI：
10.1161/01.atv.17.1.56
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
Grundy,SM
中科院分区：
文献类型：
--
作者：
Tato,F;Vega,GL;Grundy,SM
高胆固醇血症患者通常具有低水平的HDL胆固醇。甘油三酯本身升高可能是低HDL水平的原因之一，但也可能涉及其他因素。本研究旨在确定胆固醇酯转移蛋白（CETP）在高脂血症患者低HDL胆固醇中的作用;此外，还检查了其他因素-卵磷脂胆固醇酰基转移酶（LCAT），肝甘油三酯脂肪酶（HTGL）和脂蛋白脂肪酶（LPL）。在137名患有中度高甘油三酯血症（血浆甘油三酯[TG] 200至500 mg/dL，LDL胆固醇<160 mg/dL）的男性患者中测定了CETP和LCAT的血浆活性。结果与50名年龄和体型相似的正常血脂男性进行了比较。此外，在118例高胆固醇血症受试者中测定了肝素后血浆中的脂肪酶活性。CETP和LCAT活性在高脂血症组分别比对照组高17%（P<0.01）和7%（P<0.05）。逐步回归分析显示，CETP和LCAT对HDL-胆固醇水平的变化贡献率分别为15.2%和9.8%。LPL和HTGL的活性共同贡献了HDL-胆固醇变异的14.1%。相比之下，血浆TG水平仅占变异的5.4%。这些参数在冠心病患者和非冠心病患者中的相对贡献没有差异。这项研究表明，几个因素有助于高脂血症患者的HDL-胆固醇水平的变化，五个因素CETP，LCAT，HTGL，LPL和甘油三酯水平几乎占这种变化的一半。
Hypertriglyceridemic patients commonly have low levels of HDL cholesterol. Elevated triglycerides per se may be one cause of low HDL levels, but other factors also may be involved. The current study was designed to define the role of cholesterol-ester transfer protein (CETP) in causation of a low HDL cholesterol in hypertriglyceridemic patients; in addition other factors—lecithin cholesterol acyl transferase (LCAT), hepatic triglyceride lipase (HTGL), and lipoprotein lipase (LPL)—were examined. Plasma activities of CETP and LCAT were measured in 137 male patients with moderate hypertriglyceridemia (plasma triglycerides [TGs] 200 to 500 mg/dL and LDL cholesterol <160 mg/dL). Results were compared with those from 50 normolipidemic men of similar age and body habitus. In addition, lipase activities in postheparin plasma were measured in 118 of the subjects with hypertriglyceridemia. The activities of CETP and LCAT were 17% (P<.01) and 7% (P<.05), respectively, higher in the hypertriglyceridemic group than in control subjects. By stepwise regression analysis CETP appeared to contribute 15.2% and LCAT 9.8% to variation in HDL-cholesterol levels. Activities of LPL and HTGL together contributed an additional 14.1% to HDL-cholesterol variation. In contrast, levels of plasma TG accounted for only 5.4% of the variation. There were no differences in relative contributions of these parameters in patients with and those without coronary heart disease. This study indicates that several factors contribute to the variation in HDL-cholesterol levels in hypertriglyceridemic patients, and five factors—CETP, LCAT, HTGL, LPL, and triglyceride levels—account for almost half of this variation.