Echolucent, rupture-prone carotid plaques associated with elevated triglyceride-rich lipoproteins, particularly in women
Echolucent, rupture-prone carotid plaques associated with elevated triglyceride-rich lipoproteins, particularly in women
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DOI：
10.1067/mva.2002.126552
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发表时间：
2002-10-01
影响因子：
4.3
通讯作者：
Nordestgaard, BG
中科院分区：
文献类型：
--
作者：
Kofoed, SC;Gronholdt, MLM;Nordestgaard, BG
背景。我们测试了空腹和餐后富含甘油三酯的脂蛋白升高是否具有性别特异性：(1) 与对照组相比，颈动脉狭窄大于或等于 50% 的患者；(2) 与对照组相比，有回声透明、易破裂斑块的患者。方法和结果。我们研究了 66 名对照者和 323 名颈动脉狭窄大于或等于 50% 的患者，其中 160 名有回声斑块。参与者使用高分辨率 B 型超声和计算机图像分析进行了脂肪耐受性测试和颈动脉斑块评估。相比之下，颈动脉狭窄大于或等于50%的女性患者空腹和餐后甘油三酯水平高于对照组；然而，男性病例和对照之间没有观察到这种差异。空腹和餐后极低密度脂蛋白（VLDL）和中密度脂蛋白（IDL）胆固醇水平升高；与对照组相比，女性和男性病例中低密度脂蛋白（LDL）胆固醇水平没有变化，高密度脂蛋白（HDL）胆固醇水平有所降低。与对照组相比，有回声斑块的女性的空腹和餐后甘油三酯水平升高，但在有富回声斑块的女性或有回声或富回声斑块的男性中则没有升高。与对照组相比，有回声斑块的女性和男性患者的空腹和餐后 VLDL 和 IDL 胆固醇水平升高，LDL 胆固醇水平不变，HDL 胆固醇水平降低。结论。与对照组相比，颈动脉狭窄大于或等于 50% 的患者空腹和餐后富含甘油三酯的脂蛋白（但不是 LDL）升高，尤其可识别回声透明、易于破裂的颈动脉斑块。这些观察结果在女性中比在男性中更为明显。
Background. We tested whether fasting and postprandial triglyceride-rich lipoprotein elevations are gender specific (1) in patients with carotid artery stenosis greater than or equal to50% vs controls, and (2) in patients with echolucent, rupture-prone plaques compared with controls.Methods and results. We studied 66 controls and 323 patients with carotid artery stenosis greater than or equal to50%, of which 160 had echolucent plaques. Participants underwent a fat-tolerance test and carotid artery plaque evaluation with use of high-resolution B-mode ultrasound and computerized image analysis. By comparison, female cases with carotid stenosis greater than or equal to50% had higher fasting and postprandial triglyceride levels than did controls; however, this difference was not observed between male cases and controls. Fasting and postprandial very-low-density lipoprotein (VLDL) and intermediate density liprotein (IDL) cholesterol levels were elevated; low density lipoprotein (LDL) cholesterol level was unchanged, and high density lipoprotein (HDL) cholesterol level was reduced in both female and male cases vs controls. Fasting and postprandial triglyceride levels were elevated in women with echolucent plaques vs controls, but not in women with echo-rich plaques, or in men with echolucent or echo-rich plaques. Fasting and postprandial VLDL and IDL cholesterol levels were elevated, LDL cholesterol level was unchanged, and HDL cholesterol level was reduced in both female and male patients with echolucent plaques vs controls.Conclusions. Fasting and postprandial triglyceride-rich lipoproteins (but not LDLs) are elevated in patients with carotid artery stenosis of greater than or equal to50% compared with controls, and particularly identify echolucent, rupture-prone carotid plaques. These observations are more pronounced in women than in men.