LIPOPROTEIN CHOLESTEROL, APOLIPOPROTEIN-A-I AND APOLIPOPROTEIN-B AND LIPOPROTEIN-(A) ABNORMALITIES IN MEN WITH PREMATURE CORONARY-ARTERY DISEASE
LIPOPROTEIN CHOLESTEROL, APOLIPOPROTEIN-A-I AND APOLIPOPROTEIN-B AND LIPOPROTEIN-(A) ABNORMALITIES IN MEN WITH PREMATURE CORONARY-ARTERY DISEASE
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DOI：
10.1016/0735-1097(92)90520-w
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发表时间：
1992-03-15
影响因子：
24
通讯作者：
SCHAEFER, EJ
中科院分区：
文献类型：
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作者：
GENEST, J;MCNAMARA, JR;SCHAEFER, EJ
在 321 名经血管造影记录患有冠状动脉疾病的男性（平均年龄 50 +/- 7 岁）中确定了脂蛋白胆固醇、载脂蛋白 A-I 和 B 以及脂蛋白 (a) [Lp(a)] 异常的患病率，并与来自弗雷明汉后代研究的 901 名临床上无冠状动脉疾病的对照受试者（平均年龄 49 +/- 6 岁）进行了比较。对医院采样、β-肾上腺素能药物使用和饮食影响进行校正后，患者的胆固醇水平显着升高（224 +/- 53 vs. 214 +/- 36 mg/dl）、甘油三酯（189 +/- 95 vs. 141 +/- 104 mg/dl）、低密度脂蛋白（LDL）胆固醇（156 +/- 51 vs. 138 +/- 33） mg/dl）、载脂蛋白 B（131 +/- 37 与 108 +/- 33 mg/dl）和 Lp(a) 水平（19.9 +/- 19 与 14.9 +/- 17.5 mg/dl）。他们的高密度脂蛋白 (HDL) 胆固醇（36 +/- 11 与 45 +/- 12 mg/dl）和载脂蛋白 A-I 水平（114 +/- 26 与 136 +/- 32 mg/dl）也显着降低（所有 p < 0.005）。基于脂质研究诊所甘油三酯和 LDL 胆固醇的第 90 个百分位值以及第 10 个百分位值对于HDL胆固醇，最常见的血脂异常是单纯HDL胆固醇低（19.3% vs. 4.4%）、LDL胆固醇升高（12.1% vs. 9%）、高甘油三酯血症伴低HDL胆固醇（9.7% vs. 4.2%）、高甘油三酯血症和LDL胆固醇升高伴低HDL胆固醇（3.4% vs. 0.2%）和Lp(a)过量患者与对照组分别为 (15.8% vs. 10%) (p < 0.05)。逐步判别分析表明，吸烟、高血压、载脂蛋白 A-I 降低、载脂蛋白 B 升高、Lp(a) 升高和糖尿病都是区分冠状动脉疾病患者与正常对照受试者的重要因素（按重要性降序排列）（p < 0.05）。未对 β-肾上腺素能阻滞剂、抽样偏差和饮食影响进行校正，导致严重低估了冠心病患者中 LDL 异常的发生率，并高估了 HDL 异常的发生率。冠状动脉疾病。然而，35%的患者在校正后总胆固醇水平<200 mg/dl；在这些患者中，73% 的 HDL 胆固醇水平 < 35 mg/dl。
The prevalence of abnormalities of lipoprotein cholesterol and apolipoproteins A-I and B and lipoprotein (a) [Lp(a)] was determined in 321 men (mean age 50 +/- 7 years) with angiographically documented coronary artery disease and compared with that in 901 control subjects from the Framingham Offspring Study (mean age 49 +/- 6 years) who were clinically free of coronary artery disease. After correction for sampling in hospital, beta-adrenergic medication use and effects of diet, patients had significantly higher cholesterol levels (224 +/- 53 vs. 214 +/- 36 mg/dl), triglycerides (189 +/- 95 vs. 141 +/- 104 mg/dl), low density lipoprotein (LDL) cholesterol (156 +/- 51 vs. 138 +/- 33 mg/dl), apolipoprotein B (131 +/- 37 vs. 108 +/- 33 mg/dl) and Lp(a) levels (19.9 +/- 19 vs. 14.9 +/- 17.5 mg/dl). They also had significantly lower high density lipoprotein (HDL) cholesterol (36 +/- 11 vs. 45 +/- 12 mg/dl) and apolipoprotein A-I levels (114 +/- 26 vs. 136 +/- 32 mg/dl) (all p < 0.005).On the basis of Lipid Research Clinic 90th percentile values for triglycerides and LDL cholesterol and 10th percentile values for HDL cholesterol, the most frequent dyslipidemias were low HDL cholesterol alone (19.3% vs. 4.4%), elevated LDL cholesterol (12.1% vs. 9%), hypertriglyceridemia with low HDL cholesterol (9.7% vs. 4.2%), hypertriglyceridemia and elevated LDL cholesterol with low HDL cholesterol (3.4% vs. 0.2%) and Lp(a) excess (15.8% vs. 10%) in patients versus control subjects, respectively (p < 0.05). Stepwise discriminant analysis indicates that smoking, hypertension, decreased apolipoprotein A-I, increased apolipoprotein B, increased Lp(a) and diabetes are all significant (p < 0.05) factors in descending order of importance in distinguishing patients with coronary artery disease from normal control subjects.Not applying a correction for beta-adrenergic blocking agents, sampling bias and diet effects leads to a serious underestimation of the prevalence of LDL abnormalities and an overestimation of HDL abnormalities in patients with coronary artery disease. However, 35% of patients had a total cholesterol level < 200 mg/dl after correction; of those patients, 73% had an HDL cholesterol level < 35 mg/dl.