EFFECTS OF CHD PREVENTION ON LIPOPROTEIN SUBCLASSES

预防冠心病对脂蛋白亚类的影响

• 批准号: 2225901
• 负责人: PAUL T WILLIAMS
• 金额: $ 8.3万
• 依托单位: UNIVERSITY OF CALIF-LAWRENC BERKELEY LAB
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-05-01 至 1994-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2225901
• 关键词: adipose tissue; alcoholic beverage consumption; angiography; antihyperlipoproteinemic agent; blood glucose; body weight; caffeine; cardiovascular disorder chemotherapy; cardiovascular disorder epidemiology; cardiovascular disorder prevention; clinical trials; clofibrate; colestipol; coronary artery; coronary disorder; denaturing gradient gel electrophoresis; diet therapy; dietary carbohydrates; dietary lipid; disease /disorder proneness /risk; fasting; high density lipoproteins; human subject; human therapy evaluation; information systems; insulin; lifestyle; lovastatin; male; marine animal oil; nicotinate

The Stanford Coronary Risk Intervention Project was a four-year randomized clinical trial that showed that risk reduction through lifestyle change and lipid-lowering medications significantly reduced the rate of narrowing of the minimum diameter of coronary artery segments with angiographically visible lesions in 119 patients vs. 127 controls who received usual physician care. In collaboration with this trial, Dr. Ronald Krauss measured high-density lipoprotein (HDL) subclasses by gradient gel electrophoresis. HDL may be divided into two HDL2 and three HDL3 subclasses that are approximated by their estimated particle diameters: HDL3c (7.2-7.8 nm), HDL3b (7.8-8.2 nm), HDL3a (8.2- 8.8 nm), HDL2a (8.8-9.7 nm) and HDL2b (9.7-12.9 nm). The HDL- distribution can also be characterized by the diameter of the predominant peak, which may lie in either the HDL3b or HDL3a interval. Case control and angiographic studies suggest that coronary heart disease risk is increased when HDL2b is reduced relative to HDL3c and HDL3b Our objective is to assess the influence of HDL-subclasses with coronary disease progression, and to identify factors influencing HDL subclasses at baseline and over time. The specific questions to be examined are: 1. Did the risk reduction program change specific HDL subclasses as compared to controls? 2. Did the HDL gradient gel profile characterize men most likely to benefit from multifactor risk reduction? 3. Did HDL-subclasses change significantly in patients that reduced fat intake, reduce body weight, or who took one or more of the following medications: colestipol, nicotinic acid, clofibrate, probucol, gemfibrozil, fenofibrate, lovastatin, guar gum or fish oils? 4. What are the cross-sectional associations of HDL-subclasses with adiposity, fasting and post-load insulin and glucose, diet and medications at baseline? Preliminary analyses suggest that: 1) During the trial, men in the treatment group increased HDL2b; 2) the special intervention was most effective in reducing coronary disease progression in subjects with a baseline predominant HDL-peak diameter below the median; 3) HDL- subclasses were more strongly influenced by diet and adiposity than by drugs during the trial; 4) carbohydrates, alcohol and caffeine were associated with specific subclasses at baseline. The data are stored in computer files, and except for the analyses contained in this application, are unanalyzed. These data were collected as part of NIH grant Plasma lipoproteins in coronary artery disease, HL-33577.

斯坦福大学冠心病风险干预项目是一项为期四年的 一项随机临床试验表明， 生活方式改变和降脂药物显著减少 冠状动脉最小直径狭窄率 119例患者与127例患者的血管造影可见病变节段 接受常规医生护理的对照组。 与此同时， 在一项试验中，罗纳德克劳斯博士测量了高密度脂蛋白（HDL） 亚类的梯度凝胶电泳。 HDL可分为两种 HDL 2和三个HDL 3亚类，通过其估计值近似 颗粒直径：HDL 3c（7.2-7.8 nm）、HDL 3b（7.8-8.2 nm）、HDL 3a（8.2-8.2 nm） 8.8 HDL2a（8.8-9.7 nm）和HDL2b（9.7-12.9 nm）。 HDL- 分布也可以通过颗粒的直径来表征。 主峰，其可位于HDL 3b或HDL 3a区间。 病例对照和血管造影研究表明， 当HDL 2b相对于HDL 3c和HDL 3b降低时，疾病风险增加 我们的目的是评估HDL亚类对冠状动脉粥样硬化的影响， 疾病进展，并确定影响HDL亚类的因素 在基线和随时间推移。 将审查的具体问题是： 1. 风险降低计划是否改变了特定的HDL亚类， 与对照组相比，？ 2. 高密度脂蛋白梯度凝胶曲线是否表征了最有可能 从多因素风险降低中获益？ 3. HDL亚类是否在降低HDL水平的患者中显著改变？ 脂肪摄入量、减轻体重或服用一种或多种 以下药物：考来替泊，烟酸，氯贝特， 普罗布考、吉非贝齐、非诺贝特、洛伐他汀、瓜尔胶或鱼 油？ 4. 高密度脂蛋白亚类与高密度脂蛋白血症的横断面相关性如何？ 肥胖，空腹和负荷后胰岛素和葡萄糖，饮食和 基线药物？ 初步分析表明：1）在试验期间， 治疗组HDL 2b升高; 2）特殊干预组HDL 2b升高最明显 有效地减少患有冠心病的受试者的冠状动脉疾病进展， 基线主要HDL峰直径低于中位数; 3）HDL- 亚类受饮食和肥胖的影响比 试验期间的药物; 4）碳水化合物，酒精和咖啡因 与基线时的特定子类相关。 数据存储在 计算机文件，除了包含在本文件中的分析外， 应用程序，未分析。 这些数据作为NIH的一部分收集 冠状动脉疾病中的血浆脂蛋白，HL-33577。