Plasma lipoprotein(a) is an independent factor associated with carotid wall thickening in severely but not moderately hypercholesterolemic patients

被引:56
作者
Baldassarre, D [1 ]
Tremoli, E [1 ]
Franceschini, G [1 ]
Michelagnoli, S [1 ]
Sirtori, CR [1 ]
机构
[1] UNIV MILAN, INST PHARMACOL SCI, E GROSSI PAOLETTI CTR, I-20133 MILAN, ITALY
关键词
atherosclerosis; lipoproteins; LDL cholesterol; carotid arteries;
D O I
10.1161/01.STR.27.6.1044
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose To evaluate whether high levels of low-density lipoprotein cholesterol (LDL-C) may promote the atherogenic effect of lipoprotein(a) [Lp(a)], we investigated the association between elevated Lp(a) levels and thickening of intima plus media in the common carotid artery (CC-IMT) in patients with different degrees of hypercholesterolemia. Methods One hundred type II hypercholesterolemic patients and 25 normolipidemic subjects were selected for the study. Plasma lipid and lipoprotein levels were determined enzymatically; Lp(a) levels were determined by enzyme-linked immunosorbent assay. An Lp(a) concentration >30 mg/dL was arbitrarily considered a risk factor. For each patient mean CC-IMT was determined by B-mode ultrasound; in 60 patients and in the 25 control subjects, the maximal IMT in the entire carotid tree was also determined. Results CC-IMT values were higher in hypercholesterolemic patients with plasma Lp(a) levels >30 mg/dL than in those with lower levels (P<.01). CC-IMT and maximal IMT directly and independently correlated with plasma levels of Lp(a) (r=.33 and r=.25, respectively; both P<.05). The effect of LDL-C concentrations on the relationship between IMT and Lp(a) was investigated by dividing the patients into quartiles of plasma LDL-C levels. After stratification, CC-IMT significantly correlated with plasma Lp(a) levels in the patients with severe hypercholesterolemia (LDL-C >5.2 mmol/L) but not in patients in the low est quartile, ie, those with moderate hypercholesterolemia. No correlation between CC-IMT and Lp(a) was found in normolipidemic control subjects, Conclusions Elevated plasma levels of Lp(a) can be considered an additional independent factor associated with thickening of the common carotid arteries in patients with severe hypercholesterolemia but not in those with moderate hypercholesterolemia or in normocholesterolemic subjects.
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页码:1044 / 1049
页数:6
相关论文
共 41 条
[1]   THE ASSOCIATION BETWEEN SERUM LP(A) CONCENTRATIONS AND ANGIOGRAPHICALLY ASSESSED CORONARY ATHEROSCLEROSIS - DEPENDENCE ON SERUM LDL LEVELS [J].
ARMSTRONG, VW ;
CREMER, P ;
EBERLE, E ;
MANKE, A ;
SCHULZE, F ;
WIELAND, H ;
KREUZER, H ;
SEIDEL, D .
ATHEROSCLEROSIS, 1986, 62 (03) :249-257
[2]   COMMON CAROTID INTIMA-MEDIA THICKNESS MEASUREMENT - A METHOD TO IMPROVE ACCURACY AND PRECISION [J].
BALDASSARRE, D ;
WERBA, JP ;
TREMOLI, E ;
POLI, A ;
PAZZUCCONI, F ;
SIRTORI, CR .
STROKE, 1994, 25 (08) :1588-1592
[3]  
BEUMONT JL, 1970, B WORLD HEALTH ORGAN, V43, P891
[4]   ISOLATED SYSTOLIC HYPERTENSION AND VESSEL WALL THICKNESS OF THE CAROTID-ARTERY - THE ROTTERDAM ELDERLY STUDY [J].
BOTS, ML ;
HOFMAN, A ;
DEBRUYN, AM ;
DEJONG, PTVM ;
GROBBEE, DE .
ARTERIOSCLEROSIS AND THROMBOSIS, 1993, 13 (01) :64-69
[5]   THE RELATION OF LIPOPROTEIN[A] CONCENTRATIONS AND APOLIPOPROTEIN[A] PHENOTYPES WITH ASYMPTOMATIC ATHEROSCLEROSIS IN SUBJECTS OF THE ATHEROSCLEROSIS RISK IN COMMUNITIES (ARIC) STUDY [J].
BROWN, SA ;
MORRISETT, JD ;
BOERWINKLE, E ;
HUTCHINSON, R ;
PATSCH, W .
ARTERIOSCLEROSIS AND THROMBOSIS, 1993, 13 (11) :1558-1566
[6]   CAROTID STENOSIS IS A POWERFUL PREDICTOR OF A POSITIVE EXERCISE ELECTROCARDIOGRAM IN A LARGE HYPERLIPIDEMIC POPULATION [J].
BRUCKERT, E ;
GIRAL, P ;
SALLOUM, J ;
KAHN, JF ;
DAIROU, F ;
TRUFFERT, J ;
REVERDY, V ;
THOMAS, D ;
EVANS, J ;
GROSGOGEAT, Y ;
DEGENNES, JL .
ATHEROSCLEROSIS, 1992, 92 (2-3) :105-114
[7]  
BUCOLO G, 1973, CLIN CHEM, V19, P476
[8]   SERUM-LP(A) AS A DISCRIMINANT MARKER OF EARLY ATHEROSCLEROTIC PLAQUE AT 3 EXTRACORONARY SITES IN HYPERCHOLESTEROLEMIC MEN [J].
CAMBILLAU, M ;
SIMON, A ;
AMAR, J ;
GIRAL, P ;
ATGER, V ;
SEGOND, P ;
LEVENSON, J ;
MERLI, I ;
MEGNIEN, JL ;
PLAINFOSSE, MC ;
MOATTI, N .
ARTERIOSCLEROSIS AND THROMBOSIS, 1992, 12 (11) :1346-1352
[9]   EVALUATION OF THE ASSOCIATIONS BETWEEN CAROTID-ARTERY ATHEROSCLEROSIS AND CORONARY-ARTERY STENOSIS - A CASE-CONTROL STUDY [J].
CRAVEN, TE ;
RYU, JE ;
ESPELAND, MA ;
KAHL, FR ;
MCKINNEY, WM ;
TOOLE, JF ;
MCMAHAN, MR ;
THOMPSON, CJ ;
HEISS, G ;
CROUSE, JR .
CIRCULATION, 1990, 82 (04) :1230-1242
[10]   ASSOCIATION OF LEVELS OF LIPOPROTEIN LP(A), PLASMA-LIPIDS, AND OTHER LIPOPROTEINS WITH CORONARY-ARTERY DISEASE DOCUMENTED BY ANGIOGRAPHY [J].
DAHLEN, GH ;
GUYTON, JR ;
ATTAR, M ;
FARMER, JA ;
KAUTZ, JA ;
GOTTO, AM .
CIRCULATION, 1986, 74 (04) :758-765