冠心病患者血浆LCAT水平与HDL亚类组成的关系

 目的： 探讨冠心病 (coronary heart disease, CHD) 患者血浆卵磷脂胆固醇酰基转移酶 (lecithin cholesterol acyltransferase, LCAT) 与高密度脂蛋白 (high-density lipoprotein, HDL) 亚类分布的关系。方法：采用双向电泳-免疫印记法分析了73例正常对照者和144例冠心病患者HDL亚类的组成、含量及分布特征，用酶联免疫法测定其LCAT浓度。冠心病患者按血浆LCAT浓度进行四分位数（19.22、36.39和55.32 mg/L）分层（Q1：LCAT<19.22 mg/L； Q2：19.22≤LCAT<36.39 mg/L； Q3：36.39≤LCAT<55.32 mg/L； Q4：LCAT≥55.32 mg/L）。结果：随着LCAT浓度的降低，冠心病患者血浆总胆固醇（TC）、甘油三酯（TG）水平和载脂蛋白B-100/A-I(apoB-100/A-I)比值呈增加趋势，高密度脂蛋白胆固醇（HDL-C）和apoA-I水平呈减少趋势。与最高四分位数组相比，第三、第二和最低四分位数组中preβ1-HDL含量增加，HDL2a和HDL2b含量减少 (P<0.05或P<0.01)。与正常TC组比较，高TC组LCAT浓度降低，且preβ1-HDL含量增加，HDL2a 和HDL2b含量减少(P<0.01)。直线相关和多元回归分析中发现，血浆LCAT水平与preβ1-HDL浓度呈负相关，与HDL2a和HDL2b浓度呈正相关。结论：CHD患者血浆HDL颗粒呈变小趋势，并且随着LCAT水平的降低，其HDL颗粒的变小程度更加明显。

Relationship between plasma LCAT level and distribution of plasma HDL subclasses in patients with coronary heart disease

AIM：To study the relationship between plasma level of lecithin cholesterol acyltransferase (LCAT) and the distribution of plasma high-density lipoprotein (HDL) subclasses in the patients with coronary heart disease (CHD). METHODS：The levels of plasma HDL subclasses in the healthy controls (n=73) and the CHD subjects (n=144) were determined by two-dimensional gel electrophoresis associated with immunodetection method. The plasma levels of LCAT was detected by enzyme-linked immunosorbent assay (ELISA). The CHD subjects were stratified according to quartiles of the plasma LCAT level (Q1：LCAT<19.22 mg/L; Q2：19.22≤LCAT<36.39 mg/L; Q3：36.39≤LCAT<55.32 mg/L; Q4：LCAT≥55.32 mg/L). RESULTS：With the decrease in LCAT concentration, the plasma levels of total cholesterol (TC) and triglyceride (TG), and the ratio of apolipoprotein B-100/A-I(apoB-100/A-I) in CHD groups were increased significantly, while the levels of HDL-C and apoA-I were decreased significantly. Compared with the highest quartile group, preβ1-HDL was significantly increased, but HDL2a and HDL2b were significantly decreased in the third, second, and lowest quartile groups (P<0.05 or P<0.01). Compared with normal TC group, preβ1-HDL was significantly increased, but LCAT, HDL2a and HDL2b were significantly decreased in high TC group (P<0.01). The plasma LCAT was negatively correlated with the level of preβ1-HDL and positively correlated with the levels of HDL2a and HDL2b.CONCLUSION：The particle size of HDL in CHD subjects becomes smaller than that in healthy controls, and the tendency is related with the decrease in LCAT level.