臨床 トリグリセライドが正常でもレムナント様リポ蛋白コレステロールが高値であれば冠動脈疾患のリスクである
冠動脈造影を施行した208例で, LDL-コレステロール(LDL-C),HDL-コレステロール(HDL-C),トリグリセライド(TG),レムナント様リポ蛋白コレステロール(RLP-C),リポ蛋白-(a),尿酸,血糖,tissue plasminogen activator(t-PA),t-PA inhibitor type 1(PAI-1),antithrombin III,protein Cを測定した.TG値が150mg/dl以上の高TG群(59例)とそれ未満の正TG群(149例)に分け,有意狭窄の有無に対する各因子の予測値としての意義が異なるかを検討した.LDL-CとHDL-Cは,全患者で...
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| Published in | 心臓 Vol. 31; no. 11; pp. 761 - 767 |
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| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
公益財団法人 日本心臓財団
1999
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0586-4488 2186-3016 |
| DOI | 10.11281/shinzo1969.31.11_761 |
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| Abstract | 冠動脈造影を施行した208例で, LDL-コレステロール(LDL-C),HDL-コレステロール(HDL-C),トリグリセライド(TG),レムナント様リポ蛋白コレステロール(RLP-C),リポ蛋白-(a),尿酸,血糖,tissue plasminogen activator(t-PA),t-PA inhibitor type 1(PAI-1),antithrombin III,protein Cを測定した.TG値が150mg/dl以上の高TG群(59例)とそれ未満の正TG群(149例)に分け,有意狭窄の有無に対する各因子の予測値としての意義が異なるかを検討した.LDL-CとHDL-Cは,全患者での検討でも,正TG群のみでの検討,高TG群のみでの検討でも,狭窄群と非狭窄群で有意な差を認めた.これに対し,RLP-Cは正TG群では狭窄群と非狭窄群で有意な差を認めた(p=0.0116)にもかかわらず, 高T G 群では差を認めなかった( p =0.7357).正TG血症で冠動脈病変を有する例ではRLP-Cが高値といえる.TG値測定では予測できない冠動脈疾患の危険群を,RLP-Cで検出できる可能性があり,冠動脈疾患の危険因子としてのTGの意義をRLP-Cが補完できることが考えられる. |
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| AbstractList | 冠動脈造影を施行した208例で, LDL-コレステロール(LDL-C),HDL-コレステロール(HDL-C),トリグリセライド(TG),レムナント様リポ蛋白コレステロール(RLP-C),リポ蛋白-(a),尿酸,血糖,tissue plasminogen activator(t-PA),t-PA inhibitor type 1(PAI-1),antithrombin III,protein Cを測定した.TG値が150mg/dl以上の高TG群(59例)とそれ未満の正TG群(149例)に分け,有意狭窄の有無に対する各因子の予測値としての意義が異なるかを検討した.LDL-CとHDL-Cは,全患者での検討でも,正TG群のみでの検討,高TG群のみでの検討でも,狭窄群と非狭窄群で有意な差を認めた.これに対し,RLP-Cは正TG群では狭窄群と非狭窄群で有意な差を認めた(p=0.0116)にもかかわらず, 高T G 群では差を認めなかった( p =0.7357).正TG血症で冠動脈病変を有する例ではRLP-Cが高値といえる.TG値測定では予測できない冠動脈疾患の危険群を,RLP-Cで検出できる可能性があり,冠動脈疾患の危険因子としてのTGの意義をRLP-Cが補完できることが考えられる. |
| Author | 益岡, 弘司 中野, 赳 川崎, 敦 伊藤, 正明 亀井, 滋 新谷, 宇一郎 尾崎, 守宏 |
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| References | 9) Friedewald WT, Levy RI, Frederickson DS : Estimation of the concentration of lowdensity lipoprotein cholesterol in plasma without use of the preparative ultracentrifuge. Clin Chem 1972 ; 18 : 499-502 19) ECAT angina pectoris study group : ECAT angin a pectoris study : Baseline associations of haemostatic factors with extent coronary arteriosclerosis and other coronary risk factors in 3000 patients with angina pectoris undergoing coronary angiography. Eur Heart J 1993 ; 14 : 8-13 3) Austin MA : Plasma triglyceride and coronary heart disease. Arterioscler Thromb 1991 ; 11 : 2 -14 10) AHA Committee Report : A reporting system on patients evaluated for coronary artery disease. Circulation 1975 ; 51 : A 5-A 39 6)焦昇,松沢佑次:高トリグリセライド血症.現代医療1996;28:173-175 18) Mehta J, Mehta P, Lawson D, et al : Plasma tissue plasminogen activator inhibitor levels in coronary artery disease : Correlation with age and serum triglyceride concentration. J Am Coll Cardiol 1987 ; 9 : 263-268 20) Vigano S, Mannucci PM, Angelo AD, et al : Protein C antigen is not an acute phase reactant and is often high in ischemic heart disease and diabetes. Thromb Haemostas 1984 ; 52 : 263-267 7) Kissebah AH, Alfarsi S, Adams PW : Integrated regulation of very low density lipoprotein triglyceride and apolipoprotein-B kinetics in man : Normolipemic subjects, familial hypertriglyceridemia and famillial combined hyperlipidemia. Metabolism 1981 ; 30 : 856-868 2) Castelli WP : The triglyceride issue : A view from Framingham. Am Heart J 1986 ; 112 : 432-437 4) Drexel H : Plasma triglycerides and three lipoprotein cholesterol fraction are independent predictors of the extent of coronary atherosclerosis. Circulation 1994 ; 90 : 2230-2235 11) Stampfer MJ, Krauss RM, Ma J, et al : A prospective study of triglyceride level, lowdensity lipoprotein particle diameter, and risk of myocardial infarction. JAMA 1996 ; 276 : 882-888 5)岩騎雅文,多田紀夫: Remmant-like リボ蛋白.現代医療1996;28:1944-1948 21) Bonora E : Relationship of uric acid concentration to cardiovascular risk factors in young men. Int J Obes 1996 ; 20 : 975-980 17) Kugiyama K, Doi H, Motoyama T, et al : Association of remnant lipoprotein levels with impairment of endothelium - dependent vasomotor function in human coronary arteries. Circulation 1998 ; 97 : 2519-2526 12) Kameda K, Matsuzawa Y, Kubo M, et al : Increased frequency of lipoprotein disorders similar to type III hyperlipoproteinemia in survivors of myocardial infarction in Japan. Atherosclerosis 1984 ; 51 : 241-249 1) Ginsberg HN : Is hypertriglyceridemia a risk factor for atherosclerotic cardiovascular disease? A simple question with a complicated answer. Ann Intern Med 1997 ; 12 : 912-914 8) Phillips NR, Waters D, Havel RJ : Plasma lipoproteins and progression of coronary artery disease evaluated by angiography and clinical events. Circulation 1993 ; 88 : 2762-2770 14) Nakajima K, Saito T, Tamura A, et al : Cholesterol in remnantlike lipoproteins in human serum using monoclonal anti B-100 and anti apo A-I immunoaffinity mixed gels. Clinica Chimica Acta 1993 ; 223 : 53-71 16) Masuoka H, Ishikura K, Kamei S, et al : Predictive value of remnant-like particles cholesterol/highdensity lipoprotein cholesterol ratio as a new indicator of coronary artery disease.Am Heart J 1998 ; 136 : 226-230 13) National Institutes of Health : Lipid Metabolism Disorders and Coronary Heart Disease.Munich, MMV Medizin Verlag GmbH, 1993,141-160 15) McNamara JR, Shah PK, Nakajima K, et al : Remnant lipoprotein cholesterol and triglyceride reference ranges from the Framingham Heart Study. Clin Chem 1998 ; 44 : 1224-1232 |
| References_xml | – reference: 1) Ginsberg HN : Is hypertriglyceridemia a risk factor for atherosclerotic cardiovascular disease? A simple question with a complicated answer. Ann Intern Med 1997 ; 12 : 912-914 – reference: 13) National Institutes of Health : Lipid Metabolism Disorders and Coronary Heart Disease.Munich, MMV Medizin Verlag GmbH, 1993,141-160 – reference: 10) AHA Committee Report : A reporting system on patients evaluated for coronary artery disease. Circulation 1975 ; 51 : A 5-A 39 – reference: 18) Mehta J, Mehta P, Lawson D, et al : Plasma tissue plasminogen activator inhibitor levels in coronary artery disease : Correlation with age and serum triglyceride concentration. J Am Coll Cardiol 1987 ; 9 : 263-268 – reference: 20) Vigano S, Mannucci PM, Angelo AD, et al : Protein C antigen is not an acute phase reactant and is often high in ischemic heart disease and diabetes. Thromb Haemostas 1984 ; 52 : 263-267 – reference: 16) Masuoka H, Ishikura K, Kamei S, et al : Predictive value of remnant-like particles cholesterol/highdensity lipoprotein cholesterol ratio as a new indicator of coronary artery disease.Am Heart J 1998 ; 136 : 226-230 – reference: 14) Nakajima K, Saito T, Tamura A, et al : Cholesterol in remnantlike lipoproteins in human serum using monoclonal anti B-100 and anti apo A-I immunoaffinity mixed gels. Clinica Chimica Acta 1993 ; 223 : 53-71 – reference: 5)岩騎雅文,多田紀夫: Remmant-like リボ蛋白.現代医療1996;28:1944-1948 – reference: 12) Kameda K, Matsuzawa Y, Kubo M, et al : Increased frequency of lipoprotein disorders similar to type III hyperlipoproteinemia in survivors of myocardial infarction in Japan. Atherosclerosis 1984 ; 51 : 241-249 – reference: 21) Bonora E : Relationship of uric acid concentration to cardiovascular risk factors in young men. Int J Obes 1996 ; 20 : 975-980 – reference: 19) ECAT angina pectoris study group : ECAT angin a pectoris study : Baseline associations of haemostatic factors with extent coronary arteriosclerosis and other coronary risk factors in 3000 patients with angina pectoris undergoing coronary angiography. Eur Heart J 1993 ; 14 : 8-13 – reference: 4) Drexel H : Plasma triglycerides and three lipoprotein cholesterol fraction are independent predictors of the extent of coronary atherosclerosis. Circulation 1994 ; 90 : 2230-2235 – reference: 15) McNamara JR, Shah PK, Nakajima K, et al : Remnant lipoprotein cholesterol and triglyceride reference ranges from the Framingham Heart Study. Clin Chem 1998 ; 44 : 1224-1232 – reference: 2) Castelli WP : The triglyceride issue : A view from Framingham. Am Heart J 1986 ; 112 : 432-437 – reference: 6)焦昇,松沢佑次:高トリグリセライド血症.現代医療1996;28:173-175 – reference: 3) Austin MA : Plasma triglyceride and coronary heart disease. Arterioscler Thromb 1991 ; 11 : 2 -14 – reference: 8) Phillips NR, Waters D, Havel RJ : Plasma lipoproteins and progression of coronary artery disease evaluated by angiography and clinical events. Circulation 1993 ; 88 : 2762-2770 – reference: 7) Kissebah AH, Alfarsi S, Adams PW : Integrated regulation of very low density lipoprotein triglyceride and apolipoprotein-B kinetics in man : Normolipemic subjects, familial hypertriglyceridemia and famillial combined hyperlipidemia. Metabolism 1981 ; 30 : 856-868 – reference: 9) Friedewald WT, Levy RI, Frederickson DS : Estimation of the concentration of lowdensity lipoprotein cholesterol in plasma without use of the preparative ultracentrifuge. Clin Chem 1972 ; 18 : 499-502 – reference: 17) Kugiyama K, Doi H, Motoyama T, et al : Association of remnant lipoprotein levels with impairment of endothelium - dependent vasomotor function in human coronary arteries. Circulation 1998 ; 97 : 2519-2526 – reference: 11) Stampfer MJ, Krauss RM, Ma J, et al : A prospective study of triglyceride level, lowdensity lipoprotein particle diameter, and risk of myocardial infarction. JAMA 1996 ; 276 : 882-888 |
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| SubjectTerms | トリグリセライド レムナントリポ蛋白 冠動脈疾患 |
| Title | 臨床 トリグリセライドが正常でもレムナント様リポ蛋白コレステロールが高値であれば冠動脈疾患のリスクである |
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