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JCEM：异常脂蛋白血症与冠状动脉和周围血管疾病的风险增加有关

2022-09-05 MedSci原创 MedSci原创

冠状动脉疾病周围血管疾病异常脂蛋白血症
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与正常血脂对照组相比，DBL患者发生ASCVD和PVD的风险分别升高3倍和13倍。此外，DBL患者发生PVD的风险比FH患者高4倍。

异常脂蛋白血症(DBL)或III型高脂蛋白血症(HLP)是一种与血浆中残余脂蛋白(富含甘油三酯(TG)和胆固醇)的病理性积累相关的疾病。要发展DBL，必须有两个条件:载脂蛋白E(APOE)基因的遗传缺陷导致功能失调的APOE蛋白，以及次生因素，如肥胖、糖尿病、代谢综合征或胰岛素抵抗。apoE功能障碍最常见的原因是ε2ε2基因型的存在。apoE2配体对低密度脂蛋白(LDL)受体具有较低的亲和力，因此与清除残余脂蛋白(如中密度脂蛋白(IDL)和乳糜微粒残体)的减少有关。在回顾性研究中观察到这些患者患冠状动脉和周围血管疾病(PVD)的风险增加。

近日，内分泌和代谢性疾病领域权威杂志Journal of Clinical Endocrinology & Metabolism上发表了一篇研究文章，该研究的主要目的是明确DBL患者动脉粥样硬化性心血管疾病(ASCVD)和PVD的发病率，并与正常血脂对照组进行比较。其次，研究人员比较了DBL患者和FH患者的ASCVD和PVD发生率。

该研究共有221例DBL患者、725例FH患者和1481例血脂正常对照者纳入研究。这些数据是通过查阅病历获得的。

与正常血脂对照组相比，DBL患者发生PVD(风险比为13.58,95%CI为4.76-38.75)和ASCVD(风险比为3.55,95%CI为2.17-5.83)的风险总体上更高(P<0.0001)。与FH患者相比，DBL患者发生PVD的风险增加(风险比为3.89,95%CI为1.20-12.55,P=0.02)。

由此可见，与正常血脂对照组相比，DBL患者发生ASCVD和PVD的风险分别升高3倍和13倍。此外，DBL患者发生PVD的风险比FH患者高4倍。充分筛查DBL是必要的，以改善这些患者的临床治疗，防止动脉粥样硬化性心血管疾病的发生发展。

原始出处：

Martine Paquette,et al.Dysbetalipoproteinemia is associated with increased risk of coronary and peripheral vascular disease.JCEM.2022.https://academic.oup.com/jcem/advance-article/doi/10.1210/clinem/dgac503/6691221

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    2022-09-22 smallant2015

    #JCEM#

    0

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    2023-03-27 achengzhao

    #JCE#

    0

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    2022-09-06 juliusluan79

    #脂蛋白#

    0

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    2022-09-06 andy2090

    #血管疾病#

    0

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