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ヘテロジゴト性家族性高コレステロール血症およびスタチン療法への反応における残留状粒子の増加
Pernette R W de Sauvage Nolting1, Marcel B Twickler, Geesje M Dallinga-Thie
1Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands. p.desauvagenolting@amc.uva.nl
Circulation
|August 15, 2002
まとめ
残留リポタンパク質コレステロール (RLP-C) は,家族性高コレステロール血症 (FH) の患者で著しく上昇しています. スタチンの治療はRLP-Cを減少させるが,レベルは高いままであり,さらなる治療戦略の必要性を示している.
科学分野:
- 心血管医学 心血管医学
- リピドロジーは,脂質学です.
- 遺伝学 遺伝学とは
背景:
- 残留リポタンパク質 (RLP-C) は,アテロゲネシスに役割を果たします.
- RLP-Cの上昇は,動脈硬化性疾患の進行と関連しています.
- 家族性高コレステロール血症 (FH) でのRLP-Cの存在とスタチンに対する反応は,以前,大規模なコホートでは確立されていなかった.
研究 の 目的:
- FH患者のRLP-Cレベルを評価するために.
- FHにおけるRLP-Cに対するスタチン治療の影響を評価する.
主な方法:
- 36の脂質クリニックから327人のFH患者を募集しました.
- 6週間の洗い流し後に2年間80mgのシンバスタチン単独治療を投与した.
- 治療前のおよび後の免疫分離測定法を使用してRLP-Cレベルを測定しました.
主要な成果:
- FHの患者は,発症時に重度の総コレステロール,LDLコレステロール,RLP-Cの上昇を示した.
- シムバスタチン治療は,RLP-Cレベルを49% (P<0.0001) 低下させた.
- RLP-Cの上昇は,正常なトリグリセリド濃度を有するFH患者でも観察され,アテロゲンプロファイルと関連していました.
結論:
- 初期RLP-Cレベルは,FH患者で顕著に上昇しています.
- シムバスタチンはRLP-Cを著しく低下させるが,レベルは正常化しない.
- FHにおけるRLP-Cの上昇は,LDL受容体の機能障害に起因し,アテロゲンプロファイルに寄与し,治療の強化の必要性を示唆する可能性がある.
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