抄録
Distributions of HDL particle size in coronary atherosclerosis defined by coronary angiography (CAG) were investigated. Subjects were 85 patients with coronary artery stenosis (CS+) positive (stenosis≥75%) and 64 with CS negative (stenosis<75%). Thirty-five of the CS(+) patients and 29 of the CS(-) patients had no histoty of diabetes mellitus, smoking or hyperlipidemia. In all of subjects, TC and TG levels were mesured by an autoanalyzer and apoprotein levels by the TIA method. HDL-C was obtained by the dextran sulfate-Ca precipitaion method, LDL-C was caculated by Friedewald's equation. Distributions of HDL subfractions were obtained by 4-30% PAGE. The absolute amounts of HDL subfractions were estimated as HDL-subfraction cholesterol concentrations by multipling plasma HDL-C concentration by percentage of HDL subclasses using PAGE.
Among all subjects, fasting plasma glucose levels and number of cigarettes smoked/daily were significantly higher in the CS(+) group. There were no significant differeces in TC, TG, LDL-C, apoA-II and apoB levels between CS(+) and CS(-) patients. CS(+) patients had significantly lower HDL-C and apoA-I levels than CS(-) patients both overall and in patients with no history of diabetes mellitus, smoking or hyperlipidemia. (p<0.05, p<0.01). Overall, there were no significant differences in percent distribution of HDL subfractions between CS(+) and CS(-) patients. In CS(-) patients, plasma concentrations of HDL2b-C, HDL2a-C, HDL3a-C and HDL3b-C were 13.1±11.3mg/dl, 14.4±7.5mg/dl, 13.9±5.4mg/dl and 3.6±2.5mg/dl, respectively, in CS(+) patients, these values were 7.8±6.9mg/dl, 13.4±7.1mg/dl, 12.1±5.4mg/dl and 3.1±2.2mg/dl. In patients negative for diabetes mellitus, smoking and hyperlipidemia, CS(+) patients had significantly lower percentage of HDL2b (p<0.01) and significantly higher HDL3a (p<0.05) than CS(-) patients. In CS(-) patients, plasma concentrations of HDL2b-C, HDL2a-C, HDL3a-C and HDL3b-C were 18.9±15.2mg/dl, 17.7±7.1mg/dl, 12.2±5.2mg/dl and 2.8±2.4mg/dl, respectively, in CS(+) patients, these values were 7.1±6.1mg/dl, 15.8±7.0mg/dl, 11.9±4.6mg/dl and 2.8±2.0mg/dl. Both in all patients and in patients negative for diabetes mellitus, smoking and hyperlipidemia, CS(+) patients scored significantly lower than CS(-) patients only in plasma HDL2b-C concentration (p<0.01). In all patients, coronary atherosclerosis score (CAS) by AHA classification had no correlation with any of the HDL subtraction concentrations.
However CAS correlated negatively with plasma HDL2b-C level in patients negative for diabetes mellitus, smoking and hyperlipidemia (r=-0.386, p<0.01).
We conclude that the plasma levels of large HDL particle (HDL2b) are low in subjects with coronary atherosclerosis.
