Abstract
Clinical Study On The Genesis Of Coronary Atherosclerosis-The Relation Of Hypertriglyceridemia To Coronary Atherosclerosis-To assess the metabolic effects of plasma triglyceride on coronary atherosclerosis, we made a study of 74 male patients aged 32-71 years undergoing selective coronary angiogr aphy for suspected coronary heart disease as to catabolic aspect of the very low-density lipoprotein (VDL) metabolism.
Lipid concentrations of lipoprotein subfractions were measured after preparative ultracentrifugation : Plasma and VLDL apoprotein concentrations were measured by single radial immunodiffusion method (SRID). Activities of lipoprotein lipase (LPL) and hepatic triglyceride lipase (H-TGL) in postheparin plasma were measured by14c radio assay, and the reactivity of VLDL as a substrate upon which purified bovine lipoprotein acts was ascertained by enzyme assay. A coronary score reflecting the number and degree of stenosis in the four major coronary arteries was assigned to each angiogram.
It was suggested that increased serum triglyceride not only induced an increase in the number of VLDL particle, but also made characteristic changes in each lipoprotein particle as a result of the increment of the triglyceride ratio. These phenomena were found to be particularly obvios in VLDL. Men with moderate or severe hypertriglyceridemia had a defect of triglyceride clearance from the stand points of both decreased activity of lipoprotein lipase and decreased reactivity of VLDL to LPL.Concentrations of apo C- II and apo C-III in the serum and VLDL had a positive correation with the serum triglyceride concentration, and VLDL apo C-III (as concentration or as percentage of total VLDL) had a negative correlation with VLDL-reactivity. In severe hypertriglyceridemia, the decreased reactivity of VLDL to LPL was most likely due to the increment of apo C-III in VLDL. Therefore, it is necessary to study the reactivity of VLDL as a substrate upon which LPL acts, at the same time studying the activity of enzymes such as LPL and H-TGL.
Patients with high coronary scores tended to have higher plasma triglyceride and total cholesterole, but the tendency showed individual differences. Men with higher serum triglyceride besides a high coronary score had a defect of triglyceride clearance, which accelerated the coronary atherosclerosis.
