Lipid levels in high density lipoprotein subfractions in smokers with peripheral vascular disease

Serum apolipoprotein AI levels in atherosclerotic and diabetic patients

OBJECTIVE

To evaluate the association between Apolipoprotein AI (ApoAI), Apolipoprotein B100 (ApoB) and the presence of lower limb atherosclerotic occlusive disease.

MATERIALS AND METHODS

Serum lipids, lipoprotein fractions, ApoAI, ApoB and Lp(a) were measured in 52 patients (28 diabetics and 24 non-diabetics) with lower limb occlusive disease. They were evaluated according to patients' glucose and compared with those in 75 healthy controls.

RESULTS

There was a significant decrease in HDL-cholesterol and ApoAI serum levels (p = 0.000001) and an increase in Lp(a) (p = 0.000001) in patients as compared to controls. No difference was observed in total cholesterol, non HDL-cholesterol or triglycerides. Multiple regression analysis revealed a significant association between low ApoAI (or HDL) levels and the disease as well as between high Lp(a) levels and the disease. ApoAI (p = 0.0003), HDL-cholesterol (p = 0.00005) and total cholesterol (p = 0.01) levels were significantly lower in diabetic patients compared to non-diabetic patients. Lp(a) levels did not correlate with fasting glucose concentration. Multiple regression analysis revealed a significant association between low ApoAI (or HDL) levels and diabetes.

CONCLUSION

Decreased ApoAI appears to be a main component of the dyslipidaemic serum profile observed in patients with atherosclerotic occlusive disease of the lower extremities. Increased Lp(a) levels is an independent risk factor. Decreased HDL-cholesterol is also involved in the dyslipidaemic profile.

Serum Lp(a) lipoprotein levels in patients with atherosclerotic occlusive disease of the lower extremities

OBJECTIVE

To evaluate the association between Lp(a) lipoprotein levels, other serum lipids and the presence of lower limb atherosclerotic occlusive disease.

MATERIALS AND METHODS

Angiographic findings in 36 patients were related to serum Lp(a). Total cholesterol, triglycerides, LDL-cholesterol, HDL-cholesterol and Lp(a) levels were compared with those of 73 age- and sex-matched healthy controls.

RESULTS

Atheromatous lesions were localised in the femoropopliteal ( approximately 60%) and aortoiliac ( approximately 40%) segments. The number of stenosed arteries was > or =2 and the range of stenosis severity was between 40% and 100%. There was a significant increase in serum Lp(a) (p= 0.000001) and a decrease in serum HDL (p= 0.000009) levels in patients compared to controls. No difference was observed in total cholesterol, LDL-cholesterol or triglyceride. However, the ratio of total cholesterol/HDL-cholesterol was significantly higher (p= 0.005) in patients.

CONCLUSION

A dyslipidaemic serum profile, characterised by increased Lp(a) levels and decreased HDL-cholesterol levels, is associated with atherosclerotic occlusive disease of the lower extremities.

Apolipoproteins C-II and C-III in peripheral arterial disease

Apolipoprotein (apo) C-II and apo C-III serum concentrations were investigated in 119 normotriglyceridemic male subjects with peripheral arterial disease (PAD) or coronary heart disease (CHD) or without clinical manifestations of atherosclerotic disease. All subjects included in the study had similar blood levels of total cholesterol (< 400 mg/dL). High-density lipoproteins cholesterol (HDL-C) subfractions and apo A-I serum levels were significantly lower in CHD patients, as were apo A-I/apo B and HDL-cholesterol/total cholesterol ratios. Apo C-II and apo C-III showed similar serum concentrations in all three groups of subjects, but apo C-II/apo C-III ratio was significantly lower in PAD patients as compared with that in CHD patients and control subjects. This study confirms that PAD may be associated with a particular lipoprotein derangement that primarily involves very low-density lipoprotein catabolism.

Lipoprotein profile in men with peripheral vascular disease. Role of intermediate density lipoproteins and apoprotein E phenotypes

BACKGROUND

The role of lipoprotein disturbances in the development of peripheral vascular disease (PVD) has not been sufficiently clarified.

METHODS AND RESULTS

The relations among concentrations of intermediate density lipoproteins (IDL), apoprotein (apo) B, apo E, and other lipoproteins were studied in 102 men with PVD and 100 healthy men who formed the control group. Patients with PVD had significantly higher levels of serum triglycerides, very low density lipoprotein (VLDL) cholesterol, VLDL triglycerides, VLDL proteins, IDL cholesterol, and IDL triglycerides and lower levels of high density lipoproteins (HDL) than controls. Serum cholesterol and triglycerides were normal in 30 patients (cholesterol, less than 5.2 mmol/l; triglycerides, less than 2.3 mmol/l), who had significant increases in IDL triglycerides and significant decreases in HDL cholesterol compared with the 47 controls, who had normal cholesterol and triglyceride levels. Patients with more severe distal involvement showed higher cholesterol and triglycerides carried by IDL and a greater reduction in HDL cholesterol. Smoking patients with PVD showed increased VLDL cholesterol and VLDL triglycerides and lower HDL concentrations. Apo E polymorphism in our study population does not differ from that reported for other European populations. Alleles epsilon 2 and epsilon 4 had a major impact on serum triglycerides and VLDL lipids in our patients with PVD.

CONCLUSIONS

Lipoprotein disturbances are a major risk factor for PVD. IDL abnormalities play an important role in the development and severity of PVD and should also be considered a vascular risk factor in normocholesterolemic and normotriglyceridemic patients.