Elsevier

Atherosclerosis

Volume 153, Issue 2, December 2000, Pages 391-396
Atherosclerosis

Preheparin serum lipoprotein lipase mass is negatively related to coronary atherosclerosis

https://doi.org/10.1016/S0021-9150(00)00413-5Get rights and content

Abstract

In preheparin serum, there exists lipoprotein lipase (LPL) mass with little activity. The clinical significance of this preheparin serum LPL mass (preheparin LPL mass) is unclear. We studied the levels of preheparin LPL mass in patients with coronary atherosclerosis, comparing the results with those in healthy men. We also evaluated the correlation between preheparin LPL mass and the severity of coronary atherosclerosis by comparing with other risk factors such as age, smoking, family history, hypertension, hyperuricemia, diabetes mellitus, total cholesterol, triglyceride, high density lipoprotein-cholesterol and body mass index. The subjects, 70 men presenting with symptoms of coronary artery disease, underwent coronary angiographic examination. Significant narrowness was defined as≥75%. Control group comprised 77 men who had annual health checks and showed no abnormal findings. Preheparin LPL mass in the stenosis group was lower than normal coronary group and also than the control group. Multivariate analysis showed that preheparin LPL mass had the highest t-value (−2.53) for the number of lesions among the risk factors listed above. These results suggest that low preheparin LPL mass may be deeply involved in the progression of coronary atherosclerosis.

Introduction

Lipoprotein lipase (LPL) catalyzes hydrolysis of triglycerides in circulating lipoproteins [1]. This enzyme is thought to be produced mainly in the adipose tissues and muscles and is transported to the surface of endothelial cells [2], [3]. It is then anchored to the surface of vascular endothelial cells. LPL analysis was conducted using postheparin plasma, because LPL is detached from the endothelial cells by heparin injection and is released into the blood stream [4]. Tornvall et al. [5] report that LPL mass exists in preheparin serum, even though lipase activity is scarcely detected. They also reported that this preheparin plasma LPL mass is detached from the endothelial surface after degradation and is transported to the liver to be cleared away. They observed a positive correlation between preheparin LPL mass and HDL cholesterol and a weak negative correlation with triglyceride in the patients with coronary artery diseases. We also observed similar results in people who had annual heath checks, and found that there was essentially no difference in preheparin LPL mass between men and women, and preheparin LPL mass was low in remnant-positive individuals [6]. Furthermore, administration of insulin sensitizer, troglitazone increased the preheparin LPL mass [7], indicating that preheparin LPL mass could reflect some of the LPL produced in a whole body, and may be related to insulin sensitivity. However, the real clinical significance of preheparin LPL mass has not yet been fully elucidated.

The artherogenic nature of triglyceride-rich lipoproteins such as remnants or intermediate density lipoproteins has recently been pointed out [8], [9]. Among possible mechanisms for the the retention of these triglyceride-rich lipoproteins, dysfunction of lipoprotein lipase is suggested [10], [11] in addition to the role of apolipoprotein E [12] and the receptors for remnants [13]. Tsutsumi et al. report that a novel compound No-1886, which enhances lipoprotein lipase expression, suppresses atherosclerotic lesions in the cholesterol-fed rat [14]. Shimada et al. [15] produced LPL transgenic mice and reported that these mice were resistant to progression of atherosclerotic lesion induced by cholesterol feeding. These studies suggest a possibility that enhanced LPL production may work as an anti-atherosclerotic factor.

In order to study the role of preheparin LPL mass in the progression of coronary atherosclerosis, we performed an angiographic study and compared preheparin LPL mass with other risk factors such as age, smoking, family history, hypertension, hyperuricemia, diabetes mellitus, serum lipids and obesity.

Section snippets

Subjects

The subjects were 70 men who were thought to have coronary artery disease (CAD) and who underwent coronary angiography after giving their informed consent at the Cardiovascular Center of Sakura Hospital, School of Medicine, Toho University. The average age was 57 years old (S.D., ±13), ranging from 22 to 79 years. Blood samples were drawn after fasting, just before heparin injection preceding coronary angiography. Portions necessary for LPL mass measurement were frozen at −80°C, within 1 h of

Preheparin LPL mass and serum lipid levels in all subjects taking coronary angiographical study

Negative correlation between preheparin LPL mass and triglycerides (R, −0.353, P<0.05) and positive correlation between preheparin LPL mass and HDL-cholesterol (R, 0.316, P<0.05) were observed (Fig. 1A and B). Significant correlations between preheparin LPL mass and total cholesterol or LDL-cholesterol were not observed (Fig. 1C and D).

The levels of preheparin LPL mass in the control group, the normal coronary group and the stenosis group

The levels of preheparin LPL mass were compared among three groups: the healthy control group, the normal coronary group and the coronary stenosis group. The

Discussion

In the cases studied, serum cholesterol levels of patients with coronary stenosis were similar to those in the Control and Normal Coronary groups, but triglyceride was mildly elevated and low HDL-cholesterol was observed (Table 1). These lipid profiles could be interpreted as the result the retention of triglyceride-rich lipoproteins such as very low density lipoproteins and/or remnants. This could be explained as being partly due to the clearance disturbance of triglyceride-rich lipoproteins

Acknowledgements

We are greatly indebted to Drs Kazuhito Mineoka, Takeshi Sakurai, Kaneyuki Aoyagi, Shin Satoh and Kunio Yoshinaga for their assistance in conducting CAG studies. This work was supported by the fund from the memorial 60th anniversary of Toho University, and also supported by Dai-ichi Pure Chemical. We also thank Professor Dr Hisao Tomioka M.D. for reviewing this manuscript.

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