脂蛋白(α)的生理功能及其与冠心病的研究进展
《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]
- 期数:
- 2016年第2期
- 页码:
- 244-247
- 栏目:
- 综述
- 出版日期:
- 2015-11-25
文章信息/Info
- Title:
- Physiological functions and research progress of lipoprotein(α) in coronary heart disease
- Author(s):
- ZUO Rui-ping; ZHANG Jian-jun; HAN Chang-bao
- (Department of Cardiology, 263 Clinical Department, General Hospital, Beijing Military Area Command, Beijing 101149, China)
- 分类号:
- R541.4
- DOI:
- -
- 文献标识码:
- A
- 摘要:
- 载脂蛋白(a)〔apo(a)〕是一种具有高度基因多态性的糖蛋白。apo(a)在肝脏合成后与LDL上的apo(B100)具有高度亲和力，在肝细胞表面通过二硫键与之相连形成脂蛋白(α)〔Lp(α)〕。Lp(α)通过LDL受体途径及非LDL受体途径代谢。Lp(α)参与动脉粥样硬化的发生、发展，在止血、创伤愈合及血管发生中也发挥作用。Lp(α)是冠心病的独立危险因素。Lp(α)血浆水平主要由遗传因素决定，但可受疾病(如：肝脏及肾脏疾病)、激素(如：性腺激素、甲状腺激素)及药物(如：烟酸及其类似物)的轻度影响。本文对Lp(α)血浆浓度的种族差异、性别差异及药物影响进行了阐述。
- Abstract:
- Apo(a) is a glycoprotein that underlies a large genetic polymorphism. Apo(a) is synthesized predominantly in the liver. After its synthesis, it binds with high affinity to the apoB binding site of LDL on the hepatocellular surface. Lipoprotein(α)［Lp(α)］ is degraded via LDL-receptor metabolic pathway and non-LDL-receptor metabolic pathway. Lp(α) is an important agent in the development of atherosclerosis and has some physiological functions in hemostasis, wound healing and angiogenesis. Lp(α) is an independent risk marker for coronary heart disease. Lp(α) plasma concentration is highly determined by genetic factors. However, plasma concentrations of Lp(α) are also affected by different diseases (e.g., diseases of liver and kidney), hormonal factors (e.g., sex steroids, thyroid hormones) as well as pharmaceuticals (e.g., nicotinic acid derivatives). This article focuses mainly on racial and sex differences of Lp(α) levels and influences of medication.
参考文献/References
[1]Kamstrup PR,Tybj?rg-Hansen A,Nordestgaard BG.Nordestgaard.Genetic Evidence That Lipoprotein(a)Associates With Atherosclerotic Stenosis Rather Than Venous Thrombosis[J].Arterioscler Thromb Vasc Biol,2012,32(7):1732-1741.
[2]Lamon-Fava S,Marcovina SM,Albers JJ,et al.Lipoprotein(a)levels, apo(a)isoform size,and coronary heart disease risk in the Framingham Offspring Study[J].J Lipid Res,2011,52(6):1181-1187.
[3]Tsimikas S,Hall JL.Lipoprotein(a)as a Potential Causal Genetic Risk Factor of Cardiovascular Disease a rationale for increased efforts to understand its pathophysiology and develop targeted therapies[J].J Am Coll Cardiol,2012,60(8):716-721.
[4]Galvano F,Malaguarnera M,Vacante M,et al.The physiopathology of lipoprotein(a)[J].Front Biosci(Schol Ed), 2010,2:866-875.
[5]Kostner KM,Kostner GM.Therapy of Hyper-Lp(a)[J].Handb Exp Pharmacol,2005,(170):519-536.
[6]Sotiriou SN,Orlova VV,Al-Fakhri N,et al.Lipoprotein(a)in atherosclerotic plaques recruits inflammatory cells through interaction with Mac-1 integrin[J].FASEB J,2006,20(3):559-561.
[7]Lippi G,Guidi G.Lipoprotein(a):from ancestral benefit to modern pathogen?[J].QJM,2000,93(2):75-84.
[8]Lippi G,Franchini M,Salvagno GL,et al.Lipoprotein(a)and cancer:Anti-neoplastic effect besides its cardiovascular potency[J].Cancer Treat Rev,2007,33(5):427-436.
[9]Enas EA,Chacko V,Senthilkumar A,et al.Elevated lipoprotein(a)--a genetic risk factor for premature vascular disease in people with and without standard risk factors: a review［J］. Dis Mon, 2006,52(1):5-50.
[10]Desai NR,Kohli P,Giugliano RP,et al AMG145, a monoclonal antibody against proprotein convertase subtilisin kexin type 9, significantly reduces lipoprotein(a) in hypercholesterolemic patients receiving statin therapy: an analysis from the LDL-C Assessment with Proprotein Convertase Subtilisin Kexin Type 9 Monoclonal Antibody Inhibition Combined with Statin Therapy(LAPLACE)-Thrombolysis in Myocardial Infarction(TIMI)57 trial[J]. Circulation,2013,128(9):962-969.
[11]Laschkolnig A,Kollerits B,Lamina C,et al.Lipoprotein(a)concentrations, apolipoprotein(a)phenotypes, and peripheral arterial disease in three independent cohorts[J].Cardiovasc Res,2014,103(1):28-36.
[12]Ornek E,Murat S,Duran M,et al.The relationship between lipoprotein(a)and coronary artery disease,as well as its variable nature following myocardial infarction[J].Clin Invest Med,2011,34(1):E14-E20.
[13]Rifai N,Ma J,Sacks FM,et al.Apolipoprotein(a)size and lipoprotein(a) concentration and future risk of angina pectoris with evidence of severe coronary atherosclerosis in men: Physicians Health Study[J].Clin Chem,2004,50(8):1364-1371.
[14]Zlatohlávek L,Zídková K,Vrablík M,et al.Lipoprotein(a) and its position among other risk factors of atherosclerosis[J].Physiol Res,2008,57(5):777-783.
[15]Emerging Risk Factors Collaboration,Erqou S,Kaptoge S,et al.Lipoprotein(a)concentration and the risk of coronary heart disease,stroke,and nonvascular mortality[J].JAMA,2009,302(4):412-423.
[16]Virani SS,Brautbar A,Davis BC,et al.Associations between lipoprotein(a) levels and cardiovascular outcomes in black and white subjects:the Atherosclerosis Risk in Communitie(ARIC)Study[J].Circulation,2012,125(2):241-249.
[17]Enkhmaa B,Anuurad E,Zhang W,et al.HIV disease activity as a modulator of lipoprotein(a)and allele-specific apolipoprotein(a)levels[J].Arterioscler Thromb Vasc Biol,2013,33(2):387-392.
[18]Paultre F,Pearson TA,Weil HF,et al.High levels of Lp(a) with a small apo(a) isoform are associated with coronary artery disease inAfrican American and white men[J].Arterioscler Thromb Vasc Biol,2000,20(12):2619-2624.
[19]Erqou S,Thompson A,Di Angelantonio E,et al.Apolipoprotein(a)isoforms and the risk of vascular disease:systematic review of 40 studies involving 58 000 participants[J].J Am Coll Cardiol,2010,55(19):2160-2167.
[20]Suk Danik J,Rifai N,Buring JE,et al.Lipoprotein(a),hormone replacement therapy, and risk of future cardiovascular events[J].J Am Coll Cardiol,2008,52(2):124-131.
[21]Nicholls SJ,Tang WH,Scoffone H,et al.Lipoprotein(a)levels and long-term cardiovascular risk in the contemporary era of statin therapy[J].J Lipid Res,2010,51(10):3055-3061.
备注/Memo
- 备注/Memo:
- 收稿日期：2014-11-19.
作者简介：左瑞平，主任医师，硕士 Email：zuozuole84@163.com
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