HaptoglobinPhenotypeIsAssociatedWithHDL(High-DensityLipoprotein)-BoundHemoglobinContentandCoronaryEndothelialDysfunctioninPatientsWithMildNonobstructiveCoronaryArteryDiseaseATVBresearch-articleEarlyRecent,Feb07,./ATVBAHA..本文由“天纳”临床学术信息人工智能系统自动翻译点击文末“阅读原文”下载本文PDFObjective—Coronaryendothelialdysfunction(ED)isanearlystageofatherosclerosisandisassociatedwithimpairedHDL(high-densitylipoprotein)function.AfunctionalpolymorphismattheHp(haptoglobin)genelocus(rs)hasbeenassociatedwithmarkeddifferencesinHDLstructureandfunction.WesoughttodeterminewhetherHpphenotypewasassociatedwithcoronaryEDandwhethertheamountofhemoglobin(Hb)tetheredtoHDLviaHpwasHp-typedependentandassociatedwithED.冠状动脉内皮功能障碍（ED）是动脉粥样硬化的早期阶段，与HDL（高密度脂蛋白）功能受损有关。HP（触珠蛋白）基因位点（rs）的功能多态性与HDL结构和功能的显著差异有关。我们试图确定HP表型是否与冠状动脉ED相关，以及通过HP与HDL相连的血红蛋白（HB）量是否与ED相关。ApproachandResults—Microvascularandepicardialcoronaryendothelialfunctionwasassessedinindividualswithnonobstructivecoronaryarterydisease.MicrovascularEDwasdefinedas50%changeincoronarybloodflowandepicardialEDas≥20%decreaseincoronaryarterydiameterafterintracoronaryacetylcholineinfusion.TheamountofHbboundtoHDLwasmeasuredbyELISAafterHDLpurificationfromplasmasamplesusingimmune-affinitychromatography.Onehundredandseventyoftheindividualsinthisstudy(50.3%)werediagnosedwithmicrovascularED,(42.3%)withepicardialED,and67(19.7%)haddiabetesmellitus(DM).Hpphenotypewassignificantlyassociatedwithmicrovascular(P=0.01)andepicardialED(P=0.04)amongDMindividuals.TherewasasignificantandinversecorrelationbetweentheamountofHDL-boundHbandchangeincoronarybloodflow(r=?0.40;P0.)andincoronaryarterydiameter(r=?0.44;P0.)inresponsetoacetylcholineinfusion.HbcontentofHDLwassignificantlyincreasedinindividualswithHp2-2andDM.Inalogisticregressionmodel,Hp2-2phenotypewasassociatedwithmicrovascularED(oddsratio,1.9;P=0.03)andtheamountofHDL-boundHbwasanindependentpredictorofbothmicrovascular(oddsratio,4.6foreach1-SDincrease;P0.)andepicardial(oddsratio,2.2;P0.)ED.对例非阻塞性冠状动脉疾病患者的微血管和心外膜冠状动脉内皮功能进行了评估。冠状动脉内乙酰胆碱输注后，微血管ED定义为冠状动脉血流50%，心外膜ED定义为冠状动脉直径减少20%。用免疫亲和色谱法从血浆样品中纯化hdl后，用酶联免疫吸附法测定hbl与hdl的结合量。在本研究中，名患者（50.3%）诊断为微血管性ED，名患者（42.3%）诊断为心外膜性ED，67名患者（19.7%）诊断为糖尿病（DM）。在糖尿病患者中，HP表型与微血管（p=0.01）和心外膜ED（p=0.04）显著相关。乙酰胆碱输注后，高密度脂蛋白结合血红蛋白的量与冠状动脉血流变化（r=-0.40；p0.）和冠状动脉直径变化（r=-0.44；p0.）有显著的负相关。高密度脂蛋白2-2和糖尿病患者的血红蛋白含量显著升高。在logistic回归模型中，hp2-2表型与微血管ED（优势比1.9，p=0.03）相关，hdl结合的hb量是微血管（优势比每增加1-sd4.6，p0.）和心外膜（优势比2.2，p0.）ED的独立预测因子。Conclusions—HpphenotypeissignificantlyassociatedwithcoronaryEDinDMindividuals.ThisassociationislikelyrelatedtoincreasedHbtetheringtoHDLviaHp2-2inDM.在糖尿病患者中，HP表型与冠状动脉ED显著相关。这种关联可能与糖尿病患者通过2-2马力增加血红蛋白与高密度脂蛋白的结合有关。FootnotesTheonline-onlyDataSupplementisavailablewiththisarticleat
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