ارتباط سطح ليپو پروتيين و آپوليپوپروتيين ها و فعاليت آنزيم پاراكنوناز سرمي با بيماري عروق كرونر زودرس

Association of Lipoproteins, Apolipoproteins and Paraoxonase Enzyme and Premature Coronary Artery Disease

The association of serum apolipoprotein (apo) A-I and apo B concentrations, and paraoxonase (PON) enzyme activity with angiographically determined coronary artery disease (CAD) was investigated in Iranian nondiabetic patients with premature CAD and normal coronary artery control subjects in a sex and age matched case-control study. The study population consisted of 59 nondiabetics subjects with premature CAD (25 men and 34 women) and 55 CAD controls (21 men and 34 women) who were referred for their first coronary angiography. Premature ʹCAD was defined as presence of angiographically detected coronary stenosis (> 50% in 1 or more coronary arteries) in men younger than 55 and in women younger than 65 years of age. CAD- was defined as a maximum stenosis of 10% in any coronary artery. All study participants had fasting blood sugar levels of less than 140 mg/dl and had no history of taking oral hypoglycemic agents. Apo concentrations were measured by immunoturbidometric assay and Pon/arylesterase activities by spectrophotometric assay of p-nitrophenol/phenol production following addition of paraoxon /phenylacetate to serum. No significant difference was observed in mean age of CAD and control groups (52.5 ± 6.4 vs 52.5 7.4). In CAD patients, increased concentration of total cholesterol (215 ± 43 vs 193 ± 43, P<0.05) triglycerides (169 ± 125 vs 156 ± 118, P<0.05) LDL-C (138 ± 46 vs 116 ± 39, P<0.05) and apo B (102 ± 24 vs 84 ± 17.5, P<0.001) and decreased ratio of apo A-I/apo B (1.7 ± 0.4 vs 2.0 ± 0.6, P<0.001) were observed compared to control group. Other study variables were not significantly different between the two groups. On multiple logistic regression analysis in presence of all lipid and nonlipid variables, the only marker for discrimination between CAD+ group and CAD- controls was apo B. It is concluded that in Iranian nondiabetic patients with premature CAD, the concentration of apo B is a better marker than traditional lipid parameters in discriminating between CAD+ and CAD- subjects. Lack of significant difference in PON activity berween CAD + patients and CAD controls supports the concept of interethnic variability in PON polymorphism observed in other studies.