慢性期脳梗塞患者における血中Remnant-like Particles (Lipo-Z), アポリポ蛋白および血清脂質の検討

Abstract

Having recently been able to measure particle remnant, we measured the lipoproteins (particle remnant, RLP, Lipo-Z) that do not bind to an immunoaffinity gel mixture of anti-human apo B-100 and apo A-I monoclonal antibodies. RLP are known to be rich in apo E and consist of remnants of chylomicrons and VLDL. RLP have been suggested to be atherogenic. We measured the cholesterol (RLP (CHO)) and triglycerides (RLP (TG)) in RLP. RLP (CHO) has been associated with some atherosclerotic diseases. We regarded RLP (CHO) levels higher than 5mg/dl as RLP (CHO) positive. The subjects were 22 patients with chronic cerebral infarction (12 male, 10 female, mean age: 74.5±9.15 years), and 11 patients with no history of cerebral infarction as age-matched controls. In the patients with chronic cerebral infarction (CI group), RLP (CHO) levels were significantly higher than those of the control group (p<0.05). There were no significant differences between the CI group and the control group in other plasma lipid levels.Eight patients (36%) were RLP (CHO) positive in the CI group, whereas RLP (CHO) levels were negative in the entire control group. In the CI group, 7 patients (32%) had hyperlipidemia (T-CHO>220mg/dl or TG>150mg/dl). Of the 7 patients, 6 patients (86%) were highly RLP (CHO) positive. Four patients (36.4%) had hyperlipidemia in the control group. In the 8 patients with chronic cerebral infarction which were RLP (CHO) positive, the levels of total cholesterol (p<0.01), Lipo-Z (p<0.01), apo A-I (p<0.05), apo A-II (p<0.05) and apo E (p<0.01) were significantly higher than the levels in the 14 patients with chronic cerebral infarction which were RLP (CHO) negative. These results suggest that further study of the relation between RLP, cerebral infarction and hyperlipidemia may contribute to the understanding of cerebral infarction due to lipid abnormalities.