Vasospastic anginaの糖代謝および脂質代謝に関する研究

Abstract

The purpose of this study is to clarify the role of glucose and lipids metabolism in vasospastic angina. The subjects who underwent coronary angiography were 100 patients. Subjects were classified to three groups according to angiographic findings; 34 normal controls (group 1), 18 subjects (group 2) with coronary spasm and 47 subjects (group 3) of coronary atherosclerosis without coronary artery spasm. The age was younger in group 2 than in group 3. The values of serum total cholesterol and triglyceride and the prevalence of abnormal glucose tolerance, which include both diabetes mellitus and impaired glucose tolerance, were lower in group 2 than in group 3, while they were not significant statistically. The group 2 showed higher HDL-cholesterol and lower atherogenic index level than in group 3. These risk factors in group 2 were compatible with group 1 rather than in group 3. Both apo A-I and apo A-II levels of group 2 were significantly higher than group 3. Apo B level revealed higher value in group 2 and group 3 than in group 1. Apo C-II level in group 2 and group 3 showed significantly higher values than group 1. Apo E level of group 2 showed high value than in group 3.These risk factors of vasospastic angina were compatible with in normal subjects rather in coronary atherosclerosis from the results of lipids metabolism, namely classical risk factors of coronary artery disease such as cholesterol or HDL-cholesterol were not affected. However, increased apo C-II and apo E levels in vasospastic angina suggested the abnormality of triglyceride metabolism in VLDL. On the other hand, the high prevalence of abnormal glucose tolerance was noted in vasospastic angina comparing to normal subjects. It was suggested that abnormal lipids metabolism might be related on the development and progression of vasospastic angina.