Autor:in:
Dr. Julia Dittrich | Institut für Laboratoriumsmedizin, Klinische Chemie und Molekulare Diagnostik | Germany
Background and aims: Dyslipidemia is one of the major risk factors for atherosclerotic cardiovascular disease (ASCVD). Apolipoproteins (apos), which are key regulators of lipoprotein metabolism, are discussed as vascular risk factors. To elucidate the diagnostic potential of major plasma apos in cardiovascular risk assessment, we analyzed their associations with coronary artery disease (CAD), peripheral artery disease (PAD), and carotid artery plaque (CAP).
Methods: In a case-control subgroup of the Leipzig LIFE-Heart Study (N=911) the simultaneous quantitation of the apos A-I, A-II, A-IV, B-100, C-I, C-III, E, and J was accomplished from 3 µl EDTA-plasma applying LC-MS/MS. Confounder analysis with demographic and clinical covariates as well as serum lipids, cardiac, inflammatory, and hepatic markers was performed. Associations of apos with CAD, CAP, and PAD were analyzed in a multivariate regression model.
Results: Fasting and statin therapy had strongest effects on apo concentrations. Besides concentrations of apos B-100, C-I, and E also apoA-II plasma concentration was decreased under statin therapy. Further, troponin T and interleukin 6 showed inverse correlations with HDL-related apos A-I, A-II, A IV, and C-I. Solely apoB-100 (odds ratio per one SD [OR], 1.39; 95% confidence interval [CI], 1.05-1.84) was independently associated with CAD after adjustment for the identified influencing factors and related lipids. By contrast, only apoA IV (OR, 0.74; 95% CI 0.58-0.95) indicated PAD. ApoB 100 (OR, 1.55; 95% CI, 1.18-2.04), apoC-III (OR, 1.30; 95% CI, 1.06-1.58), and apoE (OR, 1.34; 95% CI, 1.13-1.58) were associated with CAP.
Conclusions: Apos A-IV, B-100, C-III, and E that are associated with triglyceride-rich lipoproteins (TRL) are independently correlated with stable ASCVD, providing further evidence for a potential role of TRLs in atherogenesis.