Purpose The purpose of this study was to characterize dyslipidemia of metabolic syndrome by apolipoprotein-defined apoA-I- and apoB-containing lipoprotein subclasses in addition to the traditional lipid profile.
Background Metabolic syndrome is usually defined as a cluster of metabolic risk factors, including abdominal obesity, raised blood pressure, elevated glucose, prothrombotic and proinflammatory states, and atherogenic dyslipidemia. This constellation of metabolic abnormalities is associated with a significantly increased risk of coronary vascular disease. The atherogenic dyslipidemia of metabolic syndrome has been characterized by increased levels of triglycerides and small dense LDL and decreased levels of HDL. To identify the chemical nature of potentially atherogenic triglyceride-rich lipoprotein(s) and that of cardioprotective HDL, we studied apolipoprotein-defined apoA-I- and apoB-containing lipoprotein subclasses.
Methods We compared 32 patients with metabolic syndrome (WHO criteria) and type 2 diabetes with 40 healthy controls. Two major apolipoprotein-defined apoA-I-containing subclasses, LpA-I and LpA-I:A-II, were determined by a differential electroimmunoassay, while the major apoB-containing lipoprotein subclasses, including cholesterol-rich Lp-B and LpB:E and triglyceride-rich LpB:C, LpB:C:E, and LpA-II:B:C:D:E, were determined sequential immunoprecipitation.
Results As expected, the metabolic syndrome was characterized by increased triglycerides and VLDL-C (p < .0001) and decreased HDL-C compared with controls. ApoA-I, LpA-I, and LpA-I:A-II were decreased in metabolic syndrome (n.s.). However, apoC-III, apoC-III bound to apoB-containing lipoproteins (apoC-III-HP) and apoE were elevated in metabolic syndrome, reflecting increased atherogenic triglyceride-rich LpB:C (11.5 6 3.9 vs 9.8 6 ?3.1 mg/dL; mean 6 SE) and LpA-II:B:C:D:E (16.4 6 8.1 vs 9.9 6 4.5 mg/dL) (p < .0001). Total cholesterol, LDL-C and cholesterol-rich Lp-B and LpB:E + LpB:C:E did not differ between subjects with metabolic syndrome and normal controls.
Conclusions Increased LpB:C, LpA-II:B:C:D:E, apoC-III, and apoC-III-HP are potentially atherogenic characteristic features of the dyslipidemia of metabolic syndrome. It remains to be determined whether these abnormalities are also characteristic of metabolic syndrome in nondiabetic subjects.
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