. 1999; 27(1): 26-30

Anjiyografik Olarak Koroner Arter Hastalığı Tanısı Almış Hastalarda LP(a) ve Lipid Peroksidlerinin Düzeyi ve Bunlar Arasındaki Korelasyon

Önder KIRIMLI1, Sema GÜNERİ1, Hülya ÖZTÜRE1, Ozan KINAY1, Cem NAZLI1, Banu ÖNVURAL1
Dokuz Eylül Üniversitesi Tıp Fakültesi Kardiyoloji ve Biyokimya Anabilim Dalları, İzmir

Bu ça!tşmada, anjiografik olarak koroner arter hastahğt (KAH) tamst a/nuş hastalarda lipoprotein (a) [Lp (a)] ve lipid peraksid/erinin bir göstergesi olan ma/on dialdehid (MDA) düzeyleri ölçiiierek aralamıda bir ilişki olup olrnadtğt araştmldt. Koroner anjiografisi yaptlan toplam 86 hasta (55 Erkek, 31 Kad111, ortalama yaş 57 ± 10) çaltşmaya al md ı. 62 Hastada KAH saptamrken (KAH +) 24'ünde koroner damarlar normal (KAH-) olarak bulundu. KAH(+) ve KAH(-) gmplamıda total kolesterol, HDL ve LDL kolesterol ve trigliserid dii:eyleri arasında fark saptanmadı. KAH(+) grupta Lp(a) ve MDA dii:ey/eri KAH(-) gmba oranla {//ılamll derecede yiiksek bulundu (37.9±29.5'e karştlik 22.3 ± 21.3 mg/d/, p=0.008 ve 1.58 ± 0.47'e karşılı k 1.26 ± 0.38 nımollnıl, p=0.002, strasıyla). Ancak KAH (+) hastalarda Lp (a) ve MDA dii:eyleri arasmda iyi bir korelasyon saptanmadı (r=0.219, p=0.09). Diabetes nıellitus saptanan 21 hastada ise total kolesterol değerleri ve MDA diizeyleri diabetik olmayanlara göre an/am!t derecede yiiksek bu!tmdu (233 ± 47'ye karşı /tk 205 ± 55 mg/d/, p=0.03 ve 1.85 ± 0.5J'e karşı/tk 1.37 ± 0.37 nımollm/, p=0.006, sırasıyla). Lp(a) diizeyleri d iabetik grupta non-d iabetik gruba oranla yüksek olmakla birlikte aradaki fark an/amlt bulun madı. Diabetik hastalarda Lp(a) ve MDA düzeyleri arasmda da korelasyonlmlımnıadı (r=0.08, p=0.34). KAH(+) diabetik hastalarda ise KAH (-) diabetik hastalara oranla Lp(a) diizeyleri an/ anı!t olarak yüksek bu!tmdu (47.9 ± 32.4'e karşı/tk 16 ± 3.1 mg/d/, p=0 .0009). Ancak MDA diizeyleri diabetik olanlarda KAH o/nıast ile birlikte onlamit artış göstermedi. Ayrıca Lp(a) ve MDA arası nda ilişki saptanmadt (r=0.02, p=0.29). Sonuç olarak, KAH (+)grupta Lp(a) ve MDA diizeyleri KAH (-) gm ba oranla anlamlt derecede yiiksek bulundu. Diabetik olup da KAH saptanan/arda, eliabetik ancak KAH olmayanlara göre Lp(a)'mn aterojenik özelliği MDA'ya oranla daha önemli olarak değerlendirildi. Anal.tar kelime/er:

Anahtar Kelimeler: Koroner arter hastalığı, lipoprotein (a), lipid peraksid/eri

Lipoprotein(a) and Lipid Peroxide Levels in Patients with Coronary Artery Disease

Önder KIRIMLI1, Sema GÜNERİ1, Hülya ÖZTÜRE1, Ozan KINAY1, Cem NAZLI1, Banu ÖNVURAL1

In this study, we have determined lipoprotein(a) [Lp(a)] and malondialdehyde (MDA) (a marker of lipid peroxides) levels in patients with eoronary artery disease (CAD) and sought to find an association between CAD and these parameters. The study group was composed of 86 phatients (3 I women, 55 man, mean age 57 ± ıo years) who underwent eoronary angiography. The latter revealed CAD in 62 patients (CAD +) while 24 patients were found to have normal eoronary arteries (CAD-). There were no s ignifieant differenees between the two groups with regard to total eholesterol, triglyceride, HDL-and LDL-eholesterol levels. Lp(a) (37.9 ± 29.5 mg/d! vs 22.3 ± 21.3 mg/di, p=0.008) and MDA (1.58 ± 0.47 mmol/ml vs 1.26 ± 0.38 mmol/ml, p=0.002) levels were signifıeantly higher in patients with CAD. However, we failed to demonstrate a good eorrelation betwecn Lp(a) and MDA levels both in patients with and without CAD (r=0.219, p=0.09). Total e hoıestero ı and MDA levels of patients with diabetes mellitus were significantly higher than those of patients without diabetes (233 ± 47 mg/d! vs 205 ± 55 mg/di, p=0.03; ı .85 ± 0.51 mmol/ml vs ı .37 ± 0.37 mmol/ml, p=0.006; respeetively). Lp(a) levels were also higher in diabetie patients but the difference did not reach signifıcanee. A eorrelation betwecn Lp(a) and· MDA levels did not exist in patients with diabetes (r=0.08, p=0.34). LP(a) levels of diabetic patients with CAD were signifieantly higher than those of diabetie patients with normal coronary arteries (47.9 ± 32.4 mg/di vs 16±3.1 mg/di, p=0.0009). However MDA levels of diabetic patients were not significantly increased in the presence of CAD. Lp(a) and MDA levels were also poorly correlated in diabetic patients with CAD (r=0.02, p=0.29). In conclusion, Lp(a) and MDA levels were shown to be higher in patients with CAD than the patients with normal coronary arteries. Atherogenic characteristics of LP(a) seem to be more important than MDA in diabetic patients with CAD.

Keywords: Coronary artery disease, lipid peroxides, lipoprotein(a)

Önder KIRIMLI, Sema GÜNERİ, Hülya ÖZTÜRE, Ozan KINAY, Cem NAZLI, Banu ÖNVURAL. Lipoprotein(a) and Lipid Peroxide Levels in Patients with Coronary Artery Disease. . 1999; 27(1): 26-30

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