2005 Fiscal Year Final Research Report Summary
Clinical significance of remnant lipoproteinemia as a therapeutic target of cardiovascular diseases
| Project/Area Number |
15390244
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Circulatory organs internal medicine
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| Research Institution | University of Yamanashi |
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Principal Investigator |
KUGIYAMA Kiyotaka University of Yamanashi, Department of Research Interdisciplinary Graduate School of Medicine and Engineering, Professor, 大学院・医学工学総合研究部, 教授 (00225129)
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| Co-Investigator(Kenkyū-buntansha) |
UMETANI Ken University of Yamanashi, University of Yamanashi Hospital, Assistant Professor, 医学部附属病院, 講師 (40262654)
TAKANO Hajime University of Yamanashi, University of Yamanashi Hospital, Assistant Professor, 医学部附属病院, 講師 (20362064)
KAWABATA Kenichi University of Yamanashi, Depatmnent of Researth Interdisciplinary Graduate School of Medicine and Engineering, Research Associate, 大学院・医学工学総合研究部, 助手 (30345706)
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| Project Period (FY) |
2003 – 2005
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| Keywords | Remnant lipoprotein / Cardiovascular diseases / Endothelial dysfunction / Metabolic syndrome / Carotid plaque |
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| Research Abstract |
This study aimed to determine whether elevated levels of remnant lipoprotein, an atherogenic triglyceride-rich lipoprotein, might be associated with coronary artery disease (CAD), endothelial vasomotor dysfunction, and future stroke in metabolic syndrome. The fasting serum levels of remnant lipoproteins (remnant-like lipoprotein particles cholesterol ; RLP-C) were measured by an immunoseparation method in 210 patients with metabolic syndrome meeting ATP III criteria. Flow-mediated endothelium-dependent dilatation (FMD) in the brachial artery during reactive hyperemia was examined by high-resolution ultrasound technique. This study found that elevated RLP-C levels were a significant and independent risk factor for impaired FMD and angiographically proven CAD. Kaplan-Meier analysis demonstrated that higher RLP-C levels resulted in a higher probability of ischemic stroke (P=0.02 by log-rank test). A multivariate Cox hazard analysis showed that high RLP-C levels were a significant predictor of a future ischemic stroke that was independent of components of the metabolic syndrome and other traditional atherosclerotic risk factors (odds ratio 3.2, 95% CI 1.2-8.1, P<0.01). Furthermore, high RLP-C levels were a significant risk of echolucent carotid plaques, assessed by carotid ultrasound with the integrated backscatter (IBS) analysis (intima-media IBS value minus adventitia IBS【less than or equal】-16 dB) that was independent of components of metabolic syndrome and other traditional atherosclerotic risk factors (odds ratio 4.3, 95% CI 1.6-6.7, P<0.01). Treatment with bezafibrate (n=20) or atorvastatin (n=20) for 4 weeks significantly reduced RLP-C levels, with a concomitant improvement in FMD. Thus, elevated levels of RLP-C are a risk factor for CAD, endothelial vasomotor dysfunction, a predictor of coronary events, and stroke in metabolic syndrome. Measurement of RLP-C is useful for assessment of risk of cardiovascular diseases and therapeutic effects in metabolic syndrome.
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Research Products
(21 results)
