Delayed intravascular catabolism of chylomicron-like emulsions is an independent predictor of coronary artery disease.
The atherogenic role of a delayed intravascular catabolism of chylomicrons has been suggested by univariate analysis of case-control studies. However, it is not established whether this association is caused by a direct atherogenic effect of these lipoproteins or results from the presence of concurrent and metabolically-related coronary artery disease (CAD) risk factors. In this study, the plasma kinetics of a chylomicron-like emulsion doubly labeled with 14C-cholesteryl oleate (CE) and 3H-triolein (TG) was determined in 93 subjects with or without angiographically-defined CAD. As compared with controls and even after adjustment for body mass index (BMI), LDL- and HDL-cholesterol, and the presence of traditional risk factors, CAD patients had 45% smaller fractional clearance rate (FCR) of TG, 41% smaller FCR-CE and 19% smaller dilapidation index (DI; P < 0.05). Among CAD patients, those with highest angiographic score had 66% smaller FCR-TG (P = 0.007), 50% smaller FCR-CE (P = 0.01) and 27% smaller DI (P = 0.004). In a multivariate logistic regression analysis, FCR-CE (P < 0.0001) and DI (P = 0.001) were the only independent predictors for the presence of CAD. In conclusion, we presently show that the rate of lipolysis and removal from the circulation of chylomicron-like emulsions constitutes an independent predictor of CAD and a marker of CAD severity.
Sposito
Andrei C
AC
Heart Institute (InCor), University of São Paulo Medical School, Hospital, Av. Dr. Eneas Carvalho Aguiar 44, 1o Andar, 5403.900 São Paulo, Brazil.
Ventura
Laura I
LI
Vinagre
Carmen G
CG
Lemos
Pedro A
PA
Quintella
Edgard
E
Santos
Raul D
RD
Carneiro
Otavio
O
Ramires
Jose A F
JA
Maranhão
Raul C
RC
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002250:Carbon Radioisotopes; D016022:Case-Control Studies; D002788:Cholesterol Esters / Q000378:metabolism; D002914:Chylomicrons / Q000378:metabolism*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000209:etiology* / Q000473:pathology*; D004655:Emulsions; D005260:Female; D006801:Humans; D007700:Kinetics; D008074:Lipoproteins / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D014304:Triolein / Q000378:metabolism
D002250:Carbon Radioisotopes; D002788:Cholesterol Esters; D002914:Chylomicrons; D004655:Emulsions; D008074:Lipoproteins; D014304:Triolein; C014409:cholesteryl oleate