Lecithin: cholesterol acyltransferase (LCAT) deficiency and risk of vascular disease: 25 year follow-up.
We have reassessed the clinical and biochemical status of a large Canadian kindred with LCAT deficiency 25 years after the initial investigations. There have been no vascular events or death in this family over the 25 years. Both the homozygous (N = 2) and heterozygous (N = 9) patients had highly abnormal lipid profiles with low HDL-C (extreme in the homozygotes); apo B levels were high in the heterozygotes. Lipoprotein and hepatic lipase activities were low in the homozygotes and several heterozygotes. In the two homozygotes the carotid intima media thickness (IMT) was above 75th percentile expected for age and gender. However, the IMT abnormalities were much more pronounced in the heterozygotes, four of whom also had detectable plaques. The homozygotes had only minimal increases in IMT, no plaques, no IMT changes over the last 4 years and normal endothelial function. We conclude that, in this kindred, no significant vascular changes were observed in the homozygotes. However, heterozygocity for LCAT deficiency is associated with both an atherogenic lipid profile and vascular abnormalities.
Ayyobi
Amir F
AF
Healthy Heart Program, St. Paul's Hospital, University of British Columbia, 1081 Burrard Street, Suite 180-20, Vancouver, BC, Canada V6Z 1Y6.
McGladdery
Sandra H
SH
Chan
Sammy
S
John Mancini
G B
GB
Hill
John S
JS
Frohlich
Jiri J
JJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D001055:Apolipoproteins B / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006579:Heterozygote; D006720:Homozygote; D006801:Humans; D007863:Lecithin Cholesterol Acyltransferase Deficiency / Q000150:complications*; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D010375:Pedigree; D010713:Phosphatidylcholines / Q000097:blood; D014463:Ultrasonography; D014652:Vascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology*
D001055:Apolipoproteins B; D008075:Lipoproteins, HDL; D010713:Phosphatidylcholines; C037978:high density lipoprotein phosphatidylcholine