title: Remnant lipoproteinemia is a risk factor for endothelial vasomotor dysfunction and coronary artery disease in metabolic syndrome.
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) and endothelial vasomotor dysfunction 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 coronary artery disease (CAD). Treatment with bezafibrate (n = 20) or atorvastatin (n = 20) for 4 weeks significantly reduced RLP-C levels, with a concomitant improvement in FMD. The % reduction in RLP-C levels from baseline after the treatment was independently correlated with the magnitude of improvement in FMD after adjustment for the % changes in levels of triglyceride, hsCRP, and IL-6, and HOMA index. Thus, elevated levels of RLP-C are a risk factor for CAD and endothelial vasomotor dysfunction, a predictor of coronary events, in metabolic syndrome. Measurement of RLP-C is useful for assessment of CAD risk and therapeutic effects in metabolic syndrome.
authors.affiliation: Department of Internal Medicine II, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, 1110 Shimokato, Nakakoma-gun, Yamanashi 409-3898, Japan.
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Nakamura
authors.forename: Hajime
authors.initials: H
authors.lastname: Takano
authors.forename: Ken
authors.initials: K
authors.lastname: Umetani
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Kawabata
authors.forename: Jyun-ei
authors.initials: JE
authors.lastname: Obata
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kitta
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Kodama
authors.forename: Akira
authors.initials: A
authors.lastname: Mende
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Ichigi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Fujioka
authors.forename: Yukio
authors.initials: Y
authors.lastname: Saito
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Kugiyama
mesh_terms: D000368:Aged; D000924:Anticholesteremic Agents / Q000008:administration & dosage; D000069059:Atorvastatin; D001629:Bezafibrate / Q000008:administration & dosage; D015415:Biomarkers / Q000097:blood; D002784:Cholesterol / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood* / Q000453:epidemiology*; D004730:Endothelium, Vascular / Q000187:drug effects / Q000502:physiology; D005260:Female; D006538:Heptanoic Acids / Q000008:administration & dosage; D006801:Humans; D006951:Hyperlipoproteinemias / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology; D000960:Hypolipidemic Agents / Q000008:administration & dosage; D008074:Lipoproteins / Q000097:blood*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000453:epidemiology*; D008875:Middle Aged; D011758:Pyrroles / Q000008:administration & dosage; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*; D014664:Vasodilation / Q000187:drug effects
chemical_list: D000924:Anticholesteremic Agents; D015415:Biomarkers; D006538:Heptanoic Acids; D000960:Hypolipidemic Agents; D008074:Lipoproteins; D011758:Pyrroles; D014280:Triglycerides; C112017:remnant-like particle cholesterol; D002784:Cholesterol; D000069059:Atorvastatin; D001629:Bezafibrate