Elevated levels of serum lipoprotein(a) and apolipoprotein(a) phenotype are not related to pre-eclampsia.

BACKGROUND: Pre-eclampsia might result from a less effective invasion of trophoblast cells in the myometrium, caused by attenuated immunosuppression in the spiral arteries, resulting from inhibition of plasmin-mediated activation of transforming growth factor-beta-like substances. In vitro evidence indicates that lipoprotein(a) is capable of inhibiting plasmin-mediated activation of transforming growth factor-beta. Thus, high plasma levels of lipoprotein(a) might result in increased incidence of preeclampsia. METHODS: The patient group consisted of 39 patients with a history of pre-eclampsia in a previous pregnancy: Forty-seven women without pre-eclampsia in their history and matched for age were the control group. All participants gave their informed consent. In both the patient and control group blood pressure, CRP, urinalysis, cholesterol, HDL-cholesterol, triglycerides, lipoprotein(a) level and apolipoprotein(a) phenotype were determined. RESULTS: None of the participants had elevated CRP levels, excluding acute phase related elevations of lipoprotein(a). Proteinuria was present in 33% of patients and in 11% of controls (p=0.01). However, no relation was observed between proteinuria and Lp(a) level. Median Lipoprotein(a) levels in both groups were equal (300 mg/l vs. 275 mg/l; p=0.48), as well as the apo(a) phenotype distribution in both groups. CONCLUSIONS: Lipoprotein(a) and apolipoprotein(a) phenotype do not contribute significantly to the pathogenesis of pre-eclampsia.

Lipids, apolipoprotein-E genotypes and other risk factors of patients with coronary artery disease in Curaçao.

We studied lipids, apolipoprotein-E (apo-epsilon) genotypes and other coronary artery disease (CAD) risk factors of 67 CAD patients (male/female ratio 5) in Curaçao. Compared with 57 controls, male CAD patients had higher cholesterol, triglycerides, LDL-cholesterol, apo-B and decreased HDL-cholesterol and HDL-cholesterol/cholesterol concentrations. Other CAD risk factors were: increased fasting glucose and HbA1c concentrations, decreased creatinine clearance, and increased prevalences of lipoprotein (a) concentration > 500 mg/l, renal disease, hyperhomocysteinaemia, diabetes mellitus type II (DM-II), positive CAD family history and cigarette smoking. Male CAD patients had higher plasma alpha-tocopheroleq. Compared with 29 female controls, female CAD patients had higher fasting plasma glucose and HbA1c concentrations, and prevalence of DM-II. Predicting factors for CAD development in the whole CAD group were: DM-II, cigarette smoking, apo-epsilon 3/epsilon 4 and apo-epsilon 4/epsilon 4 Apo-epsilon 4 was associated with lower HDL- and higher LDL-cholesterol concentrations. There is a need for local studies on improvement of diabetic control, reference values of lipoprotein (a) and homocysteine concentrations, on apolipoprotein (a) phenotypes, causes of hyperhomocysteinaemia, and dietary influences on CAD development in subjects who carry the apo-epsilon 4 allele.

The dietary fatty acids of patients with coronary artery disease and controls in Curaçao. Implications for primary and secondary prevention.

Patients with coronary artery disease are advised to augment their dietary linoleic acid intakes at the expense of saturated fatty acids. We investigated whether the dietary linoleic acid intake of 57 patients with coronary artery disease (47 males, 10 females; ages 61 +/- 10 years) in Curaçao is higher as compared with 77 controls (51 males, 26 females; ages 56 +/- 7 years). For this, we measured plasma cholesterol ester fatty acids, which reflect the dietary fatty acid composition of the preceding weeks. Patients with coronary artery disease and controls had minor differences in cholesterol ester fatty acids. Their cholesterol ester linoleic acid content suggests that the dietary polyunsaturated/saturated fatty acid ratio is far below 1. Comparison with data reported for The Netherlands, Greenland and Crete showed that the dietary fatty acid composition in Curaçao is typically Western with a high intake of saturated fatty acids, a low intake of monounsaturated fatty acids and the consumption of linoleic acid as the predominant polyunsaturated fatty acid. Intake of long chain polyunsaturated fatty acids from fatty fish is low. Reduction of dietary saturated fatty acids, augmentation of fish consumption, and an increase of the alpha-linolenic/linoleic acid ratio are likely to be of benefit to both primary and secondary prevention from coronary artery disease in Curaçao.

The dietary fatty acids of patients with coronary artery disease and control in Curacao: implications for primary and secondary prevention

Patients with coronary artery diseases are advised to augment their dietary linoleic acid intakes at the expense of saturated fatty acids. We investigated whether the dietary linoleic acid intake of 57 patients with coronary artery disease (47 males, 10 females; ages 61 ñ 10 years) in Curacao is higher as compared with 77 controls (51 males, 26 females; ages 56 ñ 7 years). For this, we measured plasma cholesterol ester fatty acids, which reflect the dietary fatty acid composition of the preceeding weeks. Patients with coronary artery disease and controls had minor differences in cholesterol ester fatty acids. Their cholesterol ester linoleic acid content suggests that the dietary polyunsaturated/saturated fatty acid ratio is far below 1. Comparison with data reported for the the Netherlands, Greenland and Crete showed that the dietary fatty acid composition in Curacao is typically Western with a high intake of saturated fatty acids, a low intake of monounsaturated fatty acids and the consumption of linoleic acid as the predominant polyunsaturated fatty acid. Intake of long chain polyunsaturated fatty acids from fatty fish is low. Reduction of dietary saturated fatty acids, augmentation of fish consumption, and an increase of the O-linolenic/linoleic acid ratio are likely to be of benefit to both primary and secondary prevention from coronary artery disease in Curaco.(AU)

Lipids, apoliprotein-E genotypes and other risk factors of patients with coronary artery disease in Curacao

We studied lipids, apolipoprotein-E (apo-E) genotypes and other coronary artery disease (CAD) risk factors of 67 CAD patients (male/female ratio 5) in Curacao. Compared with 57 controls, male CAD patients had higher cholesterol, triglycerides, LDL-cholesterol, apo-B and decreased HDL-cholesterol and HDL-cholesterol/cholesterol concentrations. Other CAD risk factors were: increased fasting glucose and Hba concentration, decreased creatinine clearance, and increased prevalences of lipoprotein (a) concentration > 500 mg/l, renal disease, hyperhomcysteinaemia, diabetes mellitus type II (DM-II), positive CAD family history and cigarette smoking. Male CAD patients had higher plasma O-tocopherol. Compared with 29 female controls, female CAD patients had higher fasting plasma glucose with HbA concentrations, and prevalence of DM-II. Predicting factors for CAD development in the whole CAD group were: DM-II, cigarette smoking, apo-E/E and apo-E/E Apo-E was associated with lower HDL-and higher LDL-cholesterol concentrations. There is a need for local studies on improvement of diabetic control, reference values of lipoprotein (a) and homocysteine concentrations, on apolipoprotein (a) phenotypes, causes of hyperhomocysteinaemia, and dietary influences on CAD development in subject who carry the apo-E allele.(AU)

Lipids, apoliprotein-E genotypes and other risk factors of patients with coronary artery disease in Curacao

We studied lipids, apolipoprotein-E (apo-E) genotypes and other coronary artery disease (CAD) risk factors of 67 CAD patients (male/female ratio 5) in Curacao. Compared with 57 controls, male CAD patients had higher cholesterol, triglycerides, LDL-cholesterol, apo-B and decreased HDL-cholesterol and HDL-cholesterol/cholesterol concentrations. Other CAD risk factors were: increased fasting glucose and Hba concentration, decreased creatinine clearance, and increased prevalences of lipoprotein (a) concentration > 500 mg/l, renal disease, hyperhomcysteinaemia, diabetes mellitus type II (DM-II), positive CAD family history and cigarette smoking. Male CAD patients had higher plasma Ó-tocopherol. Compared with 29 female controls, female CAD patients had higher fasting plasma glucose with HbA concentrations, and prevalence of DM-II. Predicting factors for CAD development in the whole CAD group were: DM-II, cigarette smoking, apo-E/E and apo-E/E Apo-E was associated with lower HDL-and higher LDL-cholesterol concentrations. There is a need for local studies on improvement of diabetic control, reference values of lipoprotein (a) and homocysteine concentrations, on apolipoprotein (a) phenotypes, causes of hyperhomocysteinaemia, and dietary influences on CAD development in subject who carry the apo-E allele.

The dietary fatty acids of patients with coronary artery disease and control in Curacao: implications for primary and secondary prevention

Patients with coronary artery diseases are advised to augment their dietary linoleic acid intakes at the expense of saturated fatty acids. We investigated whether the dietary linoleic acid intake of 57 patients with coronary artery disease (47 males, 10 females; ages 61 ñ 10 years) in Curacao is higher as compared with 77 controls (51 males, 26 females; ages 56 ñ 7 years). For this, we measured plasma cholesterol ester fatty acids, which reflect the dietary fatty acid composition of the preceeding weeks. Patients with coronary artery disease and controls had minor differences in cholesterol ester fatty acids. Their cholesterol ester linoleic acid content suggests that the dietary polyunsaturated/saturated fatty acid ratio is far below 1. Comparison with data reported for the the Netherlands, Greenland and Crete showed that the dietary fatty acid composition in Curacao is typically Western with a high intake of saturated fatty acids, a low intake of monounsaturated fatty acids and the consumption of linoleic acid as the predominant polyunsaturated fatty acid. Intake of long chain polyunsaturated fatty acids from fatty fish is low. Reduction of dietary saturated fatty acids, augmentation of fish consumption, and an increase of the Ó-linolenic/linoleic acid ratio are likely to be of benefit to both primary and secondary prevention from coronary artery disease in Curaco.

[Prevalence of discrepant lipid levels in Curaçao]. / Prevalentie van afwijkende lipideconcentraties op Curaçao.

OBJECTIVE: To assess the prevalence of lipid risk factors in Curaçao and to investigate possible interactions with socioeconomic and demographic variables. DESIGN: Cross-sectional population-based study. SETTING: Public Health Laboratory and Public Health Service, Curaçao, Netherlands Antilles. METHODS: In a random sample of persons aged 18 years and over from the population of Curaao, serum levels were measured of total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides and, in a smaller number of samples, of lipoprotein(a) (Lp(a)). The findings were in persons between 20 and 60 years compared with those reported for a random sample from the Netherlands. Multiple regression analysis was used to study the relationship between the total cholesterol values found and various socio-economic variables (age, sex, education, place of residence, race). RESULTS: Among persons aged 20-59 years serum cholesterol levels were > 6.5 mmol/l in 30 of the 288 male participants (11%) and in 42 of the 427 female participants (10%). Fifty-three of the males (18%) had HDL cholesterol levels < 0.9 mmol/l as against 31 of the females (7%). The distributions of both total cholesterol and HDL cholesterol levels was better in Curaao than in the Netherlands, among males aged 20-29 years and males and females over 40 years of age. The median Lp(a) concentration of the 225 participants of Curaao in whom it was measured was 250 mg/l, as against 80 mg/l in the Dutch group. More advanced age, female sex, higher educational level, negroid race and residence in the 'East District' were correlated with a higher serum level of total cholesterol. CONCLUSIONS: Both total cholesterol and HDL cholesterol concentrations were favourable in Curaçao compared with the Netherlands, especially in the elderly population.

Lipids, apolipoprotein-E genotypes and other risk factors of patients with coronary artery disease in Curacao, the Netherlands Antilles - abstract

We studied lipids, apolipoprotein-E genotypes (apoe) and other coronary artery disease (CAD) risk factors of 67 CAD patients (male/female ratio 6) in Curacao. Compared with 57 controls, male CAD patients had higher cholesterol, triglycerides, LDL-cholesterol, apo-apo-B, apo-B/apo-Al, and decreased HDL-cholesterol and HDL-cholesterol/cholesterol. Other CAD risk factors were increased fasting glucose, HbA1c and prevalences of renal disease, diabetes mellitus type II (DM-II), positive CAD family history and cigarette smoking. Male CAD patients had higher plasma O-tocopherol eq but normal plasma O-tocopherol eq/ total lipid and á-carotene/total lipid; 38.5 percent of male CAD patients and 37.8 percent of male controls had Lp(a) above 300 mg/l. Compared with 29 female controls, female CAD patients had higher fasting plasma glucose, HbA 1c and prevalences of renal disease and DM-II. Predicting factors for CAD development in the whole CAD group were DM-II, cigarette smoking, apo-i3/i4 and apoi4. Apo-i was associated with lower DLH-and higher LDL-cholesterol. We conclude that classical atherogenic lipid profiles are associated with CAD in Curacao. It is questionable whether Lp(a) contributes to CAD in a predominantly negroid population. DM-II may considerably contribute to CAD development, notably in women. Apoi4, possibly because of induction of atherogenic lipid profile, is likely to be a risk factor (AU)

Influence of apolipoprotein(a) phenotype on lipoprotein(a) quantification: evaluation of three methods.

Three commercially available assays (an enzyme-linked immunosorbent assay ELISA, an immunoradiometric assay, IRMA, and a nephelometric assay) for the determination of lipoprotein(a) [Lp(a)] were compared with respect to the dependency of these assays on the various apolipoprotein(a) [apo(a)] isoforms. Although there was a strong correlation between the three methods, a significant difference between the absolute values (mg/L) was observed (p < 0.001). Using purified Lp(a) preparations, we showed that the ELISA assay quantifies the Lp(a) concentration on a molar basis, independently of the apo(a) isoform size. The IRMA and the nephelometric assay however are apo(a) isoform size dependent and overestimate the Lp(a) concentration of large apo(a) isoforms whereas the amount of small apo(a) isoforms is underestimated. In general, the isoform dependency of the Lp(a) quantification is of limited clinical relevance. In this study, inconsistent risk assignments are made in approximately 3% of the cases, when the Lp(a) concentrations obtained with the apo(a) isoform dependent assays are compared with the isoform independent ELISA.

Sulfhydryl compounds influence immunoreactivity, structure and functional aspects of lipoprotein(a).

Human plasma Lp(a) is susceptible to various sulfhydryl compounds. In this study we present evidence indicating that after treatment of Lp(a) with sulfhydryl compounds, immunoreactivity is changed, structural changes occur and functional characteristics regarding the numerous kringle structures in apo(a) disappear. Purified Lp(a) was subjected to variable concentrations (0.01-10 mM) of various sulfhydryl compounds: DTT, 2-mercapto-ethanol (BME), N-acetylcysteine (NAC) and homocysteine (HCys). Free SH groups were blocked by iodoacetamide. Reduced and alkylated Lp(a) was tested in two ELISAs, one detecting apo(a) alone and one detecting apo(a)-apoB complexes. In both ELISAs polyclonal antibodies were used. For comparison a commercial apo(a) IRMA utilizing two monoclonal antibodies was used. The results indicate that a similar decrease in response of both ELISAs is observed, whereas the IRMA response is less affected. Western blotting of "DTT treated" Lp(a) after SDS-PAGE under nonreducing conditions showed that separate apo(a) and apoB-100 bands became detectable at 1 mM DTT. Native PAGE (2.5-16%) indicated structural changes of Lp(a) beginning to occur at 0.03 mM DTT. Epsilon-aminocaproic acid-inhibitable binding of "DTT-treated" Lp(a) to Desafib-X decreased with increasing DTT concentrations in concert with a loss of the capacity of Lp(a) to inhibit plasminogen activation upon treatment with DTT. The observed immunological and functional changes of Lp(a) indicate that apo(a) kringle function is severely affected by sulfhydryl compounds.