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2008, Number 4

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Arch Med Fam 2008; 10 (4)

Relationship between the Mean Diameter of the Subfractions of Cholesterol LDL with the Clinical Parameters in Patients of High Cardiovascular Risk of a Center of Health

Granero FE, Hernández MA, Albaladejo OMD, Parra PS, Moreno RS, Martinez HP, Tebar MFJ

Language: Spanish
References: 23
Page: 147-153
PDF size: 83.52 Kb.


ABSTRACT

Objectives: To establish the possible relationship of the average diameter of LDL subfractions (dmsfLDL), as a manifestation of increased cardiovascular risk (RCV) with indicators of handling more common in the asistencial. Material and Methods: We performed an observational study descriptive prevalence conducted at Primary care. They include 150 patients in family medicine, LDL subfractions obtained with the Quantimetrix Lipoprint System® using electrophoresis tube with polyacrylamide gel to 3%. Results: The concentration of triglycerides is the variable that most affects the forecast for the presence of the pattern B in a patient with an odds ratio of 1.02. The "quotient TG / HDL" is proof that better diagnosis explains and predicts the emergence of a pattern B sfLDL because the 75 percentile of the values of variable get a sensitivity of 76% a specificity of 86% with a predictive value 0.70 positive, negative predictive value of 0.90 and a percentage of hits 84%, for a value ratio equal to 3.5. Conclusions: You can make a fairly reliable approximation to dmsfLDL with simple analytical parameters (LDL cholesterol and triglycerides).


REFERENCES

  1. Grundy SM, Pasternak R, Greenland P, Smith S Jr, Fuster V. Assessment of cardiovascular risk by use of multiple-risk-factor assessment equations: a statement for healthcare professionals from the American Heart Association and the American College of Cardiology. Circulation. 1999 Sep 28;100 (13):1481-92.

  2. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001; 285: 2486-97.

  3. Otvos JD, Jeyarajah EJ, Cromwell WC. Measurement issues related to lipoprotein heterogeneity. Am J Cardiol. 2002;17;90(8A):22i-29i.

  4. Austin MA, King MC, Vranizan KM, et al Atherogenic lipoprotein phenotype: a proposed genetic marker fot coronary heart desease risk. Circulation 1990;82:495-06.

  5. Ambrosch A, Dierkes J, MühlenI et al. LDL size distribution in relation to insulin sensivity and lipoprotein pattern in young healtht subjets. Diabetes care 1998;21:2077-84.

  6. Rainwater DL. Lipoprotein correlates of LDL particle size. Atherosclerosis 2000;148:152-58.

  7. American Diabetes Association: Clinical Practice Recommendatios 2000. Diabetes Care 2000;23 (Suppl 1):S20.

  8. Krauss RM, Burke DJ. Identification of multiple subfractions of plasma low density lipoproteins in normal humans. J Lipid Res 1982;23:97- 104.

  9. Lamarche B, St Pierre AC, Ruel IL, et al. A prospective, population-based study of low density lipoprotein particle size as a risk factor for ischemic heart disease in men. Can J Cardiol. 2001;17:859–65.

  10. Lamarche B, Tchernof A, Dagenals GR et alSmall, dense LDL particles and the risk of ischemic heart disease. Prospective results from the Quebec Cardiovascular Study. Circulation 1997, 95: 69-75.

  11. Freedman DS, Otvos JD, Jeyarajah EJ, Shalaurova I, Cupples LA, Parise H, D'Agostino RB, Wilson PW, Schaefer EJ. Sex and age differences in lipoprotein subclasses measured by nuclear magnetic resonance spectroscopy: the Framingham Study. Clin Chem. 2004 Jul;50(7):1189-2000.

  12. Granero E, Hernández AM, Albaladejo MD, Parra S, Abenza P, Granero M, Martinez P, Tebar J. Síndrome Metabólico ¿Algo más que un instrumento clínico? Poster presentado a la 3ª Conferencia Internacional Mediterránea sobre riesgo cardiovascular. Murcia (España) 27-28 de abril 2007.

  13. Granero E, Hernández AM, Albaladejo MD, Parra S, Abenza P, Granero M, Martinez P, Tebar J. LDL subfractions diameter in patients with metabolic syndrome and high cardiovascular risk. Poster session at Wonca Europe 2007 Conference Paris October 17-20.2007.

  14. Sniderman AD, Scantlebury T, Cianflone K. Hypertrycliceridemic Hyperapo B: unappreciated atherogenic dysliporpoteinemia in type 2 diabetes melliyus. Ann Intern Med 2001;135:447-59.

  15. Boizel R, Benhamou PY, Lardy B, Laporte F, Foulon T, Halimi S.Ratio of triglycerides to HDL cholesterol is an indicator of LDL particle size in patients with type 2 diabetes and normal HDL cholesterol levels. Diabetes Care. 2000 Nov;23(11):1679-85.

  16. Vega GL. Obesity, the metabolic syndrome and cardiovascilar desease. Am Heart J 2001;142:1108-16.

  17. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J, Lisheng L; INTERHEART Study Investigators Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937-52.

  18. Walldius G, Jungner I, Aastveit AH, Holme I, Furberg CD, Sniderman AD.The apoB/apoA-I ratio is better than the cholesterol ratios to estimate the balance between plasma proatherogenic and antiatherogenic lipoproteins and to predict coronary risk. Clin Chem Lab Med. 2004;42(12):1355-63.

  19. Lemieux I, Pascot A, Couillard C, Lamarche B, Tchernof A, Almeras N, Bergeron J,Gaudet D, Tremblay G, Prud'homme D, Nadeau A, Despres JP.Hypertriglyceridemic waist: A marker of the atherogenic metabolic triad(hyperinsulinemia; hyperapolipoprotein B; small, dense LDL) in men? Circulation. 2000 Jul 11;102(2):179-84.

  20. LaMonte MJ, Ainsworth BE, DuBose KD, Grandjean PW, Davis PG, Yanowitz FG,Durstine JL. The hypertriglyceridemic waist phenotype among women Atherosclerosis. 2003 Nov;171(1):123-30.

  21. Blake GJ, Otvos JD, Rifai N, Ridker PM. Low-density lipoprotein particle concentration and size as determined by nuclear magnetic resonance spectroscopy as predictors of cardiovascular disease in women.Circulation. 2002 Oct 8;106(15):1930-7.

  22. Waldius G, Jungner I, Holme I, Aastvei A, Kolar W, Steiner E. High apolipoprotein B, low apolipoprotein A-I, and improvement in predictión offatal myocardial infarction (AMORIS study): a prospective study. Lancet 2001;358:2026-33

  23. Ulzurrun E, Rioja J, Ariza M, Gonzalez-Alegre C, Garcia-Arias C, Gonzalez-Santos P. Evaluación de los cocientes TRG / HHDL y LDL-C / APO-B 100 como estimadores de la concentración de colesterol en LDL pequeñas y densas en pacientes Diabéticos tipo 2. Comunicación Oral al XVII Congreso de la Sociedad Española de Arteriosclerosis. Murcia 2-5 junio 2004.




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