Negatively charged very-low-density lipoprotein (VLDL-χ) in metabolic syndrome (MetS) patients exerts cytotoxic effects on endothelial cells and atrial myocytes. Atrial cardiomyopathy, manifested by atrial remodeling with a dilated diameter, contributes to atrial fibrillation pathogenesis and predicts atrial fibrillation development. The correlation of VLDL-χ with atrial remodeling is unknown. This study investigated the association between VLDL-χ and remodeling of left atrium. Consecutively, 87 MetS and 80 non-MetS individuals between 23 and 74 years old (50.6% men) without overt cardiovascular diseases were included in the prospective cohort study. Blood samples were collected while fasting and postprandially (at 0.5, 1, 2, and 4 h after a unified meal). VLDL was isolated by ultracentrifugation; the percentile concentration of VLDL-χ (%) was determined by ultra-performance liquid chromatography. The correlations of left atrium diameter (LAD) with variables including VLDL-χ, LDL-C, HDL-C, triglycerides, glucose, and blood pressure, were analyzed by multiple linear regression models. A hierarchical linear model was conducted to test the independencies of each variable’s correlation with LAD. The mean LAD was 3.4 ± 0.5 cm in non-MetS subjects and 3.9 ± 0.5 cm in MetS patients (P < 0.01). None of the fasting lipid profiles were associated with LAD. VLDL-χ, BMI, waist circumference, hip circumference, and blood pressure were positively correlated with LAD (all P < 0.05) after adjustment for age and sex. Significant interactions between VLDL-χ and blood pressure, waist circumference, and hip circumference were observed. When adjusted for obesity- and blood pressure-related variables, 2-h postprandial VLDL-χ (mean 1.30 ± 0.61%) showed a positive correlation with LAD in MetS patients. Each 1% VLDL-χ increase was estimated to increase LAD by 0.23 cm. Postprandial VLDL-χ is associated with atrial remodeling particularly in the MetS group. VLDL-χ is a novel biomarker and may be a therapeutic target for atrial cardiomyopathy in MetS patients. ISRCTN 69295295 . Retrospectively registered 9 June 2020.

中文翻译：

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餐后极低密度脂蛋白在代谢综合征的心房重构发展中的作用。

代谢综合征（MetS）患者中带负电荷的极低密度脂蛋白（VLDL-χ）对内皮细胞和心房肌细胞产生细胞毒性作用。心房型心肌病，以直径扩大的心房重构表现出来，有助于心房颤动的发病机理，并预测心房颤动的发展。VLDL-χ与心房重构的相关性未知。本研究调查了VLDL-χ与左心房重构之间的关系。连续地，前瞻性队列研究包括了23到74岁之间的87位MetS和80位非MetS患者（男性占50.6％），没有明显的心血管疾病。禁食时和餐后（统一餐后0.5、1、2和4小时）收集血液样本。VLDL通过超速离心分离；通过超高效液相色谱法测定VLDL-χ的百分比浓度（％）。通过多元线性回归模型分析了左心房直径（LAD）与包括VLDL-χ，LDL-C，HDL-C，甘油三酸酯，葡萄糖和血压在内的变量的相关性。进行了分层线性模型以测试每个变量与LAD的相关性的独立性。非MetS患者的平均LAD为3.4±0.5 cm，MetS患者的平均LAD为3.9±0.5 cm（P <0.01）。空腹血脂谱均与LAD无关。调整年龄和性别后，VLDL-χ，BMI，腰围，臀围和血压与LAD呈正相关（所有P <0.05）。观察到VLDL-χ与血压，腰围和髋围之间存在显着的相互作用。在对肥胖和血压相关变量进行调整后，MetS患者餐后2小时VLDL-χ（平均1.30±0.61％）与LAD呈正相关。估计每增加1％VLDL-χ将使LAD增加0.23 cm。餐后VLDL-χ与心房重构有关，尤其是在MetS组中。VLDL-χ是一种新型的生物标志物，可能是MetS患者房性心肌病的治疗靶标。ISRCTN 69295295。追溯登记为2020年6月9日。VLDL-χ是一种新型的生物标志物，可能是MetS患者房性心肌病的治疗靶标。ISRCTN 69295295。追溯登记为2020年6月9日。VLDL-χ是一种新型的生物标志物，可能是MetS患者房性心肌病的治疗靶标。ISRCTN 69295295。追溯登记为2020年6月9日。