Abstract

Lipoprotein(a) (Lp(a)) and Low-density lipoprotein cholesterol (LDLc) is an important risk factor for atherosclerotic cardiovascular disease. The objective of this study was to determine the impact of Lp(a) concentration both on the indirect analytical measurement of LDLc and on the efficacy of dyslipidaemia treatment using the atorvastatin statin. Two retrospective studies were conducted, one with 340 patients and another with 107 patients treated with atorvastatin. Lp(a) concentrations were measured by turbidimetry with an assay independent of the size of the apo(a) isoform. LDLc was calculated using the Friedewald equation and the corrected LDLc was calculated using the Dahlén equation. A strong positive correlation was observed between the serum Lp(a) concentration and the LDLc-overestimation percentage (r = 0.960, p < .001). It was also observed that as the Lp(a) concentration rose there was no significant variation in the percentage decrease in corrected LDLc during atorvastatin treatment (r = 0.186, p > .05). The concentration of LDLc obtained by using the Friedewald equation included Lp(a) cholesterol. The lowering of LDLc in patients treated with atorvastatin depended solely on accessible LDL cholesterol and not on Lp(a) cholesterol.

摘要

脂蛋白（a）（Lp（a））和低密度脂蛋白胆固醇（LDLc）是动脉粥样硬化性心血管疾病的重要危险因素。本研究的目的是确定 Lp(a) 浓度对 LDLc 的间接分析测量和使用阿托伐他汀治疗血脂异常的疗效的影响。进行了两项回顾性研究，一项涉及 340 名患者，另一项涉及 107 名接受阿托伐他汀治疗的患者。Lp(a) 浓度是通过浊度法测量的，其测定与 apo(a) 异构体的大小无关。使用 Friedewald 方程计算 LDLc，并使用 Dahlén 方程计算校正后的 LDLc。在血清 Lp(a) 浓度和 LDLc 高估百分比之间观察到强烈的正相关关系 ( r = 0.960，p  < .001）。还观察到，随着 Lp(a) 浓度升高，在阿托伐他汀治疗期间校正后的 LDLc 降低百分比没有显着变化（r  = 0.186，p  > .05）。使用 Friedewald 方程获得的 LDLc 浓度包括 Lp(a) 胆固醇。在接受阿托伐他汀治疗的患者中，LDLc 的降低完全取决于可获得的 LDL 胆固醇，而不是 Lp(a) 胆固醇。