Anjiografi ile koroner kalp hastalığı tanısı konmuş kişilerde serum lipid, apoprotein, lipoprotein ve HDL subfraksiyonlarının incelenmesi
Serum lipid, apoprotein, lipoprotein and HDL subfraction analysis in patients with coronary artery diseases diagnosed angiographically
Yazar: SERVET KIZILDAĞ (İNAN)
Danışman: PROF.DR. MERAL FADILOĞLU
Dokuz Eylül Üniversitesi / Sağlık Bilimleri Enstitüsü / Biyokimya Ana Bilim Dalı
Derece: Yüksek Lisans, 1997
Konu: Biyokimya = Biochemistry
Dizin: Apoproteinler = Apoproteins ; Ateroskleroz = Atherosclerosis ; Koroner hastalık = Coronary disease ; Lipoproteinler = Lipoproteins

Özet:
ÖZET ANJİYOGRAFÎ ÎLE KORONER KALP HASTALIĞI TANISI KONMUŞ KİŞİLERDE SERUM LİPİD, APOPROTEİN, LİPOPROTEİN VE HDL SÜBFRAKSİYONLARININ İNCELENMESİ SERVET (İNAN) KIZILDAĞ Tüm dünyada, koroner kalp hastalığına yol açan ateroskleroz ve bunun komplikasyonlarına bağlı ölümler başlıca ölüm nedenlerinden biridir. Yüksek kan trigliserid ve total kolesterol düzeyleri bu hastalığın gelişiminde temel risk fektörlerindendirler. Ateroskleroz gelişiminde serum lipoproteinlerinden HDL kolesterol ve LDL kolesterol rol oynamaktadır. Yüksek serum LDL kolesterol ve düşük HDL kolesterol düzeyleri de önemli risk faktörleridir. Bir çok görüş HDL kolesterol düzeylerindeki azalmanın gerçekte HDL2 fraksiyonundaki düşmeden kaynaklandığını savunmaktadır. Lipoproteinlerin protein komponenti olan apoproteinler, lipoproteinlerin kendilerine özgü reseptörlere bağlanmasında rol oynarlar ve lipoprotein metabolizmasında önemli bir yere sahiptirler. Bu çalışmada; KKH ve aterosklerozun gelişiminde serum lipid, lipoprotein ve apoproteinleri ile birlikte HDL subfraksiyonlannm kantite edilmesi yöntemini labratuvanmıza ve rutine yerleştirmeyi ve elde edilen sonuçlan bir kontrol grubu ile karşılaştırarak incelemeyi amaçladık. Çalışmamız, anjiyografik olarak KKH tanısı konmuş 43 erkek (yaş;59"9±10.3) ve 10 kadın (yaş;60.6±8.4) hastadan oluşan hasta grupları ile sağlıklı 9 erkek (yaş;57.5±12.8) ve 11 kadın (yaş;56.1±l 1.5) bireyden oluşan kontrol grupları üzerinde gerçekleştirildi Hasta ve kontrol gruplarında açlık serum trigliserid, total kolesteroL HDL kolesterol, HDL? kolesterol, HDL3 kolesterol, LDL kolesterol, Apo AT, Apo B düzeyleri ve Total kolesterol/ HDL, HDL2/HDL3, Apo AI/Apo B, Apo B/Apo Al oranlan saptandı. Bu değerler; KKH grubunda erkek olgularda sırasıyla; 168.9±78.6*, 237.6*72.6*, 34.2*8.3*, 12.6*6.0*, 21.6*6.3*, 171.1*67.8*, 104.3*16.3*, 120.4*29.3*, 7.3*2.6, 0.6±0.4, 0.8*0.1, 1.2±0.2, KKII grubunda kadın olgularda sırasryla; 149.1*36.2*, 260.6*28.4*, 31.0*6.5*, 11.3*4.0*, 19.7*5.6*, 199.8*27.0 *, 106.7*17.6*, 129.1*29.1*, 8.2*2.1, 0.6*0.3, 0.8*0.2, 1.2*0.3, 1Kontrol grubunda erkek olgularda sırasıyla; 124.3±71.0 *, 196.7±30.2*, 46.5±16.6*, 21.7Ü1.7*, 24.7±10.5*, 125.3±32.4*, 113.6±24.5*, 99.Ü32.9*, 4.7±1.8, 1.

Abstract:
SUMMARY SERUM LIPID,APOPROTElN, LIPOPROTEIN AND HDL SUBFRACTION ANALYSIS IN PATIENTS WITH CORONARY ARTERY DISEASES DIAGNOSED ANGIOGRAPHICALLY SERVET (İNAN) KIZILDA? Atherosclerosis, which causes coronary artery disease, and its complications are the leading cause of the death throughout the world. High trigliyceride and total cholesterol levels are the main risk factors in the development of the disease. High serum LDL and low HDL levels are also important risk factors in the development of atherosclerosis. Many authors claim that low HDL levels is due to decreased HDL2 fraction. Apoproteins, which are protein components of lipoproteins, are responsible for binding of lipoproteins to their specific receptors and they have a vital role in lipoprotein metabolism. In this study, we have proposed to study the role of serum lipid, lipoprotein, apoproteins and HDL subtractions in the development of coronary artery disease and atherosclerosis and we have compared the results of the patient group with those of the control group. 43 male (age 59.9±10.3) and 10 female (age 60±8.4) in patient group and 9 healthy male (age 57.5±12.8) and 1 1 healthy female (age 56.5+1 1.5) in control group were included in the study. Fasting serum triglyceride, total cholesterol, HDL cholesterol, HDL2 cholesterol, HDL3 cholesterol, LDL cholesterol, apo AI, apo B levels and total cholesterol/HDL, HDL2/HDL3, apo AI/apo B, apo B/apo AI ratios were studied in patient and control groups. These results were as follows in males with coronary artery disease; 168.9±78.6*, 237.6*72.6*, 34.2±8.3*, 12.6±6.0*, 21.6±6.3*, 171.1±67.8*, 104.3±16.3*, 120.4±29.3*, 7.3±2.6, 0.6±0.4, 0.8±0.1, 1.2±0.2, These results were as follows in females with coronary artery disease; 149.1±36.2*, 260.6±28.4*, 31.0±6.5*, 11.3±4.0*, 19.7±5.6*, 199.8±27.0*, 106.7±17.6*, 129.Ü29.1*, 8.2±2.1, 0.6±0.3, 0.8±0.2, 1.2±0.3, These results were as follows in males control group; 124.3±71.0*, 196.7±30.2*, 46.5±16.6*, 21.7±11.7*, 24.7Ü0.5*, 125.3±32.4*, 113.6±24.5*, 99.1±32.9*, 4.7±1.8, 1.0±0.6, 1.3±1.0, 0.9±0.3, These results were as follows in female control group; 151.4±35.1*, 219.1±44.5*, 37.0±9.1*, 16.0±9.6*, 21.0±6.9*, 151.8±40.7*, 110.9±22.2*, 119.Ü31.9*, 6.0±1.4, 0.8±0.7, 0.9±0.3, 1.1±0.3. In males with coronary artery disease triglycerid (p=0.0277), total cholesterol (p=0.0418), LDL cholesterol (p=0.0226), apo B(p=0.0Q44) levels and total cholesterol/HDL (p?=0.0021), apo B/apo AI (p=0.0118) ratios were increased whereas HDL cholesterol (p=0.0277), HDLa cholesterol (p=0.0226), HDL3 cholesterol (p=0.0431), apo AI (p=O.0339) levels and HDL2/HDL3 (p=Q.Q421), apo AI/apo B (pK).0171) ratios were decreased when compared with that of control groups. In females with coranary artery disease total cholesterol (p=0.0357), LDL cholesterol (p=0.0101), apo B (p=0.0467) levels and total cholesterol/HDL (p=0.0295), apo B/apo AI (p=0.0387) ratios were increased and HDL cholesterol (p=0.0410), HDL2 cholesterol (p=0.0340), apo AI (p=0.0349) levels and apo AI/apo B (p=0.0386) ratios were decreased when compared with that of control groups. We could not obtain statistically significant difference when we compared in females triglyceride (p=0.7045), HDL3 cholesterol (p=1.000) level and HDL2/HDL3 (p=0.9725) ratio with that of control group. All data shows that HDL2 and HDL3 cholesterol levels have an important role in the development of atherosclerosis and determination of HDL2, HDL3 levels and HDL2/HDL3 ratio is a invalid tool to identify atherosclerosis risk profile. It also shows that total cholesterol/HDL, apo AI/apo B, apo B/apo AI are more valuable than sole lipoprotein levels. (*) : mg/dl Key words: Atherosclerosis, CAD, HDL subfractions, Lipoproteins, Apoproteins