Melahat DİRİCAN, Emre SARANDÖL, Dilek YEŞİLBURSA, Akın SERDAR, Zehra SERDAR

Koroner arter hastalığında lesitin: Kolesterol açiltransferaz ve kolesterol ester transfer protein aktivitelerinin araştırılması

Ters kolesterol taşınımında rol oynayan üç önemli faktör; yüksek dansiteli lipoprotein (high density lipoprotein, HDL), lesitin: Koles¬terol açiltransferaz (lecithine: Cholesterol acyl-transferase, LCAT) ve kolesterol ester transfer protein (cholesterol ester transfer protein, CETP)'dir. Bu faktörlerle ilgili çeşitli bozuk¬luklar koroner arter hastalığı gelişiminden so¬rumlu tutulmaktadır. Çalışmaya alman, koro¬ner anjiyografileri yapılmış 96 olgudan 20'si tek damar, 20'si iki damar, 23'ü üç damar lez-yonuna sahipti. 33 olgu da ise herhangi bir lez-yon saptanmadı. LCAT ve CETP aktivitesi ile total kolesterol, HDL-K, HDL2-K, LDL-K, li¬poprotein (a), apolipoprotein Al ve B düzey¬lerinde kontrol grubu ile koroner arter hastaları arasında anlamlı farklılıklar bulundu. Koroner arter hastalarında HDL-K ile LCAT aktivitesi arasında anlamlı pozitif korelasyon, HDL-K ile CETP aktivitesi arasında da anlamlı negatif korelasyon olduğu saptandı. Ayrıca, koroner stenozdaki artışla birlikte HDL-K ve HDL2-K düzeylerinin ve LCAT enzim aktivitesinin anlamlı olarak azaldığı, CETP aktivitesinin ise anlamlı olarak arttığı gözlendi. Bu çalışmada, koroner arter hastalarında HDL-K düzeylerini düşük, LCAT enzim akti-vitesini azalmış ve CETP aktivitesini artmış olarak bulmamızın yanısıra, koroner damarlar¬da saptadığımız stenozun LCAT ve CETP akti-viteleriyle anlamlı korelasyon göstermesi de bozulan ters kolesterol taşınımmm koroner ar¬ter hastalığı gelişiminden sorumlu olabileceği görüşünü destekler nitelikte bulundu

Investigation of lecithine: Cholesterol acyltransferase and cholesterol ester transfer protein activities in coronary artery disease

Background and Design.- High density lipoprotein (HDL), lecithine: Cholesterol acyltransferase (LCAT) and cholesterol ester transfer protein (CETP) are three important factors that play role in the reverse cholesterol transport. Disturbances related to these factors have been proposed to be responsible for the development of coronary artery disease. The subjects angiographically examined (total n= 96) were divided into four groups: those who had >50% luminal stenosis in single (n=20), double (n= 20) and triple (n= 23) coronary arteries and those who had normal (n= 33) coronary arteries. Results.- LCAT and CETP activities and total cholesterol, HDL-C, HDL2-C, low density lipoprotein-cholesterol, lipoprotein (a), apolipoprotein (apo)-AI and apo B levels had been found significantly different between subjects with coronary artery disease and those with normal coronary arteries. In patients with coronary artery disease, there were significant positive correlation between HDL-C and LCAT activity and significant negative correlation between HDL-C and CETP activity. In addition, HDL-C, HDL2-C levels and LCAT activity were significantly decreased and CETP activity was significantly increased as the severity of coronary stenosis increased. Conclusion.- Decreased HDL-C levels might be in connection with decreased LCAT activity and enhanced CETP activity; and as a result it might be concluded that impaired reverse cholesterol transport may be responsible for the development of coronary artery disease.

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