LIPOPROTEINS AND APOLIPOPROTEINS IN THE YOUNG AND FAMILIAL RISK OF CORONARY ATHEROSCLEROSIS

The aim of this study was to assess the predictive value of lipoprotei ns and apolipoproteins at a young age for the development of coronary artery disease at middle and older ages. Because children of coronary artery disease patients are at high risk themselves we compared lipopr otein and apolipoprotein levels between the offspring of parents with and without coronary artery disease. We selected a group of male patie nts (n = 90), who had severe coronary atherosclerosis at angiography, and a reference group of male controls (n = 62), who had no coronary a theroselerosis at angiography. Lipoprotein and apolipoprotein levels w ere determined in 115 sons and 73 daughters of the patients with sever e coronary atherosclerosis. These were compared to levels in 68 sons a nd 47 daughters of controls. Additionally, lipoprotein and apolipoprot ein levels were compared between patients and controls as well as betw een their spouses. In sons of patients, lower levels of HDL, cholester ol (- 0.07 mmol/l, standard error of the mean (SEM) 0.03, P < 0.05) an d apolipoprotein A2 (- 5.1 mg/dl (SEM, 1.4), P < 0.001) were found com pared to sons of controls. Similar differences were observed in daught ers of such patients without, however, achieving statistical significa nce. No significant differences between the groups of offspring were f ound for total cholesterol, LDL cholesterol, HDL and HDL(2) cholestero l, triglycerides and apolipoproteins A-I and B. Patients had higher le vels of total (group difference 0.6 mmol/l (SEM, 0.18), P < 0.001) and LDL cholesterol (0.6 mmol/l (SEM, 0.17), P < 0.001), triglycerides (0 .6 mmol/l (SEM, 0.16), P < 0.001) and apolipoprotein B (21.2 mg/dl (SE M, 5.1), P < 0.001), and lower HDL cholesterol (0.1 mmol/l (SEM, 0.04) , P < 0.05) than controls. Spouses of patients had higher levels of tr iglycerides (0.23 mmol/l (SEM, 0.11), P < 0.05). Our findings add to t he growing evidence that predictors for atherosclerotic disease can be detected relatively early in life. It is concluded that reduced level s of HDL(3) cholesterol and apolipoprotein A2 may be early risk indica tors for coronary atherosclerosis later in life.