Lipoprotein (a) and apoprotein B in an apparently healthy population of fighter pilots and ground personnel: their significance as potential markers of atherosclerosis

Background Individuals who carry cardiovascular risk factors (CVRF) have a higher incidence of cardiovascular pathology, Among the most commonly scree ned CVRF are apoprotein A and B and lipoprotein (a), which represent 'indep endent' risk factors for atherosclerosis. In the air force community cardio vascular pathology has been reported as the primary reason for grounding pi lots. Design The aim of this study was to evaluate the frequency of CVRF in an ap parently healthy population of military fighter pilots (group B, n=50), and military ground personnel (group A, n=50) who were matched for age, sex an d body mass index but not involved in flight activity, and to evaluate whet her any particular pattern of CVRF might be related to flight Methods Each subject fasted overnight, and underwent the following measurem ents: blood pressure and resting ECG recording; and determination of serum levels of total and high-density lipoprotein cholesterol, triglycerides, ur ic acid and plasma levels of glucose. In addition, serum levels of apolipop rotein A, B and lipoprotein (a) were detected. Results An overall risk index for coronary artery disease was calculated us ing the Framingham equation, This risk index was slightly but not significa ntly increased in group A compared with group B. By contrast, a significant increase in both apoprotein B (P<0.005) and lipoprotein (a) (P<0.0005) was found in group B compared with group A. No significant differences between groups were detected for the other parameters evaluated. Conclusions We suggest the presence in group B of an underlying trend towar ds the development of atherosclerosis, which may not be identified by a rou tine approach, Moreover, on a purely theoretical basis with no experimental evidence, the issue of the possible pathophysiological mechanism of these findings and their relationship to flight environment is also addressed. J Cardiovasc Risk 6:99-104 (C) 1999 Lippincott Williams & Wilkins.