脳血管障害における血清Lipoprotein(a)およびC<sub>4b</sub> binding Proteinの検討

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  • Lipoprotein(a) and C<sub>4b</sub> Binding Protein in Cerebrovascular Diseases

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We examined serum lipids, lipoproteins including lipoprotein(a) (Lp(a)), apolipoproteins, and C4b binding protein (C4bp) in 262 patients (130 males and 132 females) with cerebrovascular diseases (CVD), consisting of cerebral infarction of cortical artery (16 males/13 females, age; 68.4±11.3 years), cerebral infarction of the perforated artery (12/11, 70.2±8.2), multiple infarctions (39/38, 75.5±8.1), vascular dementia (16/13, 72.9±4.7), cerebral embolism (5/10, 70.1±13.6), cerebral bleeding (35/34, 66.3±11.0), and subarachnoideal bleeding (7/13, 64.9±12.1).<br>Total serum cholesterol and/or LDL-cholesterol levels increased in cerebral infarction, multiple infarction, cerebral embolism and cerebral bleeding, compared with the control subjects. Serum triglycerides levels increased in cerebral infarction, multiple infarction and cerebral bleeding, and subarachnoideal bleeding. Serum HDL-cholesterol levels were low in cerebral infarction, multiple infarction, vascular dementia, cerebral bleeding, and subarachnoideal bleeding.<br>Serum Lp(a) levels were significantly higher in all types of CVD, especially in multiple infarctions and vascular dementia, except cerebral infarction of the perforated artery.<br>C4bp, a regulatory protein in the complement system, has an important role in both the blood coagulation and the fibrinolysis system. Recently, it has been reported that C4bp is identical to prolinerich protein, which has an affinity with several serum lipids. In this study, there was no significant difference in the serum C4bp levels of the control subjects and of the patients with CVD.<br>Serum Lp(a) levels are genetically regulated, and serum Lp(a) is accepted as an independent risk factor of atherosclerotic disease. However, our study showed a positive correlation between serum Lp(a) and C4bp levels. Both proteins were involved in the change in serum lipids, blood coagulation, fibrinolysis, and inflammation. Serum Lp(a) and C4bp levels were probably correlated with each other according to these similarities.

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