- 期刊
Plasma Lipid Profiling Increased Cardiometabolic Risks in Acute Myeloid Leukaemia Patients Pre- and Post-chemotherapy
血液脂質分析顯示急性骨髓性白血病人接受治療後增加心臟代謝疾病風險
摘要
Background: Haematological malignancy affects lipid homeostasis representing elevated risks of cardiometabolic diseases. This study investigated the alteration of plasma lipids/lipoproteins and the underlying regulation mechanism. Materials and Methods: Blood samples were collected from acute myeloid leukaemia (AML) patients pre-and post-chemotherapy and matched controls. Triglyceride (TG), total cholesterol (TC), high-density-lipoprotein cholesterol (HDL-c), low-density-lipoprotein cholesterol (LDL-c) and apolipoproteins (apo) were quantified in plasma and lipoprotein-density-gradient fractions. The cardiometabolic risks and lipid loads were assessed. Results: Dyslipidaemia was revealed in 75% of AML patients pre-therapy by reduction of HDL-c and in 85% post-therapy by diverse combined patterns. Compared to the controls, AML patients exhibited increased plasma TG and cardiometabolic risks both pre- and post-therapy. The plasma TC, HDL-c, apoAI, B-100, CIII and J were decreased pre-therapy but were restored post-therapy. The plasma TG concentration was positively correlated with LDL-TG load, whereas plasma TC was positively correlated with HDL-c. Furthermore, the fractionated very-low-density lipoprotein (VLDL)-TG load was lower but LDL-TG load was higher in AML patients than in the controls, suggesting that circulating TG hydrolysis might be impaired from VLDL conversion to LDL. Conclusion: The plasma lipid profiles in AML were aberrant and predicted high cardiometabolic risks, which might need further follow-up attentions.
並列摘要
血液惡性腫瘤影響脂質代謝平衡，導致心臟代謝疾病的風險升高。本研究目的為分析白血病患者治療過程血漿中脂質／脂蛋白的變化，及其潛在的調節機制與疾病的相關性。檢體來源為急性骨髓性白血病（AML）患者化療前後與健康對照組的血液樣本。本研究利用超高速密度梯度離心法分離脂蛋白，通過分析血漿三酸甘油脂（TG）、總膽固醇（TC）、高密度脂蛋白膽固醇（HDL-c）、低密度脂蛋白膽固醇（LDL-c）和載脂蛋白（apo），進行心臟代謝疾病風險評估和脂質恆定測試。分析結果顯示，在治療前，75%的AML患者呈現血脂異常，主要為HDL-c降低；而治療後，則有85%AML患者血脂異常並出現多樣組合模式。與健康對照組相比較，AML患者在治療前和治療後，TG與心血管代謝疾病的風險皆有升高的表現。同時，總膽固醇、高密度脂蛋白膽固醇、載脂蛋白apoAI、載脂蛋白B-100、載脂蛋白CIII和載脂蛋白J在治療前顯著降低，治療後與健康對照組則是沒有顯著差異。相關性分析結果顯示，血漿TG濃度與低密度脂蛋白TG含量，而血漿TC濃度與HDL-c出現正相關。此外，與健康對照組相比，AML患者的極低密度脂蛋白（VLDL）-TG負荷較低，但LDL-TG負荷較高，暗示在VLDL轉化為LDL的過程中TG水解可能受損。本研究結果顯示急性骨髓性白血病患者血液脂質代謝發生異常，可能增加併發心臟代謝疾病的風險，因此需要長期追蹤治療後病人的後續發展。