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Concentraciones elevadas de lipoproteína(a) en plasma en pacientes psiquiátricos: una posible contribución al aumento del riesgo vascular

Published online by Cambridge University Press:  12 May 2020

Enzo Emanuele ,
Maria V. Carlin ,
Angela D’Angelo ,
Emmanouil Peros ,
Francesco Barale ,
Diego Geroldi  and
Pierluigi Politi
Enzo Emanuele
Affiliation:
Laboratorio de Medicina Nuclear, Clinica Medica 2, IRCCS Policlínico San Mateo, Universidad de Pavía, Piazzale Golgi, 2, 27100Pavía, Italia
Maria V. Carlin
Affiliation:
Servicio Psiquiátrico de Diagnóstico y Cura, IRCCS Policlínico San Mateo, ASL, Universidad de Pavía, Pavía, Italia
Angela D’Angelo
Affiliation:
Laboratorio de Medicina Nuclear, Clinica Medica 2, IRCCS Policlínico San Mateo, Universidad de Pavía, Piazzale Golgi, 2, 27100Pavía, Italia
Emmanouil Peros
Affiliation:
Laboratorio de Medicina Nuclear, Clinica Medica 2, IRCCS Policlínico San Mateo, Universidad de Pavía, Piazzale Golgi, 2, 27100Pavía, Italia
Francesco Barale
Affiliation:
Servicio Psiquiátrico de Diagnóstico y Cura, IRCCS Policlínico San Mateo, ASL, Universidad de Pavía, Pavía, Italia
Diego Geroldi
Affiliation:
Laboratorio de Medicina Nuclear, Clinica Medica 2, IRCCS Policlínico San Mateo, Universidad de Pavía, Piazzale Golgi, 2, 27100Pavía, Italia
Pierluigi Politi
Affiliation:
Servicio Psiquiátrico de Diagnóstico y Cura, IRCCS Policlínico San Mateo, ASL, Universidad de Pavía, Pavía, Italia
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Resumen

Se ha comunicado un aumento de la incidencia de acontecimientos cardiovasculares adversos en los pacientes psiquiátricos, pero los mecanismos exactos que subyacen a esta asociación no están claros todavía. La elevación de la concentración de lipoproteána(a) [Lp(a)] en plasma es un factor de riesgo independiente para la enfermedad aterotrombótica en la población general. Para estudiar las implicaciones de la Lp(a) en los pacientes psiquiátricos, medimos las concentraciones de Lp(a) en plasma en 74 pacientes con trastornos psiquiátricos (39 con esquizofrenia, 10 con depresión mayor, 13 con trastorno bipolar y 12 con trastorno de la personalidad) y 74 controles sanos. Las concentraciones de Lp(a) de los grupos de pacientes con esquizofrenia, depresión mayor y trastorno bipolar fueron significativamente más altas que las del grupo de control. La mediana del valor de Lp(a) de estos grupos diagnósticos fue comparable a la comunicada en pacientes con acontecimientos aterotrombóticos anteriores. Por otra parte, no se encontraron diferencias entre el grupo con trastorno de la personalidad y los controles. Nuestros hallazgos indican que la elevación de Lp(a) en plasma puede contribuir a un aumento del riesgo cardiovascular en algunos pacientes con trastornos psiquiátricos.

Keywords

Depresión mayorEsquizofreniaTrastorno bipolarLipoproteína(a)Riesgo cardiovascular
Type
Original
Information
European Psychiatry (Ed. Española) , Volume 13 , Issue 6 , September 2006 , pp. 301 - 306
Copyright
Copyright © European Psychiatric Association 2006

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References

Bibliografía

Albers, JJ, Marcovina, SM, Lodge, MS. The unique lipoprotein(a): properties and immunochemical measurement. Clin Chem 1990;36: 2019–26CrossRefGoogle ScholarPubMed
Anda, R, Williamson, D, Jones, D, Macera, C, Eaker, E, Glassman, A, et al. Depressed affect, hopelessness, and the risk of ischemic heart disease in a cohort of US adults. Epidemiology 1993;4:285–94CrossRefGoogle Scholar
Bihari-Varga, M, Gruber, E, Rotheneder, M, Zechner, R, Kostner, GM. Interaction of lipoprotein Lp(a) and low density lipoprotein with glycosam inoglycans from human aorta. Arteriosclerosis 1988;8: 851–7CrossRefGoogle Scholar
Cassidy, F, Carroll, BJ. Vascular risk factors in late onset mania. Psychol Med 2002;32:359–62CrossRefGoogle ScholarPubMed
Cremer, P, Nagel, D, Labrot, B, Mann, H, Mache, R, Elster, H, et al. Lipoprotein Lp(a) as predictor of myocardial infarction in comparison to fibrinogen, LDL cholesterol and other risk factors: results from the prospective Gottingen Risk, Incidence and Prevalence Study (GRIPS). Eur J Clin Invest 1994;24:444–53CrossRefGoogle Scholar
Hopkins, PN, Wu, LL, Hunt, SC, James, BC, Vincent, GM, Williams, RR. Lipoprotein(a) interactions with lipid and nonlipid risk factors in early familial coronary artery disease. Arterioscler Thromb Vasc Biol 1997;17:2783–92CrossRefGoogle ScholarPubMed
Horrobin, DF, Bennett, CN. Depression and bipolar disorder: relationships to impaired fatty acid and phospholipid metabolism and to diabetes, cardiovascular disease, immunological abnormalities, cancer, ageing and osteoporosis. Possible candidate genes. Prostaglandins Leukotrienses Essent Fatty Acids 1999;60:217–34CrossRefGoogle ScholarPubMed
Imhof, A, Rothenbacher, D, Khuseyinova, N, Hoffmeister, A, Maerz, W, Nauck, M, et al. Plasma lipoprotein Lp(a), markers of haemostasis and inflammation, and risk and severity of coronary heart disease. J Cardiovasc Risk 2003;10:362–70CrossRefGoogle Scholar
Joynt, KE, Whellan, DJ, O’Connor, CM. Depression and cardiovascular disease: mechanisms of interaction. Biol Psychiatry 2003;54:248–61CrossRefGoogle ScholarPubMed
Kojima, S, Harpel, PC, Rifkin, DB. Lipoprotein(a) inhibits the generation of transforming growth factor β: an endogenous inhibitor of smooth muscle cell migration. J Cell Biol 1991;113:1439–45CrossRefGoogle ScholarPubMed
Kostner, GM, Avogaro, P, Cazzolato, G, Marth, E, Bittolo-Bon, G, Quinci, GB. Lipoprotein Lp(a) and the risk for myocardial infarction. Atherosclerosis 1987;38:51–61CrossRefGoogle Scholar
Lippi, G, Guidi, G. Lipoprotein(a): an emerging cardiovascular risk factor. Crit Rev Clin Lab Sci 2003;40:1–42CrossRefGoogle ScholarPubMed
Maes, M. Evidence for an immune response in major depression: a review and hypothesis. Prog Neuropsychopharmacol Biol Psychiatry 1995;19:11–38CrossRefGoogle ScholarPubMed
Maes, M, Bosmans, E, Suy, E, Vandervorst, C, DeJonckheere, C, Raus, J. Depression-related disturbances in mitogen-induced lymphocyte responses and interleukin-lb and soluble interleukin-2 receptor production. Acta Psychiatr Scand 1991;84:379–86CrossRefGoogle Scholar
Maes, M, Van der Planken, M, Van Gastel, A, Desnyder, R. Blood coagulation and platelet aggregation in major depression. J Affect Disord 1996;40:35–40CrossRefGoogle ScholarPubMed
McCreadie, RG, Scottish Schizophrenia Lifestyle Group. Diet, smoking and cardiovascular risk in people with schizophrenia: descriptive study. Br J Psychiatry 2003;183:534–9Google ScholarPubMed
McKenney, J.Niacin for dyslipidemia: considerations in product selection. Am J Health Syst Pharm 2003;60:995–1005CrossRefGoogle ScholarPubMed
Messamore, E, Hoffman, WF, Janowsky, A. The niacin skin flush abnormality in schizophrenia: a quantitative dose-response study. Schizophr Res 2003;62:251–8CrossRefGoogle ScholarPubMed
Milionis, HJ, Mittari, V, Exarchakos, G, Kalaitzidis, R, Skevas, AT, Elisaf, MS. Lipoprotein(a) and acute-phase response in patients with vestibular neuronitis. Eur J Clin Invest 2003;33:1045–50CrossRefGoogle ScholarPubMed
Milionis, HJ, Efstathiadou, Z, Tselepis, AD, Bairaktari, ET, Tsironis, LD, Tsatsoulis, A, et al. Lipoprotein (a) levels and apolipoprotein (a) isoform size in patients with subclinical hypothyroidism: effect of treatment with levothyroxine. Thyroid 2003;13:365–9CrossRefGoogle ScholarPubMed
Miwa, K, Nakagawa, K, Yoshida, N, Taguchi, Y, Inoue, H. Lipoprotein(a) is a risk factor for occurrence of acute myocardial infarction in patients with coronary vasospasm. J Am Coll Cardiol 2000;35: 1200–5CrossRefGoogle ScholarPubMed
Musselman, DL, Evans, DL, Nemeroff, CB. The relationship of depression to cardiovascular disease: epidemiology, biology, and treatment. Arch Gen Psychiatry 1998;55:580–92CrossRefGoogle Scholar
O'connor, CM, Gurbel, PA, Serebruany, VL. Depression and ischemic heart disease. Am Heart J 2000;140:63–9CrossRefGoogle ScholarPubMed
Palabrica, TM, Liu, AC, Aronovitz, MJ, Furie, B, Lawn, RM, Furie, BC. Antifibrinolytic activity of apolipoprotein(a) in vivo: human apolipoprotein(a) transgenic mice are resistant to tissue plasminogen activator-mediated thrombolysis. Nat Med 1995:256–9CrossRefGoogle ScholarPubMed
Plotsky, PM, Owens, MJ, Nemeroff, CB. Psychoneuroendocrinology of depression. Hypothalamic-pituitary-adrenal axis. Psychiatr Clin North Am 1998;21:293–307CrossRefGoogle ScholarPubMed
Politi, P, Piccinelli, M, Klersy, C, Madini, S, Segagni, LG, Fratti, C, et al. Mortality in psychiatric patients 5-21 years after hospital admission in Italy. Psychol Med 2002;32:227–37CrossRefGoogle Scholar
Ramharack, R, Spahr, MA, Kreick, JS, Sekerke, CS. Expression of apolipoprotein[a] and plasminogen mRNAs in cynomolgus monkey liver and extrahepatic tissues. J Lipid Res 1996;37:2029–40Google ScholarPubMed
Rhoads, GG, Dahlen, G, Berg, K, Morton, NE, Dannenberg, AL. Lp(a) lipoprotein as a risk factor for myocardial infarction. JAMA 1986; 256:2540–4CrossRefGoogle ScholarPubMed
Rouy, D, Grailhe, P, Nigon, F, Chapman, J, Angles-Cano, E. Lipoprotein(a) impairs generation of plasmin by fibrin-bound tissue type plasminogen activator: in vitro studies in a plasma milieu. Arterioscler Thromb 1991;11:629–38CrossRefGoogle Scholar
Scanu, AM, Hinman, J. Issues concerning the monitoring of statin therapy in hypercholesterolemic subjects with high plasma lipoprotein(a) levels. Lipids 2002;37:439–44CrossRefGoogle ScholarPubMed
Schaefer, EJ, Lamon-Fava, S, Jenner, JL, McNamara, JR, Ordovas, JM, Davis, CE, et al. Lipoprotein(a) levels and risk of coronary heart disease in men: the Lipid Research Clinics Coronary Primary Prevention Trial. JAMA 1994;271:999–1003CrossRefGoogle ScholarPubMed
Tavares, H, Yacubian, J, Talib, LL, Barbosa, NR, Gattaz, WF. Increased phospholipase A2 activity in schizophrenia with absent response to niacin. Schizophr Res 2003;61:1–6CrossRefGoogle ScholarPubMed
Terres, W, Tatsis, E, Pfalzer, B, Beil, FU, Beisiegel, U, Hamm, CW. Rapid angiographic progression of coronary artery disease in patients with elevated lipoprotein(a). Circulation 1995;91:948–50CrossRefGoogle Scholar
Utermann, G, Kraft, HG, Menzel, HJ, Hopferwieser, T, Seitz, C. Genetics o f the quantitative Lp(a) lipoprotein trait. I. Relation of LP(a) glycoprotein phenotypes to Lp(a) lipoprotein concentrations in plasma. Hum Genet 1988;78:41–6CrossRefGoogle Scholar