| Sažetak (hrvatski) | Ovim se radom želio utvrditi udio nasljednih hiperlipidemija: familijarne hipertrigliceridemije, heterogene familijarne hiperkolesterolemije i familijarne kombinirane hiperlipidemije u osoba koje su preživjele infarkt miokarda, te analizirati osobitosti skupina s nekom od hiperlipidemija. Prospektivnom studijom analizirana su 154 pacijenta koji su 20·30 dana nakon infarkta miokarda liječeni u Thalassotherapiji u Opatiji. Žene su statistički značajno starije (60,0:51,5 godina) od muškaraca. Analizirani su parametri: ukupni lipoproteini, trigliceridi, ukupni kolesterol u serumu, HDL (% i g/l), HDL-kolesterol, HDL-kol/kol,VLDL, LDL (% i g/l), LDL kolesterol, LDL-kolesterol/kolesterol i Q-indeks (LDL+VLDL/ HDL). Ispitanici su podijeljeni u test-skupine po spolu onih s hiperlipidemijom (MhL i ÆhL) i onih koji su preboljeli infarkt miokarda, ali nemaju poremećaj lipida u krvi (Mn i Æn). 76% ispitanika ima neki nasljedni poremećaj lipida, dok je u skupini pacijenata mla- ðih od 40 godina učestalost 83,3%. Najučestaliji (42,9%) tip poremećaja je IIb-kombinirana hiperlipidemija. I muškarci i žene s poremećajem lipida u prosjeku su deset godina mlaði od ispitanika bez poremećaja lipida (MhL:Mn = 42,3:52,3; p<0,00001; ÆhL:Æn = 51,1:62,8; p=0,0014). MhL skupina se u mnogo čemu razlikuje od ostalih testiranih skupina. Ti muškarci imaju statistički značajno više vrijednosti ukupnih lipida, kolesterola, triglicerida,VLDL (g/l) i svih vrijednosti LDL-a, te značajno niži HDL-kolesterol/ kolesterol od ispitanika bez nasljednog poremećaja lipida. Postoji razlika u pobolu od infarkta miokarda srodnika I. stupnja ispitivanih skupina osoba koje imaju poremeÊaj lipida, prema ispitanicima koji nemaju poremeÊaj lipida (48,7%:40,5%), ali ta razlika nema statistiËku značajnost. Vrlo velik genetički rizik, sliËno kao i rizik od dominantno nasljedne bolesti (50%), za infarkt miokarda imaju relativno mlaðe osobe (42±4 godine) s nekom familijarnom hiperlipidemijom i srodnikom I. stupnja, koji je prebolio infarkt miokarda. Rad pokazuje da su nasljedne hiperlipidemije glavni čimbenici rizika infarkta miokarda, posebno mlaðih muškaraca kojima svakako treba posvetiti veću pozornost. |
| Sažetak (engleski) | The aim of this study was to analyse hereditary hyperlipoproteinemias: family hypertriglyceridemia, primary hypercholesterolemia and combined hyperlipidaemia in the patients who had survived the cardiac infarction. 20-30 days after the heart attack, 154 (128 male and 26 female) patients of the Thalassotherapia, Opatija, were divided in several age groups. The female group was statistically older (60.0: 51.5) than male patients. We analysed the serum level of total lipoproteins, triglycerides, total cholesterol, HDL, HDL·cholesterol, HDL·cholesterol/cholesterol, VLDL, LDL, LDL·cholesterol, LDL-cholesterol/cholesterol and index Q (LDL+VLDL/HDL). The patients were also divided in female and male test groups of those with myocardial infarction and hereditary hyperlipidaemias (FhL and MhL) and those with myocardial infarction without hyperlipidaemias (Fn and Mn). 76% of patients had some kind of a hereditary lipid disorder and the frequency is 83.3 % for those who are 40 years old and younger. The most common type (42.9%) is the IIb-combined hyperlypidaemia. Both male and female patients with hereditary hyperlipidaemias are in average 10 years younger than the patients with a normal serum lipid level (MhL:Mn = 42.3:52.3; p< 0.00001; FhL:Fn = 51.1:62.8; p=0.0014). The MhL test group has a statistically significant higher total serum lipids, higher cholesterol serum level, triglycerides, VLDL level (g/l) and all values of serum LDL, while there is a significantly lower level of HDL cholesterol /cholesterol than in the Mn group. The frequency of the first-degree relatives with myocardial infarction of Mn and MhL groups is 40.5% and 48.7% respectively, but the difference is not statistically significant. A very high genetic risk of the myocardial infarction, similarly to a risk of a dominantly inherited disease (50%), have patients of a relatively young age (42±44) with a kind of familial hyperlipidaemia and a firstdegree relative who had suffered the myocardial infarction. This study has showed that hereditary hyperlipidaemias are the most important risk factors for the cardiac infarction, especially for the younger males. |
