Diet and the role of lipoproteins, lipases, and thyroid hormones in coronary lesion growth.
Relationships between lipoprotein fractions, lipoprotein lipase activities, thyroid hormones, and coronary lesion growth were studied among 35 male patients with severe coronary atherosclerosis, who had participated in the Leiden Intervention Trial, a lipid-lowering dietary intervention program. Coronary arteriography was performed at the beginning of the study and again 2 years later at its termination. The lesions were quantified using a computer-based analysis system to assess the progression rate of coronary lesions based on absolute arterial dimensions in a patient's coronary tree. For this reason an absolute coronary score was computed. Based on absolute coronary scores, patients could be divided into a no-lesion growth group (14 patients) and a progression group (21 patients). Lipoprotein fractions, lipoprotein lipases, and thyroid hormones were determined at the end of the trial. No significant differences were found between the no-lesion growth and progression groups for total cholesterol and low-density lipoprotein (LDL) cholesterol. In the progression group very-low-density lipoprotein (VLDL) cholesterol and triglycerides were significantly higher (p less than 0.05) and high-density lipoprotein (HDL) cholesterol was almost significantly lower (p = 0.058). Hepatic lipase (HL) values were significantly higher in the no-lesion growth group, when compared with the progression group, whereas lipoprotein lipase (LPL) values were not significantly different. Triiodothyronine (T3) was significantly lower (p less than 0.01) in the progression group. Multivariate regression analysis showed HL to be the most important determinant of changes in coronary atherosclerotic lesions. T3 and HDL cholesterol were also independently inversely related to coronary lesion growth.(ABSTRACT TRUNCATED AT 250 WORDS)