Abstract

OBREGON, OSWALDO et al. C REACTIVE PROTEIN (CRP), LEVELS OF MALONIL-DIALDEHYDE (MDA) AND INSULIN RESISTANCE IN EVOLUTION OF ACUTE ATHEROTHROMBOTIC EVENTS IN PATIENTS WITH LOW LEVELS HIGH DENSITY LIPOPROTEIN (HDL). rev.fac.med [online]. 2007, vol.15, n.2, pp.163-169. ISSN 0121-5256.

The High Density Lipoprotein (HDL) has antiinflammatory, antioxidant and antithrombotic properties. Low levels of HDL in patients who recovering from a miocardial necrosis and stroke, are associated with an unfavorable prognosis, and had established an important role of HDL in the injury process during ischemia and reperfusion. We evaluated 59 patients that entered with clinical symptoms of atherothrombotics disease (36 with low HDL and 23 with normal levels). Our objective was to measure the levels of C Reactive Protein (CRP) in the entrance, 48 hours after and 3 months later to determine the insulin resistance (HOMA) and oxidative stress by malonil-dialdehyde (MDA). Patients with lower HDL show higher levels of PCR and a pike at 48 hours that was not observed in the group with normal HDL. The MDA in patients with low level HDL were higher. The HOMA was positive in 73% women with acute atherothrombotic disease and low HDL and in 65% of the men with low HDL. It was concluded that: the inflammation is greater at 48 hours of the acute event in patients with low HDL when ischemia and delayed reperfussion occurred; oxidation stress (MDA) continues high after three months of treatment with statin unable to elevate the levels of HDL: and that the resistance to the insulin is present in a great percentage of these patients with a dysfunctional HDL.

Keywords : high density lipoprotein; C reactive protein; atherothrombolism; insulin resistance; malonil-dialdehyde.