Summary
Background. Numerous studies have demonstrated that elevated concentrations of acute-phase
proteins affect red blood cell (RBC) aggregation. Plasma lipids and lipoproteins were
also shown to be correlated with RBC aggregation in hypercholesterolemia. However,
whether acute-phase proteins promote RBC hyperaggregation in hyper-lipidemic patients
is unknown. The main objective of the study was to identify the impact of acute-phase
proteins such as fibrinogen (Fib), haptoglobin (Hp), ceruloplasmin (Cp), α1-acid glycoprotein
(AGP), α1-antitrypsin (AT), immunoglobulin G (IgG), and albumin (Alb) on RBC aggregation
in 35 hyperlipidemic patients. The influence of these proteins in 32 normolipidemic
subjects was also determined.
Methods and Results. RBC aggregation parameters reflecting the kinetics of rouleau
formation and the adhesive strength between RBCs were measured by laser reflectometry.
Multivariate forward stepwise linear regression analyses were performed to study the
relationship between RBC aggregation and these acute-phase proteins, total cholesterol
(TC), triglycerides (TG), high (HDL-C) and low (LDL-C) density lipo-protein cholesterol,
age, gender, body mass index (BMI), mean blood pressure (Mpressure), and smoking habit. The kinetics of rouleau formation was positively correlated
with the linear combination of IgG and Hp (r = 0.76, p <0.0001) in hyperlipidemic
patients, whereas IgG, smoking, AGP and gender were significant independent predictors
in healthy subjects (r = 0.79, p <0.0001). The correlations obtained for the models
predicting the adhesive strength between RBCs were 0.69 in patients (Alb, HDL-C, IgG,
p <0.002) and 0.71 in healthy individuals (AGP, BMI, p <0.0001).
Conclusion. This study suggests that acute-phase proteins such as IgG, Hp, AGP and
Alb influence significantly and in an independent way the level of RBC aggregation.
The close association between RBC aggregation and cardiovascular risk factors further
strengthens its clinical importance.