首发抑郁症患者糖脂代谢研究

目的:探讨首发抑郁症患者的糖脂代谢情况。方法:对80例首发抑郁症患者及40名健康对照者先进行简易体脂参数的测量,然后进行糖耐量试验(OGTT),并检测其空腹血浆胰岛素、三酰甘油(TG)、总胆固醇(TC)的浓度。结果:体脂参数、空腹血浆胰岛素的浓度、餐后0、1、3h血糖值,两组间差异均无显著统计学意义(P均>0.05);抑郁症组空腹血糖值(FBS)、餐后2h的血糖值、OGTT血糖曲线下面积(AUC)、TG值明显高于对照组(P<0.01);而高密度脂蛋白(HDL-c)、载脂蛋白A1(ApoA1)值抑郁症组明显低于对照组(P<0.01),TC、低密度脂蛋白胆固醇(LDL-c)和载脂蛋白B(ApoB)值两组间差异均无统计学意义(P均>0.05);两组糖耐量减退(IGT)的发生率差异有统计学意义(P<0.05),抑郁症组IGT发生率较对照组高。结论:首发抑郁症患者存在一定的糖脂代谢异常,临床医师应该对抑郁症患者的血糖、血脂进行随访监测,以便早期发现、治疗糖脂代谢性疾病。     

脑梗死与颈动脉粥样斑块及相关生化指标的关系

目的评价脑梗死与颈动脉粥样斑块及其相关生化指标的关系。方法对53例脑梗死患者进行颈动脉彩色超声检查,并取同期住院患者中无脑梗死者53例作为对照组,同时监测两组患者入院24 h内空腹血浆总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、血糖(FBG)及纤维蛋白原(Fib)的含量。结果脑梗死患者颈动脉粥样斑块发生率明显高于对照组,差别有显著性意义(P＜0．05);颈动脉粥样斑块阳性患者与颈动脉粥样斑块阴性患者的TC、TG、Fib及FBG的含量间差别均有显著性意义(P＜0．05)。结论脑梗死的发病与颈动脉粥样斑块的形成密切相关,有效控制血脂、Fib及FBG水平可降低颈动脉粥样斑块发生率;早期干预高血脂、高血糖、颈动脉斑块等对降低脑梗死发病率具有重要临床意义。     

齐拉西酮与奎硫平对首发精神分裂症患者体质量及糖脂代谢影响的对照研究

目的:比较齐拉西酮与奎硫平对精神分裂症患者体质量、糖脂代谢的影响. 方法:将82例精神分裂症患者随机分为齐拉西酮组与奎硫平组,每组各41例,分别给予齐拉西酮和奎硫平治疗6个月.于治疗前和治疗6个月后分别测体质量、空腹血糖及血脂总胆固醇(CHo)、三酰甘油(TG)、低密度脂蛋白(LDL)及高密度脂蛋白(HDL)进行比较. 结果:齐拉西酮组治疗前后各项指标差异无统计学意义(P＞0.05),而奎硫平组治疗6个月后体质量、空腹血糖、CHO及TG显著升高(P＜0.05或P＜0.01). 结论:奎硫平可能对精神分裂症患者体质量、血糖及血脂有较多影响,而齐拉西酮影响较小.     

不同剂量氯氮平与精神分裂症患者血脂、血糖代谢的对照研究

目的　探讨不同剂量氯氮平对精神分裂症患者治疗前后血脂、血糖的影响。方法　87例男性精神分裂症患者分为3组接受氯氮平治疗,低剂量组<150mg/d(30例);中剂量组150 ~300mg/d(29例);高剂量组>300mg/d( 28例)。治疗前及治疗第6周后分别进行葡萄糖耐量试验(OGTT)、血脂检测,并计算体质量指数。结果　治疗第6周后, 3组患者甘油三酯(TG)均升高,差异有统计学意义(F=12 16,P=0 000),其中以低剂量组为著(P<0 05);低剂量组总胆固醇(TC)高于高剂量组(P<0 05);高剂量组高密度脂蛋白胆固醇(HDL)下降和低密度脂蛋白胆固醇(LDL)水平明显升高(P<0 05,P<0 01 )。3组患者血糖于餐后1h升高,差异有统计学意义(F=4 67,P=0 015),其中高剂量组增高明显(P<0 01)。同时,高剂量组OGTT异常的发生率明显高于低剂量组(χ2 =5 087,P=0 024)。3组患者治疗后体质量增加的差异无统计学意义(P>0 05)。未发现体质量增加与血糖、TG、HDL和LDL有明显相关关系(均P>0 05)。结论　氯氮平可导致精神分裂症患者不同程度的血脂水平改变、血糖升高及体质量增加,其程度可能与氯氮平的剂量有关。     

氯丙嗪和阿立哌唑对精神分裂症患者血脂、血糖影响的对照分析

目的探讨氯丙嗪、阿立哌唑对精神分裂症患者治疗前、后的血脂、血糖的影响。方法对30例服用氯丙嗪和29例服用阿立哌唑的精神分裂症患者,在治疗前、治疗8周、16周后的血胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、空腹血糖的进行测定并分析。结果氯丙嗪组血胆固醇、甘油三酯治疗前、后有显著差异（P〈0．05）,低密度脂蛋白的治疗前、后有显著的差异（P〈0．05）,高密度脂蛋白、血糖治疗前、后变化无显著差异;阿立哌唑组治疗前、后血中胆固醇（TC）、甘油三酯（TG）、甘油三酯（TG）、低密度脂蛋白（LDL）、高密度脂蛋白、血糖均无显著差异。结论氯丙嗪可引起精神分裂症患者的脂类代谢异常,阿立哌唑对血脂、血糖的影响较小。     

抑郁症患者单胺类神经递质与血脂的相关性

目的：探讨抑郁症患者血浆单胺类神经递质与血脂的关系。方法：检测55例抑郁症患者和21例正常人的血浆去甲肾上腺素(NE)、5—羟色胺(5—HT)、血清总胆固醉(CH0)、甘油三酯(TG)、高密度脂蛋白—胆固醇(HDL-C)和低密度脂蛋白—胆固醇(LDL-C)。结果：抑郁症患者的血浆5—HT浓度和血清CH0浓度显著低于正常对照组，血浆NE浓度显著高于正常对照组；抑郁症患者的血浆5-HT浓度和血清CH0浓度呈显著正相关，血浆NE浓度与血清HDL-C浓度呈显著正相关。结论：抑郁症患者的血脂代谢异常与血浆单胺类神经递质有关。     

急性脑梗死患者血尿酸变化及临床意义

目的 探讨高尿酸(UA)血症与急性脑梗死(ACl)的关系。方法 将80例ACl患者作为观察组，70例非脑血管病患者作为对照组。结果 观察组和对照组UA异常增高率分别为62．5％和8．57％(P＜0．05)，观察组UA、血脂水平均高于对照组(P＜0．01)，且UA与甘油三酯(TG)水平呈正相关；尿酸水平与病情、预后有关(P＜0．05，0．01)。结论 高尿酸血症可能是ACI危险因子之一，测定血尿酸含量有利于判断病情及评估预后。     

女性精神分裂症患者雌激素水平及其与精神症状及糖脂代谢的关系

目的:探讨女性精神分裂症患者雌激素水平及其与精神症状及糖脂代谢的关系。方法:检测107例未服药或停药超过3个月且月经周期规律的女性精神分裂症患者血清雌激素相关指标;根据雌激素水平分为低雌激素组(n=47)和正常雌激素组(n=60);以阳性和阴性症状量表(PANSS)评估患者的精神症状;检测患者糖脂代谢相关指标(空腹血糖、三酰甘油、总胆固醇、高密度脂蛋白、低密度脂蛋白、载脂蛋白A、载脂蛋白B、脂蛋白α);由空腹血糖及三酰甘油水平计算简易指数(Ty G);分析雌激素水平与精神症状及糖脂代谢的相关性。结果:低雌激素组PANSS总分、一般病理分及空腹血糖水平明显高于正常雌激素组(P均0.05);女性精神分裂症患者雌激素水平与血清高密度脂蛋白、载脂蛋白A水平呈正相关(r=0.303,P=0.002;r=0.329,P=0.001);与Ty G指数呈负相关(r=-0.227,P0.05)。结论:低雌激素水平可能是影响女性精神分裂症患者精神症状及糖代谢异常的危险因素之一。     

抑郁症患者的APOE基因多态性及血脂水平的研究

目的探索载脂蛋白E(apolipoprotein E,APOE)基因多态性与抑郁症之间的关系及其对抑郁症患者脂代谢的影响。方法对92例符合中国精神障碍分类与诊断第三版(CCMD-3)抑郁发作的患者和60例正常对照进行APOE基因分型、测量他们的体重、身高、腰围、臀围,并测定血脂水平,包括总胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL)。以17项汉密尔顿抑郁量表(HAMD17)和汉密尔顿焦虑量表(HAMA)评定抑郁症患者的抑郁、焦虑症状。结果抑郁症与对照组间APOE基因型及等位基因频率无显著差异。抑郁症组中,携带APOEε4等位基因的患者平均TC显著高于不携带APOEε4等位基因的患者,差异有统计学意义(P(0.05)。对照组中,携带APOEε4等位基因者与不携带APOEε4等位基因者相比,体质参数、血脂平均值均无差异(P(0.05)。携带和不携带APOEε4等位基因的抑郁症患者TG值均分别高于携带和不携带APOEε4等位基因的对照组TG值,差异有显著性(P(0.05,P(0.01);携带和不携带APOEε4等位基因的抑郁症患者的HDL值分别比对照组相应者低,差异有显著性(P(0.01,P(0.001);携带APOEε4等位基因的抑郁症患者的HAMD17阻滞项评分高于不携带此等位基因的抑郁症患者,差异有显著性(P(0.05)。结论抑郁症与APOE基因多态性无明显关联。抑郁症患者存在一定的血脂紊乱,尤其是携带APOEε4等位基因的抑郁症患者可能有更多的血脂代谢问题,而且携带APOEε4等位基因的抑郁症患者HAMD17阻滞项评分较高。     

奥氮平替换利培酮对催乳素及糖脂代谢的影响

目的探讨用奥氮平替换利培酮治疗精神分裂症后,催乳素水平及糖脂代谢的变化。方法对52例服用利培酮治疗的精神分裂症患者换为奥氮平治疗8周。于基线及换药后第8周测空腹催乳素、胰岛素、血糖、甘油三酯、胆固醇、脂蛋白及体重。结果换用奥氮平8周后,催乳素水平显著下降,胰岛素、甘油三酯、栽脂蛋白A1、载脂蛋白B水平均显著升高,体重显著增加（均P〈0．05）。总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平略有升高,空腹血糖略有下降,但差异均无统计学意义（均P〉0．05）。结论奥氮平替换治疗能够明显的改善利培酮所致的高催乳素血症,但也可能会引起脂代谢异常。     

Serum cholesterol levels and the risk of multiple system atrophy: A case‐control study

Cholesterol in brain membranes may modulate the conformational state and accumulation of α‐synuclein in α‐synucleinopathies.We examined the association between serum cholesterol and the risk of multiple system atrophy (MSA), one of the α‐synucleinopathies. We enrolled 142 patients with probable MSA from two tertiary referral hospitals and 155 age‐ and gender‐matched healthy people with no neurological disease. The levels of total cholesterol, low‐density lipoprotein cholesterol (LDL‐C), and high‐density lipoprotein cholesterol (HDL‐C) were significantly lower in MSA patients than in controls (total cholesterol: 172.7 vs. 196.3 mg/dL, P < 0.001; LDL‐C: 104.0 vs. 115.3 mg/dL, P = 0.001; HDL‐C: 47.3 vs. 54.2 mg/dL, P < 0.001). After adjusting for age, gender, use of cholesterol‐lowering drugs, and histories of hypertension, diabetes mellitus, and smoking, the odds ratios was 5.9 (95% CI = 2.3–11.5, P < 0.001) for MSA patients in the lowest quartile of total cholesterol and 2.6 (95% CI = 1.2–5.5, P = 0.016) for those in the lowest quartile of HDL‐C, compared with the highest quartiles. Levels of serum cholesterol did not significantly correlate with disease duration or severity. Our data suggest that lower levels of total cholesterol and HDL may be associated with an increased risk of MSA. © 2009 Movement Disorder Society     

血清胆固醇与脑胶质瘤的关系

对37例脑胶质瘤病人及42例住院对照组病人血清脂类及脂蛋白胆固醇进行了分析.结果显示,脑胶质瘤病人血清甘油三酯和总胆固醇含量均明显高于对照组,其中女性病人升高尤为显著.表明血清胆固醇及甘油三酯含量升高与脑胶质瘤的发生、发展有关.     

非高密度脂蛋白胆固醇水平与周围动脉疾病的相关性研究

目的 评估不同非高密度脂蛋白胆固醇（non-high-density lipoprotein cholesterol，non-HDL-C）水平与周 围动脉疾病（peripheral artery disease，PAD）的关系。 方法 本研究纳入2010年6月-2011年6月年龄≥40岁、既往无心脑血管病史的社区人群，收集人口 学信息、血管相关危险因素、生化相关检查等资料。PAD定义为踝臂指数＜0.9；non-HDL-C水平分为： 正常＜4.1 mmol/L，边缘升高4.1～4.9 mmol/L，升高≥4.9 mmol/L；采用单因素和多因素logistic回归分 析non-HDL-C水平与PAD的相关性。 结果 共纳入5132例受试者，平均年龄55.13±11.80岁，男性3214例（60.07%），平均non-HDL-C水平 为3.42±1.00 mmol/L，其中PAD患病率为3.39%（174/5132）。PAD受试者non-HDL-C水平高于无PAD受 试者，但差异无统计学意义（3.51±1.03 mmol/L vs 3.42±1.00 mmol/L，P＞0.05）。进一步多因素分析 结果显示，边缘升高（OR 1.23，95%CI 0.78～1.93，P ＞0.05）和升高non-HDL-C水平（OR 1.24，95%CI 0.60～2.55，P＞0.05）与PAD患病风险无关。 结论 本研究中未发现non-HDL-C与PAD的相关性。     

Plasma HDL cholesterol in epileptics with elevated triglyceride and cholesterol

Due to the metabolic changes induced, e.g. in the liver by anti-epileptic drugs, the significance of high serum triglyceride and cholesterol in epileptics was studied and the plasma HDL cholesterol level was compared in 190 epileptic patients with elevated or normal triglyceride and cholesterol, with the corresponding values in 43 healthy subjects. One-third of the epileptic patients showed elevated plasma HDL cholesterol levels. Female epileptics had higher plasma HDL cholesterol than the normolipidemic healthy subjects. Epileptics with elevated triglyceride or a combination of elevated triglyceride and cholesterol had a lower plasma HDL cholesterol level than normolipidemic patients with epilepsy. HDL cholesterol level in epileptics with high serum cholesterol did not diverge from the level in epileptics with normal serum triglyceride and cholesterol. The results show significant differences of plasma HDL cholesterol between epileptic patients and normolipidemic healthy controls on one hand, and between epileptics with altered and epileptics with normal serum lipid levels on the other. The findings suggest that the increase of plasma HDL cholesterol level in epileptics undergoing anticonvulsant treatment is influenced by endogenous triglyceride metabolism.     

急性脑卒中与脂代谢紊乱的相关性分析

目的探讨急性脑卒中与血脂代谢紊乱的关系。方法收集2006年7月-2008年7月我科收治的符合入选条件的急性脑卒中患者1026例(出血性卒中442例,缺血性卒中584例),对其空腹血脂进行分析。结果急性脑卒中患者血脂异常发生率较高,且本组显示甘油三酯增高明显。其中脑梗死组总胆固醇、甘油三酯、低密度脂蛋白胆固醇的异常率分别达到29.79%、40.58%和28.25%;而脑出血组为30.54%38.69%和29.41%,与对照组比较均有统计学意义。结论血脂代谢紊乱是脑卒中患者发病的重要危险因素之一。     

Biochemical Study of Adrenoleukodystrophy (ALD)

Abstract: Adrenoleukodystrophy (ALD) is an x-linked hereditary neurological disorder characterized by the accumulation of cholesterol ester with long chain fatty acids in the brain and adrenal gland. We examined cholesterol ester metabolism for the postmortem brain tissues of ALD patients, using cholesterol ester with short and long chain fatty acids as the substrate for hydrlyzing enzyme, as well as short and long chain fatty acids for synthesizing enzyme.
No enzyme abnormality was found. However, there was a discrepancy between hydrolytic and synthetic activities with short or long chain fatty acids. The findings suggest that the accumulation of cholesterol ester with long chain fatty acids in ALD brain is not due to enzyme abnormalities, but is a secondary phenomenon which comes from abnormal fatty acid metabolism causing a high concentration of long chain fatty acids.     

LDL-C/HDL-C ratio and risk of all-cause mortality in patients with intracerebral hemorrhage

Background: The low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio has been recognized as a strong risk predictor of cardiovascular diseases. However, the association between the LDL-C/HDL-C ratio and the prognosis of acute intracranial hemorrhage (ICH) is unclear. Thus, we prospectively investigated whether a low LDL-C/HDL-C ratio could predict all-cause mortality and whether LDL-C/HDL-C ratio is superior to traditional lipid profiles in predicting mortality among Chinese patients with acute ICH.

Methods: A prospective cohort study of 356 patients with acute ICH was conducted, and the mean follow-up time point was 80.4 days. Participants were divided into four categories based on LDL-C/HDL-C ratio quartiles. Three-month outcomes were evaluated by in-person or telephone interviews with patients or their family members. The end point was three-month mortality from all causes.

Results: Forty-seven deaths from all causes were documented. The multivariate analysis found that LDL-C/HDL-C ratio [hazard ratio (HR) = 0.49, p = 0.008] and LDL-C (HR = 0.27, p = 0.044) were significantly associated with all-cause mortality. The Kaplan–Meier curves show that patients in the lowest quartiles had the highest cumulative incidence rates (log-rank p = 0.027). After adjusting for covariates, a low LDL-C/HDL-C ratio was associated with a 3.55-fold increase in the risk of all-cause mortality (HR, 3.55 [95% confidence interval, 1.04–12.14]; P-trend = 0.011) when the highest and lowest quartiles were compared. The C-statistic of the LDL-C/HDL-C ratio was significantly larger than other traditional lipid profiles (all p < 0.05).

Conclusions: A low LDL-C/HDL-C ratio was independently associated with an increased risk of all-cause mortality at three months in patients with ICH. Moreover, the LDL-C/HDL-C ratio appeared to be a best lipid predictor of all-cause mortality than traditional lipid profiles.     

Distribution of cholesterol 24-hydroxylase in the monkey brain

Objective

Cholesterol 24-hydroxylase catalyzes the conversion of cholesterol to 24-hydroxycholesterol, which is a major pathway for cholesterol elimination from the brain, since 24-hydroxycholesterol can readily cross the blood brain barrier. The present study aimed to elucidate the distribution of cholesterol 24-hydroxylase in the monkey brain.

Methods

The distribution of cholesterol 24-hydroxylase in the monkey brain was examined using Western blot and immunohistochemistry methods, and was observed under light microscopy and electron microscopy.

Results

High levels of cholesterol 24-hydroxylase were observed in projection neurons and neuropil in structures derived from telencephalon, including the cerebral neocortex, hippocampus, amygdala, nucleus basalis of Meynert, and striatum. Electron microscopy revealed that the enzyme was localized in the axon terminals. One the other hand, cholesterol 24-hydroxylase was expressed at a lower level in the thalamus, globus pallidus and brainstem.

Conclusion

The high level of cholesterol 24-hydroxylase in the telencephalon possibly reflects a high rate of cholesterol turnover in this part of brain.     

Serum cholesterol and aggressive behavior in psychiatrically hospitalized children

The relationship between serum cholesterol and a number of measures of impulsiveness and aggression was examined in 38 prepubertal, psychiatrically hospitalized children. Although care was taken to use reports and direct observations of both variables within 2 weeks of admission and 8 weeks later, no consistent relationship was found. The reasons for these findings are discussed.     

Metabolism of cholesterol and triacylglycerol in cultured chick neuronal cells, glial cells, and fibroblasts: accumulation of esterified cholesterol in serum-free culture

Metabolism of free and esterified cholesterol and triacylglycerol was compared in cultured neuronal cells, glial cells, and fibroblasts grown from chick embryos. Cellular contents of free and esterified cholesterol were comparable in these cells and triacylglycerol content in the neuronal cells was about 40% of that in the other cell types. Cholesterol synthesis from [3H]acetate was high in all these cells and was not affected by fetal calf serum in the culture medium. Monensin, which has been shown to influence cholesterol metabolism through the inhibition of low-density lipoprotein receptor recycling in human fibroblasts, did not induce profound effects on cholesterol metabolism in these cells. Higher incorporation of [3H] oleic acid into esterified cholesterol was observed in the glial cells and fibroblasts when fetal calf serum was removed from the culture medium. Cellular content of the esterified cholesterol also increased in the glial cells under a serum-free arrangement. 25-Hydroxycholesterol induced higher incorporation of both [3H]acetic acid and [3H]oleic acid into esterified cholesterol in all of these cells. The results indicate that the active metabolism of cholesterol found in cultured chick neural cells and fibroblasts may not be regulated by an LDL receptor-mediated system and some factors in fetal calf serum inhibit cellular accumulation of esterified cholesterol.