高果糖诱导IR大鼠模型血清脂质代谢的改变及意义

目的: 评估高果糖膳食对机体胰岛素敏感性及血清脂质代谢的影响及意义.方法:以高果糖膳食(果糖占总热量34.5%)诱导并经钳夹技术证实建立胰岛素抵抗(IR)大鼠模型,生化比色法测定血清游离脂肪酸(FFA),生化酶法测定血清甘油三酯(TG)及总胆固醇(TC).结果:高果糖膳食喂养4周后,实验组大鼠葡萄糖输注率由(11.5±0.6)mg/kg·min-1下降至(6.6±0.4)mg/kg·min-1(P<0.01);血清FFA由(0.45±0.09)mmol/L增至(0.78±0.19)mmol/L(P<0.01);TG由(0.54±0.10)mmol/L增至(0.96±0.22)mmol/L(P<0.01);TC由(1.96±0.32)mmol/L增至(2.42±0.21)mmol/L(P<0.01).结论:高果糖膳食可导致机体严重IR,是建立IR大鼠模型的有效手段;该模型同时伴有血清脂代谢各相关指标的明显异常,血脂的变化既是IR的结果,也是IR向纵深发展的原因和必要条件.     

两种清除法测定低密度脂蛋白胆固醇的临床评价

目的对表面活性剂清除法 (SUR法 )和过氧化氢酶清除法 (CAT法 )两种低密度脂蛋白胆固醇 (LDL C)均相测定法进行临床评价。方法将上述两种方法与聚乙烯硫酸沉淀法 (PVS法 )进行比较 ,分析各自方法的精密度、准确性、特异性和干扰因素。结果两种清除法与PVS法 (X)具有良好的相关性 ,SUR法 (Y1) :Y1=0 .9311X +0 .10 2 2 ,r =0 .980 1;CAT法 (Y2 ) :Y2 =0 .94 0 1X +0 .0 991,r=0 .9832。高、中、低三种LDL C浓度混合血清所测定结果表明两种方法均具有良好的精密度 ,总CV值SUR法 3.4 5 - 3.89% ,CAT法 3.5 1- 3.99% ,均达到临床满意的程度。两法线性范围均较宽 (线性均至 8.2 2mmol/L) ,最低检测浓度均为 0 .12mmol/L ,平均回收率SUR法为 98.0 % ,CAT法为 97.6 %。TG <14 .2mmol/L ,Hb <5g/L ,HDL C <3.88mmol/L ,胆红素 <4 5 0 μmol/L对两法基本无影响。 结论两种LDL C清除法测定结果的准确度和精密度均符合临床要求 ,适宜自动分析 ,值得在临床推广应用。     

769例教职工血清脂质含量的分析

目的 :检测不同年龄段教职工血清甘油三酯 (TG)及血清总胆固醇 (TC)含量 ,并对各年龄段血脂含量进行分析比较。方法 :将 769例教职工分为 60岁以上、50～ 59岁、40～ 49岁、30～ 39岁、30岁以下五个年龄段组 ,分别用COP -PAP法和CHOD -PAP法测定其血清TG和TC水平。结果 :60岁以上的教职工TG、TC含量显著高于 60岁以下组 (P <0 .0 5) ;30～ 39岁组男性TG、TC含量分别高于同组女性 (P <0 .0 1 ) ,且此组男性TG、TC含量分别高于(除 60岁以上年龄组外 )其它各男性组 ;总体男性TG、TC含量高于总体女性 ,差异有高度显著性 (P <0 .0 1 )。结论 :60岁以上组教职工高血脂发病率明显高于 60岁以下教职工 ;男性教职工高血脂发病率明显高于女性教职工 ;TG、TC含量及高血脂的发病率随年龄增加呈渐进性增高     

High-density lipoprotein subfractions,apolipoproteins and antipyrine clearance in normal subjects

Summary Serum high density lipoprotein (HDL) subfractions HDL₂ and HDL₃, apolipoproteins, and plasma antipyrine clearance (AP-CL) rate, an index of liver microsomal enzyme activity, were determined in 21 healthy subjects. High HDL cholesterol and HDL₂ cholesterol concentrations and HDL cholesterol/cholesterol and HDL₂/HDL₃ cholesterol ratios were associated with high AP-CL. Phenobarbital enhanced antipyrine elimination and increased the apolipoprotein A-I/A-II ratio. Subjects who had high AP-CL had a more antiatherogenic HDL subfraction and apolipoprotein profile than those with low AP-CL.     

Cholesterol atheromatous embolism: an increasingly recognized cause of acute renal failure

BACKGROUND.: Cholesterol atheromatous embolism is a systemic disease resultingfrom cholesterol crystal embolization to many organs, includingthe kidney. Vascular surgery, vascular radiology investigationsand anticoagulation have been identified as inciting factors. METHODS.: Fifteen patients with extensive atherosclerosis, presentingwith simultaneous occurrence of acute renal failure and peripheralischaemic changes were diagnosed as having acute renal failuredue to cholesterol atheromatous embolism. RESULTS.: The patients, 12 men and three women, had an average age of65 years. In one patient, spontaneous occurrence of the diseasewas observed. An inciting factor was identified in 14 patients:aortography in 10, aortic surgery in two, and thrombolysis intwo. Clinical course of acute renal failure was quite variable.Four patients required dialysis; 11 were conservatively managed.All patients had concomitant skin lesions, including digitalmottling, cyanosis and gangrene of the toes, and livedo reticularisof the lower limb and abdomen. Eosinophilia was the most commonlaboratory abnormality. The diagnosis of cholesterol atheromatousembolism was confirmed by tissue examination in eight; in threeit was based on the finding of retinal cholesterol emboli; infourpatients it was made on clinical grounds. Seven patientsdied within 36 months. Death was most commonly from cardiaccauses. CONCLUSIONS.: Since the population at risk for cholesterol embolism is growingand the disease is iatrogenic in origin, we should expect todetect cholesterol embolism with greater frequency as causeof acute renal failure in the future.     

Intakes and major dietary sources of cholesterol and phytosterols in the British diet

Cholesterol intakes in Britain have been re-estimated by analysing Total Diet samples taken in 1991 and from 1993 National Food Survey records. The Total Diet samples contained only 284 mg/day compared with 319 mg/day in 1987 and 337 mg/day in 1981, while the National Food Survey showed intakes had fallen to 238 mg/day from 259 mg/day in 1990 and 405 mg/day in 1970-75. More details of the intakes by adults in 1986/87 are given, and compared with the results from the other methods. Daily intakes of eight phytosterols were also estimated, the main ones being β-sitosterol, campesterol, stigmasterol and 57-stigmastenol whose intakes were 104, 49, 10 and 4 mg/day, respectively, in 1991. These intakes had increased since 1981, reflecting the rising consumption of vegetable oils.     

延边地区警察人群血脂水平

目的了解延边地区警察人群的血脂水平。方法将382例（男350例，女32例；朝鲜族165例，汉族217例）延边少数民族自治州公安局职工作为观察组，将100例健康人群作为对照组，应用日立7600生化分析仪分别测定甘油三酯（TG）、总胆固醇（CHO）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C），并进行对比分析。结果观察组检出血脂异常者220例，占58．9％；对照组28例，占28％，两者差异有统计学意义（Х^2=27．78，P〈0．01），观察组明显高于对照组。此外，观察组中朝鲜族与汉族的血脂异常率差异无统计学意义（P〉0．05），但男女差异显著（P〈0．01）。结论延边地区警察人群的血脂代谢异常率明显高于普通人群，无民族差异，提示该人群应及早加强健康教育和其他预防措施。     

北京市城乡乳母的营养状况、乳成分和婴儿摄入母乳量及生长发育的关系——Ⅲ母乳的脂质分析

本文报导了1983～1984年北京市城区(宣武区),近郊区(西红门)和远郊区(大皮营)母乳脂质成分的测定结果,并结合乳母营养状况给予评价。 共测定了207例母乳比重,平均范围在1.018～1.023之间;测定了216例母乳的脂肪含量(g/100g乳),城区平均值为3.78,近郊区为3.31,远郊区为3.08,城区的显著较高;测定了194例母乳胆固醇含量,初乳的最高(23.4mg/100g乳),以后逐渐减低,到第三个月后达稳定水平(约10mg/100g乳),三个调查点的情况相同,测定了221例母乳的脂肪酸组成,其主要成分为油酸(29～37％),棕榈酸(17～25％)和亚油酸(12～25％),远郊区母乳中所含的必需脂肪酸显著较高。 统计分析证明三个地区的乳脂含量(％)与乳胆固醇含量(mg/100g乳)间有显著性相关(P<0.01);188例乳母的膳食脂肪摄入量(g/日或％kcal)与乳脂含量间也有显著性相关(P<0.05),此结果表明,北京城乡母乳的乳脂含量可能受膳食脂质与量的影响,其脂肪酸组成的特点是亚油酸含量高,反映了我国人民以素食为主的饮食习惯。乳中的必需脂肪酸供给量可满足婴儿所需,胆固醇供给量为70～85mg/d,可作为同龄婴儿自母乳摄入量的参考。     

抑郁症患者的血糖、血脂水平及其与症状关系的对照研究

目的了解抑郁症患者糖脂代谢的情况及其与精神症状的关系。方法以HAMD17和HAMA评定92例近期未服用精神药物的抑郁症患者的精神症状,了解他们简易体质参数、测定其空腹血糖和血脂,并与60例健康者组成的对照组进行比较。结果抑郁症组的甘油三酯(TG)、空腹血糖(FBS)值显著高于对照组(P＜0．001),而高密度脂蛋白胆固醇(LDL—ch)、载脂蛋白A1(ApoA1)值显著低于对照组(P＜0．01)；血浆总胆固醇(TC)、高密度脂蛋白胆固醇(HDL—ch)和载脂蛋白B(ApoB)两组之间无显著性差异(P＞0．05)；相关分析发现,抑郁症患者的HAMA总分、精神性焦虑因子分以及躯体性焦虑因子分与TG水平呈正相关(P＜0．01或P＜0．05)。结论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、血脂进行监测,以便早期发现,早期治疗。     

Reduction of Mortality in the Stockholm Ischaemic Heart Disease Secondary Prevention Study by Combined Treatment with Clofibrate and Nicotinic Acid

Consecutive survivors of a myocardial infarction from the Southern Hospital, below 70 years of age, were randomized into a Control group (n=276) and a Treatment group (n=279). The latter was openly prescribed the combination of clofibrate and nicotinic acid for serum lipid lowering. Each patient should remain in the study for 5 years and be seen regularly every 4 months at a special IHD outpatient clinic within the hospital. The concentration of serum cholesterol and triglyceride was lowered by 13% and 19%, respectively, in the Treatment group compared to the Control group. Total mortality was 82 cases in the Control group and 61 in the Treatment group, a 26% reduction (p<0.05). For patients above 60 years of age in the Treatment group the reduction in mortality was 28% (p<0.05). IHD mortality was reduced by 36% (p<0.01)in the Treatment group compared to the Control group. The beneficial effect of the serum lipid lowering treatment was related to the serum triglyceride concentration in two ways. First, it only occurred in patients with a triglyceride level >1.5 mmol/l (n=216). Secondly, it was most pronounced in the 44% of the treated patients who had a lowering of the serum triglyceride concentration by 30% or more, and in this subgroup the reduction of IHD mortality was 60% (p<0.01). For serum cholesterol there were no such relations. The difference between serum triglycerides and cholesterol concerning these relations to the treatment outcome may be due to the fact that hypertriglyceridaemia was the most common hyperlipidaemia among our patients, occurring in 50%, while hypercholesterolaemia only occurred in 13 %. Caution should be exercised in the interpretation of the results as the trial was not blind. However, the fact that the decrease in IHD deaths was directly related to the degree of serum triglyceride lowering indicates that it was the drug effect on serum lipids that was reponsible for the beneficial effect of the treatment.