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1.
目的探讨脂蛋白a[Lp(a)]联合单核细胞/高密度脂蛋白胆固醇(HDL-C)比值(MHR)在非ST段抬高型急性冠脉综合征(NSTE-ACS)患者冠状动脉(冠脉)病变严重程度及预后中的评估及其价值。方法选择2020年3月至2021年3月安徽医科大学第一附属医院符合纳入标准的NSTE-ACS患者(n=310),依据冠脉造影结果进行Gensini评分,以Gensini积分的第3四分位数(QU=38)为切点,分为高危组(QU≥38,n=74)和非高危组(QU<38,n=236),比较其一般资料,并使用Logistic回归分析Lp(a)、MHR与冠脉病变严重程度的相关性;使用ROC曲线评估Lp(a)联合MHR评估冠脉病变严重程度及预后的价值。结果高危组和非高危组患者性别、吸烟史、高血压病、糖尿病、高胆固醇血症、肾功能不全等病史、他汀药物应用发生率差异无统计学意义(P>0.05),但高危组患者年龄、血Lp(a)水平和MHR均显著高于非高危组(P<0.01)。Spearman相关分析发现,Lp(a)和MHR分别与Gensini评分呈正相关(r=0.316,P<0.05;r=0.715,P<0.05)。Logistic多因素二元回归分析示,Lp(a)、年龄和MHR是冠脉高危病变的独立危险因素(P<0.01,P<0.05)。ROC曲线分析示,Lp(a)和MHR联合检测对冠脉高危病变评估的AUC(0.854),分别大于Lp(a)和MHR单独检测的AUC(0.852、0.754);联合评估的敏感度73.0%,高于单独检测Lp(a)的55.6%,但低于MHR的82.4%;联合评估的特异度85.6%,高于Lp(a)及MHR单独检测(84.1%、61.9%)。ROC曲线分析示,Lp(a)和MHR联合对NSTE-ACS患者不良预后评估的AUC(0.800),分别大于Lp(a)和MHR单独检测的AUC(0.781、0.739);联合评估患者预后的敏感度为72.2%,高于Lp(a)及MHR单独检测(66.7%、66.7%);联合评估的特异度为81.9%,高于MHR单独检测的80.9%,但低于Lp(a)单独检测的84.8%。结论异常升高的血Lp(a)水平联合MHR对NSTE-ACS患者冠脉病变的严重程度和不良预后具有较高的判断价值。  相似文献   
2.
王华  何雄 《天津医药》2022,50(8):827-831
目的 探究护心通络方通过调控胆固醇脂转运蛋白(CETP)抗兔动脉粥样硬化(AS)的效果及作用机制。方法 将40只雄性新西兰兔按照随机数字表法分为空白对照组、AS模型组、辛伐他汀组[0.33 mg/(kg·d)]、护心通络方组[0.34 g/(kg·d)],每组10只。空白对照组予普通饲料喂养22周,其他3组予高脂饲料喂养14周后分组给药干预8周。实验前、给药14周、给药22周检测血清高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、三酰甘油(TG)水平。第22周末处死动物,分离胸主动脉,苏木素-伊红(HE)染色观察病理改变。实时荧光定量PCR法(qPCR)和蛋白免疫印迹检测肝脏腺苷三磷酸结合盒转运子1(ABCA1)、载脂蛋白A-I(apoA-I)和卵磷脂胆固醇脂酰转移酶(LCAT)表达水平。结果 实验前各组血清TC、TG、HDL-C、LDL-C水平差异均无统计学意义(P>0.05)。实验14周时,与空白对照组比较,AS模型组、辛伐他汀组、护心通络方组血清TC、TG、LDL-C水平升高,HDL-C水平下降(P<0.05)。实验22周时,与AS模型组相比,辛伐他汀组、护心通络方组血清TC、TG、LDL-C水平下降,HDL-C水平升高(P<0.05)。与空白对照组相比,AS模型组血清CETP表达水平升高;与AS模型组相比,辛伐他汀组和护心通络方组CETP水平降低。与空白对照组相比,AS模型组肝脏ABCA1、apoA-I、LCAT mRNA和蛋白表达水平降低。与AS模型组相比,辛伐他汀组和护心通络方组肝脏ABCA1、apoA-I和LCAT mRNA和蛋白水平升高(P<0.05)。结论 护心通络方可通过降低CETP水平,激活ABCA1/apoA-I/LCAT通路,最终提高HDL-C水平,改善兔动脉粥样硬化。  相似文献   
3.
李小勇  郭琴  郭海志 《安徽医药》2022,26(11):2249-2252
目的通过检测阿尔茨海默病( AD)病人血清中可溶性低密度脂蛋白受体相关蛋白 1(sLRP-1)的表达水平,分析其与 AD病人临床指标之间的关系,解析其在 AD诊断中的临床意义。方法选择 2016年 7月至 2020年 2月在资阳市第一人民医院确诊的 AD病人 82例为 AD组,同时选择在资阳市第一人民医院进行体检的健康者 95例为对照组,采用酶联免疫吸附实验(ELISA)法对所有受试者血清中 sLRP-1、β淀粉样蛋白 1-42(Amyloid-beta 1-42,Aβ1-42)水平进行测定、用全自动生化分析仪对血清中总胆固醇( TC)、三酰甘油( TG)、高密度脂蛋白胆固醇( HDL-C)、低密度脂蛋白胆固醇( LDL-C)含量进行测定,分析 AD病人血清中 sLRP-1表达水平与临床病理各项指标的相关性,受试者操作特征曲线(ROC)分析血清 sLRP-1表达水平对 AD的诊断价值。结果 AD病人 ADAS-cog评分高于对照组[( 18.90±5.06)分比( 5.52±2.38)分, P<0.05],血清中 HDL-C水平[( 1.27± 0.29)mmol/L比( 1.43±0.22)mmol/L]、 ADL评分[( 70.92±23.13)分比( 98.87±23.73)分]、 MMSE评分[(24.03±5.17)分比( 28.73±7.37)分]均低于对照组( P<0.05); AD组病人血清 sLRP-1表达水平显著低于对照组[(11.16±3.63)mg/L比( 17.84±5.31)mg/L,P<  相似文献   
4.
Background and aimsMetabolic syndrome (MetS) affects ~10% of adolescents and is associated with cardiometabolic disease risk. The most prevalent MetS component is abdominal obesity. Healthy diet and physical activity (PA) are inversely associated with abdominal obesity and may reduce MetS risk in youth. Our aim was to examine associations of diet, activity, and abdominal obesity with MetS z-score (MetS-z).Methods and resultsAn analysis of National Health and Nutrition Examination Survey (NHANES) 2011–2016 data in adolescents was performed. Healthy Eating Index (HEI)- 2015 scores were calculated for diet quality, PA habits were used to determine alignment with national guidelines, and abdominal obesity was assessed by sagittal abdominal diameter (SAD). MetS-z represented severity or potential risk for MetS. Multivariable regression evaluated the relationships of HEI, SAD and PA with MetS-z. Among 1214 black and white adolescents, SAD was significantly associated with MetS-z [β (95% CI) = 0.17 (0.16, 0.19); P <0.0001] while HEI-2015 components showed associations with MetS-z overall (HEI total, dairy, and sodium scores), and by sex (total, refined grains, dairy for males; added sugar, protein, whole grains for females). Mean HEI-2015 score was 47.4/100 (51.6 using the population-ratio method), and the proportion of adolescents meeting national PA guidelines was 37.6%, yet PA was not a significant predictor of MetS-z.ConclusionsUS adolescents have poor diet quality and fewer than half meet PA guidelines. Strategies for preventing MetS and related conditions in adolescence should focus on weight management – specifically, abdominal fat reduction – with individualized diet counseling.  相似文献   
5.
目的 探讨Sdccag3在高脂环境中通过Wnt信号通路影响骨髓间充质干细胞(BMSCs)成脂成骨分化以及高脂血症大鼠种植体周围骨结合的能力。 方法 构建高脂血症大鼠模型以及高脂环境培养BMSCs并进行成骨诱导,慢病毒载体过表达/沉默结肠癌抗原3(Sdccag3)的表达,采用RT-PCR、Western blotting、Micro-CT以及硬组织切片HE染色、油红O染色、免疫荧光染色等方法检测高脂环境中Sdccag3对大鼠骨代谢以及BMSCs分化平衡的影响。 结果 高脂成骨诱导BMSCs后过表达Sdccag3,下调成脂分化指标脂肪酸结合蛋白4(FABP4)、过氧化物酶体增殖剂激活受体γ(PPAR-γ),并上调Wnt信号通路标志基因低密度脂蛋白受体相关蛋白 5(LRP5)、LRP6、β-catenin及Wnt5a、Wnt5b,上调成骨分化指标碱性磷酸酶(ALP)、 Runt相关的转录因子2(Runx2);在高脂血症大鼠种植体周围骨组织中,过表达Sdccag3可上调Wnt信号通路标志基因并抑制周围脂形成,沉默LRP5会下调Sdccag3、成骨分化指标,上调成脂分化指标,与沉默Sdccag3表达一致。 结论 高脂血症促进种植体周围脂肪形成并抑制Sdccag3表达;过表达Sdccag3抑制BMSCs成脂分化并降低高脂血症大鼠种植体周围的成脂,促进成骨,促进Wnt信号通路标志基因表达。  相似文献   
6.
7.
Cardiovascular (CV) diseases and cancer share several similarities, including common risk factors. In the present investigation we assessed the relationship between cholesterol levels and mortality in a cardiooncological collective. In total, 551 patients receiving anticancer treatment were followed over a median of 41 (95% CI 40, 43) months and underwent regular cardiological surveillance. A total of 140 patients (25.4%) died during this period. Concomitant cardiac diseases were more common in patients who deceased (53 (37.9%) vs. 67 (16.3%), p < 0.0001), as well as prior stroke. There were no differences in the distribution of classical CV risk factors, such as hypertension, diabetes or nicotine consumption. While total cholesterol (mg/dL) was significantly lower in patients who deceased (157 ± 59 vs. 188 ± 53, p < 0.0001), both HDL and LDL cholesterol were not differing. In addition, cholesterol levels varied between different tumour entities; lowest levels were found in patients with tumours of the hepatopancreaticobiliary system (median 121 mg/dL), while patients with melanoma, cerebral tumours and breast cancer had rather high cholesterol levels (median > 190 mg/dL). Cholesterol levels were significantly lower in patients who died of cancer; lowest cholesterol levels were observed in patients who died of tumours with higher mitotic rate (mesenchymal tumours, cerebral tumours, breast cancer). Cox regression analysis revealed a significant mortality risk for patients with stem cell transplantation (HR 4.31) and metastasised tumour stages (HR 3.31), while cardiac risk factors were also associated with a worse outcome (known cardiac disease HR 1.58, prior stroke/TIA HR 1.73, total cholesterol HR 1.70), with the best discriminative performance found for total cholesterol (p = 0.002).  相似文献   
8.
9.
Lipoprotein a (Lp (a)) and coronary artery calcification (CAC) are markers of coronary artery and cardiovascular diseases. However, the association between Lp (a) and CAC in asymptomatic individuals remains unclear. In this study, we aimed to determine the influence of Lp (a) on CAC in asymptomatic individuals.We included 2019 asymptomatic Korean adults who underwent testing for a coronary artery calcium score (CACS) and Lp (a) at the Gangnam Severance Hospital Health Checkup Center in Korea from January 2017 to August 2019. Participants were divided into 2 groups: CACS = 0 and CACS > 0. Factors affecting the CACS were analyzed by sex. Because age is a major risk factor for atherosclerosis, ≥45 years in men and ≥55 years in women, we further divided participants into 4 subgroups (≥45 and <45 in men, ≥55 and <55 in women). Factors affecting the CACS in the 4 groups were analyzed.There was a positive correlation between the CACS and traditional cardiovascular risk factors. Lp (a) positively correlated with the CACS in men (P < .01) and remained significant after multivariable logistic regression (P < .01). The same result was observed in men aged ≥45 years (P < .01).Lp (a) is an independently associated factor of CAC and a marker of coronary atherosclerosis in asymptomatic men aged ≥45 years. In asymptomatic men aged ≥45 years, Lp (a) should be measured, and intensive Lp (a)-lowering treatment should be considered.  相似文献   
10.
There is evidence that serum 25-hydroxyvitamin D [25-(OH) D] levels may be associated with cardiovascular disease and its risk factors. This study aimed to investigate the relationship between 25-(OH) D levels and blood pressure (BP), blood lipids, and arterial elasticity in middle-aged and elderly cadres in China.In this retrospective study, we included 401 civil servants and cadres aged >42 years who underwent medical examinations at Guiyang Municipal First People''s Hospital, China in 2018. The participants were assigned to deficiency (≤20 ng/mL), insufficiency (20–30 ng/mL), and sufficiency (≥30 ng/mL) groups according to 25-(OH) D levels in their blood. Demographics, brachial–ankle pulse wave velocity (baPWV), BP, ankle–brachial index (ABI), and blood lipids were compared among groups. The associations between 25-(OH) D and other parameters were evaluated using linear regression analysis.Median (range) 25-(OH) D levels in the deficiency (n = 162), insufficiency (n = 162), and sufficiency (n = 77) groups were 15.32 (2.93–19.88), 25.12 (20.07–29.91), and 33.91 (30.23–82.42) ng/mL, respectively. There were significant differences in systolic BP, pulse pressure, baPWV (left and right sides), ABI (left side), high-density lipoprotein-cholesterol, and triglycerides (TGs; all P < .05) among groups. Multivariate linear regression revealed that TG, left baPWV, and right baPWV were significantly negatively correlated with 25-(OH) D levels (all P < .05).In this study, 25-(OH) D levels were found to be associated with TG, left baPWV, and right baPWV values. 25-(OH) D deficiency may be associated with reduced arterial elasticity.  相似文献   
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