血糖调节异常者血脂代谢的初步研究

目的初步评价血糖调节受损患者血脂代谢异常情况。方法检测糖耐量正常(NGT)、单纯空腹血糖异常(IFG)、单纯糖耐量异常(IGT)、空腹血糖异常合并糖耐量异常(IFG IGT)和糖尿病(DM)患者空腹血糖和餐后2 h血糖及空腹血清总胆固醇(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)、载脂蛋白A-I(apo A-I)和载脂蛋白B(apo B)水平,计算非高密度脂蛋白胆固醇(non-HDL-C)和血浆致动脉硬化指数(AIP),比较各组间血清脂质成分的差异。结果IFG组血清TC、LDL-C、non-HDL-C和apo B水平较NGT组明显升高(P<0.01),而TG、HDL-C、AIP差异无统计学意义(P>0.05)。IGT组血清TC、TG、LDL-C、non-HDL-C、apo A-I、apo B和AIP水平较NGT组显著升高(P<0.01),前6项指标与IFG IGT组差异无统计学意义(P>0.05)。IFG IGT组与NGT组比较,各指标差异均有统计学意义(P<0.01);HDL-C、non-HDL-C和AIP水平与IFG组比较差异有统计学意义(P<0.01)。DM组表现出典型的DM性脂代谢紊乱伴AIP水平显著异常。non-HDL-C和apo B间存在良好的相关性(P<0.01)。结论血糖调节受损者不同程度的存在血脂代谢异常,主要表现为TC、TG、LDL-C、non-HDL-C和apo B水平的升高和HDL-C、apo A-I的降低,伴不同程度AIP水平的改变。     

血清脂质、脂蛋白胆固醇和载脂蛋白在冠心病中的临床意义

目的研究冠心病患者的血清脂质、脂蛋白胆固醇和载脂蛋白的变化、辨别力和诊断价值。方法测定64例冠心病(CHD)患者和60例正常人的血脂、脂蛋白胆固醇和载脂蛋白,并比较计算其辨别力和诊断价值。结果和结论冠心病患者的TC(女)、TG、LDL-C、ApoB、LDL-C/HDL-C和ApoB/ApoAI明显高于正常人(P<0.05),HDL2-C、HDL3-C、HDL-C、ApoAI和HDL-C/TC明显低于正常人(P<0.05)。由HDL-C、TC和TG血脂三项可代替HDL-C、LDL-C、VLDL-C、TC和TG血脂五项,对冠心病的诊断目前有应用价值,若加上HDL2-C和HDL3-C或ApoAI和ApoB,则对冠心病的诊断更有意义。     

血清非高密度脂蛋白胆固醇测定在非酒精性脂肪肝中的应用

目的探讨非酒精脂肪肝患者非高密度脂蛋白胆固醇（non-HDL-C）水平及临床应用价值。方法检测973名职工健康体检者的总蛋白（TP），白蛋白（Alb）、球蛋白（Glo）、天门冬氨酸氩基转移酶（AST）、丙氨酸氨基转移酶（ALT）、总胆红素（TBil）、直接胆红素（DBil）、间接胆红素（IBil）、葡萄糖（Glu）、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）、载脂蛋白A-I（apo A-I）、载脂蛋白B（apo B）、计算non-HDL-C及apo B/apo A-I、LDI-C／HDL-C、apo B／HDL-C、TC／HDL-C比值，并对其中89例非酒精性脂肪肝与202名体检健康者进行比较结果脂肪肝检出率为9．15％，男性检出率为12．50％，显著高于女性的5．99％（P〈0．05）；与对照组比较，59例男性患者的ALT、IBil、TG、HDL-C、LDL-C、apo A-I、non-HDL-C水平及apo B／apo A-I、LDL-C／HDL-C、apo B／HDL-C、TC／HDL-C比值差异具有统计学意义（P〈0.5，P〈0.01）,30例女性患者的AST、TBil、DBil、IBil、Glu、TC、TG、LDL-C、apo A-I、non-HDL-C水平及apo B／apo A-I、LDL-C/HDL-C、apo B/HDL-C、TC／HDL-C比值差并具有统计学意义（P〈0．05，P〈0．01）。non-HDL-C与TC、LDL-C、TG、HDL-C、apo A-I、apo B、apo B/apo A-I、TC／HDL均显著相关[相关系数（r）=0．4113～0．9893，P〈0．01]。结论非酒精性脂肪肝普遍具有代谢异常和肝脏受损等特点，non-HDL-C的检测有助于全面了解非酒精性脂肪肝脂炎代谢状况。     

Low-dose effect of simvastatin (MK-733) on serum lipids, lipoproteins, and apolipoproteins in patients with hypercholesterolemia

The effects of simvastatin (MK-733), a competitive inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase, on serum lipids, lipoproteins, and apolipoproteins were investigated in 29 patients (12 men, 17 women, aged 37 to 73) with moderate to severe hypercholesterolemia. It was given in doses of 2.5 mg/day for four months and 5 mg/day for the succeeding four months. Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and apolipoprotein (apo) B decreased by 18% (263 +/- 7 mg/dl to 216 +/- 7 mg/dl, P less than 0.01), 24% (180 +/- 7 mg/dl to 136 +/- 7 mg/dl, P less than 0.01), and 21% (133 +/- 4 mg/dl to 104 +/- 3 mg/dl, P less than 0.01), respectively, four months after treatment. Similar reductions (17%, 24%, and 23%, respectively, P less than 0.01) were observed at eight months. A significant reduction in triglyceride (TG) was observed (173 +/- 15 mg/dl to 136 +/- 11 mg/dl at eight months, P less than 0.01), as was a significant increase in serum high-density lipoprotein cholesterol (HDL-C) (48 +/- 2 mg/dl to 52 +/- 2 mg/dl at eight months, P less than 0.01). However, apo AI and apo AII remained unchanged. Atherogenic indices of (TC--HDL-C)/ HDL-C, LDL-C/HDL-C, and apo B/Apo AI ratios were significantly (P less than 0.01) reduced after treatment. No significant changes were observed in lipoprotein lipase, hepatic TG lipase, and lecithin: cholesterol acyltransferase (LCAT) activities. Simvastatin was well tolerated and no critical side effects were noted in the eight-month study period. These data indicate that simvastatin, even at a low dose of 2.5 to 5 mg daily, causes consistent reductions in serum TC, LDL-C, apo B, and TG, and a rise in HDL-C and antiatherogenic lipoproteins.     

慢性肾功能衰竭患者血清甲状腺激素水平与血脂代谢关系的临床探讨

目的探讨慢性肾功能衰竭（CRF）患者血清甲状腺激素水平的变化对血脂代谢的影响及其临床意义。方法采用放射免疫法（RIA）检测56例CRF患者和35名正常对照者血清总三碘甲状腺原氨酸（TT3）、总甲状腺素（TT4）、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、高敏促甲状腺素（h-TSH）的含量，同时测定其血清总胆固醇（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）、载脂蛋白A-Ⅰ（apo A-Ⅰ）、载脂蛋白B（apo B）及肌酐（Cr）、β2微球蛋白（β2-MG）和白蛋白（A1b）等，并分析各指标的相关性。结果CRF患者血清TT3、FT3显著低于对照组（P〈0．01），TT4、FT4、h-TSH虽低于对照组，但差异无统计学意义（P〉0．05）；血清TG、LDL-C和apo B显著高于对照组（P〈0．01、P〈0．05、P〈0．05），HDL-C明显低于对照组（P〈0．05），TC和apo A-Ⅰ虽略高于对照组，但无统计学意义（P〉0．05）；血清Cr、β2-MG明显高于对照组（P〈0．01），A1b明显低于对照组（P〈0．01）。直线回归和相关性分析显示，CRF患者血清TT3、FT3均分别与Cr、TG、LDL-C、apo B呈显著负相关（P〈0．01），而与HDL-C呈显著正相关（P〈0．01），h-TSH与Cr、TG、HDL-C、LDL-C和apo B均无显著相关性（P〉0．05）。结论血清甲状腺激素水平降低与肾功能损害程度密切相关，与CRF患者血脂代谢紊乱有一定的关系。因此，CRF患者血清甲状腺激素水平的监测具有一定的临床价值。     

2型糖尿病患者大血管并发症与血脂血糖关系的临床观察

目的　探讨 2型糖尿病患者血脂、血糖水平与大血管并发症的关系。方法　采用免疫透射比浊法及酶法 ,分别测定空腹血糖 (FBS)、总胆固醇 (TC)、甘油三酯 (TG)、高密度脂蛋白 (HDL C)、低密度脂蛋白(LDL C)、载脂蛋白A1(apoA1)及载脂蛋白B(apoB)水平。结果　有大血管并发症组FBS、TC、LDL C、apoB水平及糖尿病病程与对照组比较有显著升高 (P <0 .0 5 )。结论　 2型糖尿病大血管并发症的发生与血脂代谢异常有关     

缺血修饰清蛋白对高脂血症患者继发急性冠状动脉综合征的预警作用

目的探讨缺血修饰清蛋白(IMA)联合血脂指标对高脂血症患者继发急性冠状动脉综合征(ACS)预警作用。方法对109例ACS患者、119例高脂血症患者和104例健康对照者进行血清IMA、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)检测,计算TC/HDL-C、TG/HDL-C、LDL-C/HDL-C、ApoA1/ApoB比值。结果 ACS患者TC/HDL-C、ApoA1/ApoB和IMA水平与健康对照者比较差异有统计学意义(P<0.05)。高脂血症患者IMA水平与健康对照者比较差异无统计学意义(P>0.05),但高脂血症患者随着TC/HDL-C比值升高血清IMA水平也升高。结论对于TC/HDL-C升高的TC、TG均升高的高脂血症患者,若血清IMA水平也升高提示其具有继发ACS的危险性;血清IMA有可能成为评估ACS危险性的指标之一。     

糖尿病患者血清糖化低密度脂蛋白水平研究

目的分析糖尿病患者血糖、血脂及糖化低密度脂蛋白（G-LDL）水平,探讨糖尿病患者G-LDL与冠心病的关系。方法检测80例糖尿病患者及80名健康人群的血清G-LDL、血糖及常规血脂[包括三酰甘油（TG）、胆固醇（Chol）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白A-Ⅰ（apoA-Ⅰ）和载脂蛋白B100（apoB100）],糖尿病组同时测定糖化血红蛋白（HbA1c）。结果糖尿病组LDL-C和apoB100与对照组比较无差异（P〉0.05）;G-LDL、血糖、TG和Chol水平明显高于对照组（P〈0.05）;HDL-C和apoA-Ⅰ水平低于对照组（P〈0.05）。糖尿病组G-LDL与血糖浓度呈正相关关系（r=0.636,P〈0.05）,与LDL-C及HbA1c不相关（r=0.331,r=0.327,P〉0.05）。结论糖尿病患者G-LDL明显升高,脂质糖化是糖尿病患者发生冠心病的危险因素,G-LDL有望成为评价糖尿病患者并发冠心病的生化指标。     

Serum lipids and apolipoproteins A-I, A-II and B in primary hypothyroidism before and during treatment

Serum lipids and apolipoproteins (apo) A-I, A-II, and B were measured in twenty-four patients with severe primary hypothyroidism (Thyrotropin above 40 mU/l), before and during 1-thyroxine treatment. Apo A-I, A-II, and B were assayed by immunonephelometry, using monospecific antisera. The serum levels of total cholesterol (TC), of low-density lipoprotein cholesterol (LDLc), and of the major LDL apoprotein, apo B, were markedly increased in the untreated hypothyroid patients compared to the values during therapy (TC: mean +/- SD, 8.87 +/- 2.9 v. 5.48 +/- 1.6 mmol/l; LDLc: 6.66 +/- 2.6 v. 3.78 +/- 1.4 mmol/l; apo B: 1.66 +/- 0.48 v. 1.14 +/- 0.37 g/l; P less than 0.00001 for all variables). High-density lipoprotein cholesterol (HDLc) was slightly higher before than during therapy (1.58 +/- 0.7 v. 1.31 +/- 0.4 mmol/l; P less than 0.05), while the main HDL apoprotein, apo A-I, was significantly elevated (1.49 +/- 0.42 v. 1.13 +/- 0.27 g/l; P less than 0.0002). The increase of the second major HDL apoprotein, apo A-II, was less pronounced (0.33 +/- 0.1 v. 0.30 +/- 0.08 g/l; P less than 0.022). The apo A-I to apo A-II ratio, which reflects the relative concentrations of the HDL subfractions HDL2 and HDL3, was significantly higher before than during treatment (P less than 0.0006). Serum triglyceride levels were moderately elevated in the untreated hypothyroid patients (1.34 +/- 0.6 v. 0.95 +/- 0.4 mmol/l; P less than 0.002). The small decrease in body weight during therapy did not correlate with the changes of the various lipid and apoprotein parameters.(ABSTRACT TRUNCATED AT 250 WORDS)     

脑动脉硬化症患者血脂,脂蛋白及其亚类的测定

测定142例脑动脉硬化症患者的血脂、脂蛋白及其亚类水平,并以70例健康成人为对照。结果发现疾病组血清TC、TG、PL、HDL-TG、LDL-C水平及LDL-C/HDL-C值明显增高,HDL-C、HDL-PL、HDL_2-C和HDL_3-C水平与对照组相比无明显变化。认为脑动脉硬化症的发生和发展与脂代谢紊乱有关,但HDL-C对脑动脉硬化症无保护作用。     

血脂与脑梗死患者颈动脉粥样硬化的关系

目的了解血脂与脑梗死患者颈动脉粥样硬化的关系。方法对344例脑梗死疑似患者进行三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A-I(apo A-I)、载脂蛋白B(apo B)、脂蛋白(a)[Lp(a)]检测,同时用计算机断层扫描(CT)、B超检测颈动脉病变。结果344例脑梗死疑似患者中有303例经临床及CT检查诊断为脑梗死,其余41例作为对照组。303例确诊患者中颈动脉管壁内膜-中层厚度(IMT)>0.9 mm或有斑块者206例,占68.0%;其余97例无病变,占32.0%。脑梗死患者LDL-C水平无论有无颈动脉病变均高于对照组(P<0.05)。无脑梗死的颈动脉粥样硬化患者apoA-I水平低于对照组(P<0.05)。结论LDL-C、apo A-I是发生脑梗死和颈动脉硬化病变重要的危险因素和诊疗的观察指标,B超检测颈动脉粥样硬化再结合血脂检查,对于脑血管疾病的预防、早期诊断、指导治疗以及观察疗效具有一定的临床价值。     

糖耐量受损的冠心病患者血浆同型半胱氨酸和血脂水平的变化

目的探讨糖耐量受损的冠心病患者血浆总同型半胱氨酸（tHcy）和血脂水平的变化。方法采用高效液相层析技术测定45例糖耐量受损的冠心病患者（糖耐量受损组）和51例糖耐量正常的冠心病患者（糖耐量正常组）血浆tHcy水平,同时测定常规血脂。结果糖耐量受损组血浆tHcy、总胆固醇（TC）、载脂蛋白B（apo B）、低密度脂蛋白胆固醇（LDL-C）、水平高于糖耐量正常组（P〈0.05、P〈0.01）;而三酰甘油（TG）、载脂蛋白A-I（apo A-I）、高密度脂蛋白胆固醇（HDL-C）2组差异无统计学意义（P〉0.05）。tHcy水平和患者年龄、apo A-I相关（P〈0.05）,而与其他血脂指标不相关（P〉0.05）。结论血浆tHcy水平的增高与糖耐量受损和冠心病的发生密切相关。     

Lipoprotein composition in agnogenic myeloid metaplasia

Lipoproteins have previously, been studied in various myeloproliferative disorders. This study focused only on agnogenic myeloid metaplasia (AMM). Total cholesterol (TC), phospholipids (PL) and triglycerides (TG) were measured not only in serum but also in HDL, VLDL and LDL with in the same time total apolipoproteins A1 and B. Besides hypocholesterolemia (p less than 0.01) HDL-TC were significantly diminished in mmol/l (p less than 0.01) and in percentage (p less than 0.01) while LDL.TC was decreased in mmol/l (p less than 0.01). The whole lipid moity (TC + PL + TG) of VLDL was increased (p less than 0.05). Cardiovascular diseases occur frequently in these hypocholesterolemic patients. Atherogenic ratios: LDL.TC on HDL.TC or VLDL.TC + LDL.TC on HDL.TC were not significantly higher than matching age and sex controls. Atherogenic risks could be partly related to the significant decrease of HDL.TC.     

A rapid micro-scale procedure for determination of the total lipid profile

We describe a one-day micro-scale procedure for determining the total lipid profile. Only 0.55 mL of plasma is needed for complete quantification of total cholesterol (TC), triglyceride (TG), and all lipoproteins. After precipitation with dextran sulfate and magnesium, the high-density lipoprotein (HDL) fraction was separated by centrifugation in an Eppendorf microcentrifuge. Very-low-density lipoprotein (VLDL) was separated from low-density lipoprotein (LDL) plus HDL in a Beckman TL 100 ultracentrifuge. TC, TG, and cholesterol in different lipoprotein fractions were measured enzymatically in a Baker "Encore II" automated analyzer. CVs, both within-day and day-to-day, were less than 3% for TG and TC, and less than 5% for HDL-C determinations. CVs for LDL-C and VLDL-C were less than 7.5% and 15%, respectively. Results by our micromethods (n = 66) agreed well with those by the conventional methods used at the Northwest Lipid Research Center, which are standardized against the Reference Methods of the Centers for Disease Control. Coefficients of correlation between the two methods were 0.98 for TC, 1.0 for TG, 0.98 for HDL-C, 0.94 for LDL-C, and 0.96 for VLDL-C. Results of electrophoresis on agarose gel and radioactivity-recovery studies indicate that our micro-centrifugation and slicing procedures result in clean separation of VLDL from other lipoproteins.     

Effect of cyclosporin A on serum lipids in primary biliary cirrhosis patients

Hyperlipidemia is a common complication of PBC. Ten patients with serologically and histologically defined PBC were randomized to receive either oral cyclosporin A (CyA) or placebo for one year. Fasting blood samples were obtained from subjects at the beginning, and following one year of treatment, for plasma lipids, apolipoproteins AI (apo AI) and B (apo B), and lecithin-cholesterol acyltransferase (LCAT) activity. On entry to the study there were no significant differences between groups for serum concentrations of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), free cholesterol (FC), total phospholipids (TPL), apo AI, apo B and LCAT activity. Compared to normal laboratory values, baseline TC was elevated in 5/10, LDL-C in 5/10, TPL in 6/10, while LCAT activity was decreased in 8/10 patients. The percent change after one year for CyA group vs the placebo group are as follows: total cholesterol, -22 vs -8%; LDL cholesterol -33 vs -25%; free cholesterol, -39 vs -14%; total phospholipids, -46 vs -23%; and LCAT activity, +/- 236 vs +/- 43%. The decrease in TC, LDL-C, FC, TPL with increase in LCAT activity suggests that CyA administration is associated with improvement in the lipid abnormalities of PBC.     

脑梗死患者血脂水平与颈动脉内中膜厚度的相关性分析

目的 探讨脑梗死(CI)患者血脂水平与颈动脉内中膜厚度(CIMT)的相关性.方法 测定120例CI患者(CI组)和120例神经科非CI患者(对照组)CIMT、血浆氧化低密度脂蛋白(ox-LDL)及血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(Apo-A1)、载脂蛋白B (Apo-B)、脂蛋白(a)[ LP(a)]水平,并进行相关分析.结果 CI组TC、TG、Apo-B、LP(a)和ox-LDL水平高于对照组(P＜ 0.01);CI组CIMT检测结果 为1.1±0.32 mm,高于对照组的0.8±0.54 mm(P＜0.01);CI组TC、TG、LDL-C、Apo-B 、LP(a)、ox-LDL与CIMT呈正相关(P＜0.01),HDL-C、Apo-A1与CIMT呈负相关(P＜0.01).结论 脂代谢异常与CI患者动脉粥样硬化密切相关;CI患者体内可能存在脂质过氧化反应;抑制脂质过氧化,减少ox-LDL的生成有助于预防和治疗CI.     

北京地区晚发性阿尔兹海默病患者apo E基因多态性与血脂的相关性

目的探讨晚发型阿尔兹海默病(LOAD)患者载脂蛋白E(apo E)基因多态性与血脂水平之间的关系。方法采用基因芯片法检测150例LOAD患者(LOAD组)及150名体检健康者(正常对照组)apo E基因多态性,同时检测总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、小而密低密度脂蛋白胆固醇(sd-LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白B(apo B)、脂蛋白(a)[Lp(a)]水平。采用多因素非条件Logistic回归分析筛选LOAD的相关危险因素。结果LOAD组E2/3和E3/3基因型频率均低于正常对照组(P<0.05),E3/4和E2/4基因型频率均高于正常对照组(P<0.01)。LOAD组ε3等位基因频率低于正常对照组(P<0.05),ε4等位基因频率高于正常对照组(P<0.01)。与正常对照组比较,LOAD组TC、LDL-C和sd-LDL-C水平明显升高(P<0.01),HDL-C水平明显降低(P<0.01),其他血脂项目差异均无统计学意义(P>0.05)。TC及LDL-C水平在LOAD组ε2、ε3和ε4表型患者中依次升高(P<0.05)。正常对照组ε4表型LDL-C水平明显高于ε2表型(P<0.05)。apo Eε4等位基因和LDL-C升高是LOAD发生的危险因素[比值比(OR)值分别为14.454、5.824,95%可信区间(CI)分别为5.793~16.368、2.582~7.973],HDL-C升高则是LOAD的保护因素(OR=0.020,95%CI为0.006~0.352)。结论apo E基因多态性与脂质代谢密切相关,ε4等位基因可能是LOAD发病的重要遗传因素之一。     

Effect of moxonidine on lipid subfractions in patients with hypertension

Moxonidine is centrally acting imidazoline type-1 receptor agonist that significantly lowers blood pressure and has some insulin-sensitising actions. Its effects on plasma lipid profiles are uncertain. This study examined the effects of moxonidine on detailed lipid and lipoprotein profiles in 12 patients with hypertension and type 2b Fredricksen hyperlipidaemia. Treatment with moxonidine in six patients who completed the study resulted in a 10/5 mmHg reduction in 24-h ambulatory blood pressure (p = 0.01). A significant reduction in total and low-density-lipoprotein cholesterol (LDL-C) of 10% (p = 0.04) and 18% (p = 0.03), respectively, was seen. Triglycerides were reduced non-significantly by 23%, and high-density-lipoprotein cholesterol (HDL-C) was increased by 16%. There were no significant changes in apolipoprotein (apo) A-1 and B concentrations. No significant shifts were seen in HDL-C, LDL-C, very-low-density-lipoprotein cholesterol (VLDL-C) or apolipoprotein peak positions with therapy. Analysis of area under curve for each subfraction showed that moxonidine therapy resulted in a redistribution within the apoB profile. A slight non-significant reduction in VLDL apoB was seen. There was a reduction in the dense LDL apoB peak (p = 0.02) but less in the buoyant LDL apoB peak (p = 0.17) with a countervailing increase in LDL-C in the buoyant fraction (p = 0.01). The HDL-C and apoA-1 profile showed a shift from dense HDL apoA-1 (p = 0.01) to a buoyant HDL apoA-1sub-species (p = 0.01). These changes are consistent with a tendency for moxonidine to improve atherogenic lipid and lipoprotein profiles by actions on insulin-sensitisation and possibly through a direct cholesterol-reducing effect as seen with other imidazoles.     

血液透析对脂蛋白（a）及相关检验指标的影响

目的动态观察血液透析对慢性肾功能衰竭（CRF）患者血清脂蛋白（a）[Lp（a）]的影响。方法分别测定50例进行血液透析的CRF患者透析前、后以及30名健康体检者血清Lp（a）及相关指标[三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白A（apo A）、载脂蛋白B（apo B）、白蛋白（A lb）、尿素（Urea）、肌酐（Cr）]浓度并作比较。结果 CRF组血液透析后Lp（a）、Urea、Cr浓度明显低于透析前（P〈0.05）,TG、TC、HDL-C、LDL-C、apo A、apo B浓度与透析前比较差异无统计学意义（P〉0.05）。CRF组血液透析前Lp（a）、TC、TG、LDL-C浓度明显高于对照组（P〈0.05、P〈0.01）,HDL-C、A lb浓度低于对照组（P〈0.05、P〈0.01）,而apo A和apo B 2组间差异无统计学意义（P〉0.05）。结论血液透析可以有效降低CRF患者Lp（a）的浓度,有利于防止各种血栓性疾病的发生与发展。     

Fractional esterification rate of cholesterol and ratio of triglycerides to HDL-cholesterol are powerful predictors of positive findings on coronary angiography

BACKGROUND: We examined the predictive value of various clinical and biochemical markers for angiographically defined coronary artery disease (aCAD). Specifically, we assessed the value of the ratio of plasma triglyceride (TGs) to HDL-cholesterol (HDL-C) and the fractional esterification rate of cholesterol in plasma depleted of apolipoprotein B (apoB)-containing lipoproteins (FER(HDL)), a functional marker of HDL and LDL particle size. METHODS: Patients (788 men and 320 women) undergoing coronary angiography were classified into groups with positive [aCAD(+)] and negative [aCAD(-)] findings. Patient age, body mass index, waist circumference, blood pressure (BP), medications, drinking, smoking, exercise habits, and plasma total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-unesterified cholesterol, HDL-C, TGs, FER(HDL), apoB, log(TG/HDL-C), and TC/HDL-C were assessed. Lipids and apoproteins were measured by standard laboratory procedures; FER(HDL) was determined by a radioassay. RESULTS: Members of the aCAD(+) group were older and had a higher incidence of smoking and diabetes than those in the aCAD(-) group. The aCAD(+) group also had higher TG, apoB, FER(HDL), and log(TG/HDL-C) and lower HDL-C values. aCAD(+) women had greater waist circumference and higher plasma TC and TC/HDL-C. aCAD(+) men, but not women, had higher plasma LDL-C. In the multivariate logistic model, the significant predictors of the presence of aCAD(+) were FER(HDL), age, smoking, and diabetes. If only laboratory tests were included in the multivariate logistic model, FER(HDL) appeared as the sole predictor of aCAD(+). Log(TG/HDL-C) was an independent predictor when FER(HDL) was omitted from multivariate analysis. CONCLUSIONS: FER(HDL) was the best laboratory predictor of the presence of coronary atherosclerotic lesions.