原发性胆汁性胆管炎血脂异常分布特点

目的了解原发性胆汁性胆管炎(PBC)患者血脂异常特点,分析其分布与单纯血脂异常患者的差异及临床意义。方法对2010—2016年在北京协和医院住院及门诊就诊的PBC并血脂异常者100例(PBC组)及同期体检中心年龄和性别匹配的单纯血脂异常者83例(对照组)的临床资料进行回顾性分析,评估两组患者血脂异常分布特点的差异及其临床意义。结果PBC组患者的血脂异常以高胆固醇(TC)血症为主,对照组患者以高低密度脂蛋白(LDL-C)血症为主。临床分类分析发现,PBC组单纯TC和单纯三酰甘油(TG)均明显高于对照组(TC:14%vs. 5%;TG:19%vs. 8%),差异均有统计学意义(P=0. 046、0. 042),PBC组混合型高脂血症比例明显低于对照组(57%vs. 77%),差异有统计学意义(P=0. 004)。PBC组患者血浆TG水平明显高于对照组[(2. 36±2. 13) mmol/L vs.(1. 57±0. 75) mmol/L],PBC组患者HDL-C水平明显高于对照组[(1. 64±0. 75) mmol/L vs.(1. 31±0. 38) mmol/L],差异均有统计学意义(均P=0. 001)],PBC组患者LDL-C水平明显低于对照组[(3. 27±1. 22) mmol/L vs.(3. 61±0. 69) mmol/L],差异有统计学意义(P=0. 033)。结论 PBC血脂异常与单纯血脂异常患者血脂分布类型不同,其中临床分类差别更为明显,PBC血脂异常者较单纯血脂异常者更易出现高TC血症,且前者TG、HDL-C水平较后者高,LDL-C水平较后者低。     

不同类型高脂血症患者血清高密度脂蛋白亚类组成的研究

目的 :探讨不同类型高脂血症患者血清高密度脂蛋白 (HDL)亚类组成和相对百分含量的变化及其之间的差异。方法 :采用双向电泳 免疫印迹检测法分析了 39例高胆固醇 (TC)血症患者、97例高甘油三酯 (TG)血症患者及 32例混合性高脂血症 (MHL)患者血清HDL亚类组成及相对百分含量。结果 :高TC、高TG及MHL患者血清中小颗粒的前 β1 HDL、前 β2 HDL、及HDL3b 含量显著增加 (P<0 .0 5 ～ <0 .0 1) ,而大颗粒的HDL2a及HDL2b含量显著减少 (P <0 .0 5～<0 .0 1)。高TC患者血清中HDL2b含量显著高于高TG及MHL患者 (P <0 .0 1及P<0 .0 5 ) ,而前 β1 HDL含量低于或显著低于高TG及MHL患者 (P<0 .0 1) ;高TG患者血清中HDL3a含量显著高于高TC及MHL患者 (P<0 .0 1) ,而HDL2b含量均较其他二者为低。结论 :高TC、高TG及MHL患者血清HDL颗粒直径均呈变小趋势 ,但其HDL亚类组成的具体变化特征却有一定差异。     

新疆帕米尔高原塔吉克族血脂异常患病率及相关因素分析

目的了解新疆帕米尔高原塔吉克族血脂水平及血脂异常流行情况, 探索血脂异常的相关因素。方法本研究为横断面研究。于2021年5至10月在新疆塔什库尔干塔吉克自治县采用多阶段整群随机抽样调查了5 635名18岁以上塔吉克族, 收集问卷调查(一般信息、疾病史、个人史等)、体格检查(身高、体重、腰围、血压等)和血液标本检测数据[总胆固醇(TC), 甘油三酯(TG), 低密度脂蛋白胆固醇(LDL-C), 高密度脂蛋白胆固醇(HDL-C)等], 分析塔吉克族血脂异常患病情况及相关因素。结果塔吉克族研究对象年龄(41.9±15.0)岁, 男性2 726人(48.4%)。TC、LDL-C、TG水平边缘升高患病率分别为17.2%、14.7%、8.9%。高TC血症、高LDL-C血症、高TG血症、低HDL-C血症患病率分别为4.1%、4.9%、9.4%、32.4%, 血脂异常患病率为37.0%。男性、更高的文化程度、更大的体重指数和腰围、生活在城镇、吸烟是血脂异常的正相关因素。结论新疆帕米尔高原塔吉克族血脂异常患病情况以较低的高TC、高LDL-C和高TG血症患病率和较高的低HDL-C血症患病率为主要特点。较低...     

氧化修饰低密度脂蛋白对冠心病的预测价值

目的　观察氧化修饰低密度脂蛋白 (Ox-LDL)检测对冠心病 (CHD)的预测价值 ,并与其它血脂指标进行比较。方法　对 68例冠心病组和 3 0例对照组进行前瞻性研究 ,比较两组病人 Ox-LDL ,脂蛋白 a(Lp(a) )总胆固醇 (TC)、低密度脂蛋白 (L DL )、三酰甘油 (TG)及高密度脂蛋白 (HDL)的检测结果。Ox-LDL的测定采用化学法 ;Lp(a)测定采用酶联免疫吸附试验 (EL ISA)双抗夹心法 ;TC、TG、HDL和 LDL采用酶法测定。结果　 (1) CHD组 Ox-LDL、TC及 L DL高于对照组 (P<0 .0 0 1) ,TG和 HDL无统计学差异 (P>0 .0 5 ) ;(2 )经配对 X2检验 ,除 HDL 外 Ox-LDL 异常检出率明显高于 TC、TG、L DL、L p(a) ;(3 )对冠心病预测价值的比较 ,Ox-LDL优于 L p(a)及其它血脂指标。结论　 Ox-LDL的检出率高于其它血脂指标 ,对冠心病诊断具有一定预测价值     

东莞市东部地区35岁以上居民血脂水平及分布特征

目的探讨东莞市东部地区35岁以上居民血脂水平及分布特征。方法 2011年7月至2012年4月,采用整群抽样的方法,对东莞市横沥镇35岁及以上的19 058户籍居民进行问卷调查及总胆固醇(total cholesterol,TC)、三酰甘油(triacylglycerol,TG)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)和低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)检测。结果完成问卷调查、血脂检测共9 921人。血脂异常标化患病率为35.47%。TC、TG、HDL-C、LDL-C浓度分别为(5.20±1.02)mmol/L、(1.56±1.34)mmol/L、(1.49±0.38)mmol/L、(3.03±0.90)mmol/L。血脂异常类型以高TG、高TC为主。男性49岁以下年龄段组的TC、LDL-C浓度及LDL-C血症患病率较女性同年龄段组高,50岁以上较女性低,差异有统计学意义(P<0.05)。男女间TC、TG、HDL-C浓度及高TC、高TG、低HDL-C血症患病率比较,差异均有统计学意义(P<0.05)。结论东莞市东部地区35岁以上居民TC、TG、LDL-C浓度及高TC、高TG、高LDL-C患病率较高;血脂异常类型以高TG、高TC为主;中年男性及更年期以后女性血脂水平较高。     

周围动脉硬化闭塞症在老年血脂异常人群中的现患率调查

目的　了解周围动脉硬化闭塞症 (PAOD)在老年血脂异常人群中的现患率。方法　北京市万寿路地区老年居民 2 0 4 11位中 ,以家委会为单位 ,整群随机抽样抽得 2 12 4例。周围动脉硬化闭塞症的诊断以踝肱动脉压力指数(Ankle Armindex ,AAI)≤ 0 .9为标准 ;对血脂异常的诊断采用美国胆固醇教育计划 (NCEP)成人治疗第三次报告(ATPⅢ )提供的参考标准即满足下列 4条之一者为血脂异常的诊断标准 :甘油三酯 (TG)≥ 2 .2 6mmol L ,总胆固醇(TC)≥ 5 .72mmol L ,低密度脂蛋白 (LDL)≥ 3.6 4mmol L ,高密度脂蛋白 (HDL)≤ 1.0 4mmol L。结果　血脂异常患者为 10 71例 ,男 4 10例 ,女性 6 6 1例 ,年龄 6 0～ 92 (6 8.3± 5 .4 )岁 ,现患率为 5 0 .4 2 % ;其中PAOD 184例 ,现患率为17.18% ,男 6 0例 ,女 12 4例 ;PAOD在各类血脂异常患者中的患病率分别为 :高TG血症 14 .12 % ;高LDL血症10 .10 % ;高TC血症 15 .94 % ;低HDL血症 19.6 5 % ;血脂异常合并高血压患者 19.18% ;高血压患者 14 .98% ;血脂异常合并糖尿病患者 19.4 76 % ;糖尿病患者 15 .38% ;高龄血脂异常患者 4 2 .86 %。结论　HDL降低是PAOD的独立的危险因素 ;各型血脂异常对PAOD现患率的影响没有差异 ;血脂异常合并其他危险因素将明显增加PAOD的现患率 ;高     

镇海炼化公司老年人血脂异常横断面调查

目的调查镇海炼化公司老年人血脂异常的现况。方法通过2004年1362位老年人体检化验血脂各组分结果,参照“血脂异常防治建议”判断血脂异常。结果公司老年人的血脂各组分中,总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)女性均高于男性(P<0.01)。血脂异常的总患病率为57.78%(男性为52.25%,女性为68.22%,P<0.001);血脂异常中,最常见的是高TC血症为37.52%(男性为34.27%,女性为43.64%,P<0.05);高LDL-C血症的患病率为36.20%(男性为30.22%,女性为47.49%,P<0.01);高TG血症的患病率为20.34%(男性为17.30%,女性为26.06%,P<0.001);低HDL-C血症的患病率为7.49%(男性为8.88%,女性为4.87%,P<0.01)。单种血脂异常率为21%(男性为22.02%,女性为19.07%);合并2种血脂异常率为26.36%(男性为22.58%,女性为33.47%);合并3种血脂异常率为9.69%(男性为7.08%,女性为14.62%);合并4种血脂异常率为0.73%(男性为0.56%,女性为1.06%)。结论公司内老年人无论男性还是女性血脂异常患病率都超过半数,高TC血症最为常见,其次为高LDL-C血症,且以合并2种以上脂质成分异常更为常见。老年女性的血脂异常率明显高于男性。     

慢性腹膜透析患者血脂改变

目的　了解连续性不卧床腹膜透析 (CAPD)患者血脂异常及动态改变。方法　对上海市 12家单位10 5例CAPD患者血脂水平进行横断面调查 ,并与 5 0例正常对照组进行比较分析 ,并前瞻性观察了CAPD对患者血脂的影响。结果　结果CAPD患者血TG、apoB和Lp(a)水平均显著高于正常 ,血HDL -ch、HDL2 、apoA1和LCAT均显著低于正常 ;CAPD治疗后 ,血Lp(a)、apoE、LDL -ch和apoB水平均显著升高。 结论　CAPD患者脂代谢紊乱相当常见 ,并随透析时间改变而变化     

新疆2585例汉、维、哈族血脂水平调查

目的调查新疆汉、维、哈民族血脂水平,了解其血脂水平分布特点,分析其影响因素。方法采用整群随机抽样的方法,选取新疆乌鲁木齐市、呼图壁县、托里县、托克逊县、和田市、喀什市为调查点,收集年龄18~70岁的汉、维、哈居民共2 585人,测定血浆总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)浓度。结果 (1)所调查人群中共有1 474人符合血脂异常诊断。其中低高密度脂蛋白血症最多,占61.5%;其次是混合型血脂异常,占27.5%;高TG血症占6.4%;高TC血症最少,仅占2.2%。(2)汉、维、哈民族血脂水平的比较:TC及TG水平,汉族与维吾尔族明显高于哈萨克族(P0.05);HDL-C及LDL-C水平比较,哈萨克族HDL-C水平最高,其次为汉族,维吾尔族HDL-C水平最低,哈萨克族LDL-C水平最低,维吾尔族LDL-C水平最高(P0.05)。(3)汉、维、哈民族不同性别血脂水平比较:汉、维、哈民族TG水平男性均高于女性,HDL-C水平女性均高于男性(P0.05);维吾尔族女性的LDL-C水平高于汉族女性(P0.05)。(4)汉、维、哈民族不同年龄段血脂水平比较:汉、维、哈民族TC水平随着年龄增长而呈递增趋势(P0.05)。结论不同民族血脂水平存在差异。与哈萨克族人群相比,汉族与维吾尔族TC、TG、LDL-C水平较高,而HDL-C水平偏低。差异可能与性别、年龄、生产方式、饮食结构、肥胖、遗传等因素有关。     

石龙机关工作人员血脂水平分类及分型的统计分析

目的 研究石龙职业人群血脂水平分类及分型特征。方法 根据近年1200例血脂调查资料(男女各600例，年龄20—98岁)，按我国“血脂异常防治建议”作血脂分类及分型研究。结果 本组人群中40岁以上者只有1／3总胆固醇(1℃)及甘油三酯(TG)都在合适水平，高1℃者超过50％。高1℃明显多于高TG，Ⅱa型高脂蛋白血症比Ⅳ型多2倍。男／女性中约有6％高密度脂蛋白胆固醇（HDL-C)降低；女性组达60％，男性中仅有45％HDL-C明显增高；高HDL-C多见于高TC者，而抵HDL-C多见于高TC者。结论 本调查结果示中老年人血脂异常者已达2／3，表明动脉粥样硬化性心血管病的风险明显增高，防治血脂异常应有利于冠心病预防。     

健脾化痰通脉方治疗冠心病血脂异常30例临床观察

目的 观察健脾化痰通脉方对冠心病血脂异常患者临床症状及血脂水平的影响.方法 将60例冠心病血脂异常患者随机分为治疗组和对照组各30例,在常规治疗的基础上,治疗组给予健脾化痰通脉方,每日一剂,分早晚两次温服;对照组给予辛伐他汀20 mg,于每晚睡前口服.疗程均为8周.疗程结束时比较两组中医症状积分变化及血清总胆固醇(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)等指标.结果 健脾化痰通脉方能明显改善冠心病血脂异常患者胸闷、胸痛、气短、体胖多痰、身体困重等临床症状,与对照组比较差异有统计学意义(P<0.05或P<0.01);且能明显改善患者各项血脂指标(P<0.01),实验室指标总有效率为73.33%,与对照组比较疗效接近,差异无统计学意义(P>0.05).结论 健脾化痰通脉方能明显改善冠心病血脂异常患者临床症状及各项血脂指标,并具有较高的安全性.     

Impaired glucose tolerance, beta cell function and lipid metabolism in HIV patients under treatment with protease inhibitors.

OBJECTIVES: To evaluate metabolic abnormalities, beta-cell function, lipid profile and vascular risk factors in HIV patients on protease inhibitors (PI). DESIGN: Prospective cross-sectional study. METHODS: Thirty-eight HIV-1-infected patients receiving at least one PI were compared with 17 PI-naive HIV patients in an oral glucose tolerance test (OGTT). Serum glucose, insulin, proinsulin, and C-peptide were determined. The fasting lipid pattern was analysed using electrophoresis and the assessment of apolipoproteins including lipoprotein (a). Fibrinogen, homocysteine, and anticardiolipin antibodies were also assessed. RESULTS: Twenty-seven (71%) of the PI-treated group had detectable hyperlipidaemia. Isolated hypertriglyceridaemia was present in 12 patients (44%), two (7%) of them had type V and 10 (37%) subjects had type IV hyperlipidaemia (Frederickson classification). Type IIb hyperlipidaemia defined as an increase of both very-low-density lipoproteins (VLDL) and low-density lipoproteins (LDL) was found in 10 (36%) subjects, and five (18%) patients presented with isolated hypercholesterolaemia (type IIa). PI treatment was associated with significant higher fasting cholesterol, triglycerides, LDL and VLDL levels. Apolipoprotein B and E concentrations were significantly increased in patients receiving PI. Elevated concentrations of lipoprotein (a) (> 30 mg/dl) were detected in six (16%) of the hyperlipidaemic patients on PI. Eighteen (46%) patients on PI had impaired oral glucose tolerance and five (13%) had diabetes. Although four (24%) of the PI-naive patients were glucose intolerant, none had diabetes. Fasting concentrations and secretion response of insulin, proinsulin, and C-peptide to glucose ingestion was significantly increased in the PI-treated group suggesting a beta-cell dysfunction in addition to peripheral insulin resistance. Beta-cell abnormalities were associated with the abnormal lipid pattern and PI treatment. CONCLUSION: Combination drug regimens including PI are accompanied by impaired glucose tolerance, hyperproinsulinaemia as an indicator for beta-cell dysfunction, and lipid abnormalities proved to be significant risk factors for coronary heart disease. Moreover, PI may have an impact on the processing of proinsulin to insulin.     

Lipid profile in children with coronary artery disease in Sindh,Pakistan

AIM:To evaluate lipid profile in children with coronary artery disease(CAD)in Hyderabad,Sindh,Pakistan.METHODS:The study included 100 children(6-15years),of which 43 were children of young parents(one or both)with recognized CAD,while the other 57 were children with no evidence of CAD(controls).All were evaluated for fasting blood lipid profile.Blood samples were collected from patients with CAD and healthy controls and analysis of the levels of lipid profile were carried out using a kit method on Microlab 300.RESULTS:Children with CAD had significantly higher levels of total serum cholesterol and triglycerides and decreased levels of high density lipoprotein and low density lipoprotein compared to children in the control group.Systolic and diastolic blood pressures were significantly higher,without any significant difference.CONCLUSION:CAD risk factors are significant regarding abnormal lipid levels.Genetic tendency seems to be important in the development of CAD in children.     

Diabetic dyslipidemia and pathogenesis of ischemic heart disease

BACKGROUND: Type II diabetes is associated with high risk of ischemic heart disease (IHD), diabetes and IHD have similar risk factors, abdominal obesity as well as interrelated disturbances of lipid and carbohydrate metabolism play important roles in pathogenesis of both diseases. AIM: To elucidate characteristics of metabolism and transport of lipids and carbohydrates in patients with type II diabetes and IHD with normal and excessive body mass with abdominal type of fat distribution. MATERIAL AND METHODS: Parameters of carbohydrate metabolism, blood serum levels of free fatty acids, lipid and apoprotein (apo-) parameters of lipoprotein spectrum were evaluated in subjects without diabetes or IHD (group 1), patients with IHD and normal body mass (group 2), patients with IHD combined with diabetes with normal body mass (group 3), patients with IHD, diabetes and abdominal obesity (group 4). RESULTS: Patients with combination of diabetes and IHD compared with those of groups 1 and 2 in addition to higher blood glucose had lower growth hormone, higher triglycerides, lower high density lipoprotein cholesterol (CH) and apo-A1, higher low/high density lipoprotein CH and apo-B/apo-A1 ratios. These atherogenic changes were more pronounced in patients of group 4 who had highest levels of insulin, free fatty acids, low density lipoprotein CH and apo-B and lowest glucose/insulin ratio and level of apo-A1. CONCLUSION: Insulin resistance and hyperinsulinemia are most important features of disturbed carbohydrate and lipid metabolism. Insulin resistance and hyperinsulinemia are most pronounced in subjects with abdominal obesity in whom they create conditions for impaired glucose utilization, development of atherogenic dyslipidemia and eventually emergence of IHD.     

2型糖尿病患者活化血小板糖基化复合物活性与脂代谢异常的相关性

探讨2型糖尿病患者血小板活化与脂代谢异常的关系.将120例2型糖尿病患者按有无脂代谢异常分为有脂代谢异常组(n=62)和无脂代谢异常组(n=58),并选择25例正常者作对照.应用流式细胞仪分别测定各组的活化血小板糖基化复合物活性,比较两组糖尿病患者活化血小板糖基化复合物活性的差异,并分析其与甘油三酯、高密度脂蛋白胆固醇及低密度脂蛋白胆固醇水平的相关性.结果发现,两组糖尿病患者的活化血小板糖基化复合物活性均明显高于正常对照组,且有脂代谢异常的糖尿病组活化血小板糖基化复合物活性高于无脂代谢异常组,低密度脂蛋白胆固醇水平与活化血小板糖基化复合物活性显著正相关(r=0.64, P<0.05).结果提示, 2型糖尿病患者脂代谢异常是导致血小板活化水平增高的重要因素.     

Incidence of abnormal thyroid function in patients with low titers of thyroid microsomal antibodies

The incidence of abnormal thyroid function related to autoimmune disorders was examined in a district of Shimane Prefecture in 1988. Thyroid microsomal antibodies (MCPA) in sera were measured in a general population of 1,646, including 678 males and 968 females, aged 57.8 +/- 14.8 (mean +/- SD) yr. MCPA titer was defined as high (less than 1:128), low (1:16, 1:32, 1:64) or negative (less than 1:16) according to the highest dilution of test serum capable of agglutinating gelatin particles coated with the appropriate antigen. Test of MCPA revealed high titers in 141 subjects (group A), low in 43 subjects (group B) and negative in 1,462 (group C). Twenty-four patients with overt thyroid disorders were found in groups A and B: five with Graves' disease, two with Hashimoto's thyroiditis and 15 with goiter in group A, and two with goiter in group B. In the remaining 119 subjects in group A and 41 subjects in group B, serum free T4 (FT4) and TSH levels were measured. According to abnormalities in the levels of serum FT4 and/or TSH, their thyroid function was divided into the following 3 subgroups: 1) hyperthyroid (FT4 greater than 2.0 ng/dl, TSH less than 0.4 mu U/ml), 2) latent hypothyroid (0.8 less than FT4 less than 2.0 ng/dl, TSH greater than 5.0 mu U/ml) and 3) hypothyroid (FT4 less than 0.8 ng/dl, TSH greater than 5.0 mu U/ml). The hyperthyroid group consisted of two patients in group A and one in group B. Ten latent hypothyroid patients were found in group A and two in group B. Hypothyroidism was found in four patients in group A. The incidence of abnormal thyroid function was not different between group A (16 out of 119, 13.4%) and group B (three out of 41, 7.3%). Graves' disease and primary myxedema were found in one patient each in group B; these patients had no subjective symptoms but showed low titers of MCPA. These findings suggest that not only high titers of MCPA but also low titers of MCPA are closely related to abnormal thyroid function.     

Troglitazone increases the resistance of low density lipoprotein to oxidation in healthy volunteers

Summary The oxidative modification of low density lipoprotein is of importance in atherogenesis. Antioxidant supplementation has been shown, in published work, to increase low density lipoprotein resistance to oxidation in both healthy subjects and diabetic subjects; in animal studies a contemporary reduction in atherogenesis has been demonstrated. Troglitazone is a novel oral antidiabetic drug which has similarities in structure with vitamin E. The present study assessed the effect of troglitazone 400 mg twice daily for 2 weeks on the resistance of low density lipoprotein to oxidation in healthy male subjects. Ten subjects received troglitazone and ten received placebo in a randomised, placebo-controlled, parallel-group design. The lag phase (a measure of the resistance of low density lipoprotein to oxidation) was determined by measurement of fluorescence development during copper-catalysed oxidative modification of low density lipoprotein. The lag phase was increased by 27 % (p < 0.001) at week 1 and by 24 % (p < 0.001) at week 2 in the troglitazone treated group compared with the placebo group. A number of variables known to influence the resistance of low density lipoprotein to oxidation were measured. They included macronutrient consumption, plasma and lipoprotein lipid profile, alpha-tocopherol, beta-carotene levels in low density lipoprotein, low density lipoprotein particle size, mono and polyunsaturated fatty acid content of low density lipoprotein and pre-formed low density lipoprotein hydroperoxide levels in low density lipoprotein. Troglitazone was associated with a significant reduction in the amount of pre-formed low density lipoprotein lipid hydroperoxides. At weeks 1 and 2, the low density lipoprotein hydroperoxide content was 17 % (p < 0.05) and 18 % (p < 0.05) lower in the troglitazone group compared to placebo, respectively. In summary the increase in lag phase duration in the troglitazone group appeared to be due to the compound's activity as an antioxidant and to its ability to reduce the amount of pre-formed low density lipoprotein lipid hydroperoxides. This antioxidant activity could provide considerable benefit to diabetic patients where atherosclerosis accounts for the majority of total mortality. [Diabetologia (1997) 40: 1211–1218] Received: 18 February 1997 and in revised form: 6 June 1997     

Proton magnetic resonance spectroscopy and single photon emission computed tomography study of the brain in asymptomatic young hyperlipidaemic Asian Indians in North India show early abnormalities

OBJECTIVE: To evaluate brain metabolism and cerebral blood flow in young patients with hyperlipidaemia. PATIENTS AND METHODS: Proton magnetic resonance spectroscopy ((1)H MRS) and single photon emission computed tomography (SPECT) of the brain was carried out in 19 asymptomatic young patients with hyperlipidaemia (mean age 32.6 +/- 6.0 years, range 22-45 years) and 21 age-matched healthy controls divided into the following three groups; (i) hyperlipidaemics on pharmacological treatment (group 1, n = 13), (ii) hyperlipidaemics not on pharmacological treatment (group 2, n = 6) and (iii) control group of healthy subjects (group 3, n = 21). RESULTS: No statistical difference was observed in the brain metabolite ratios between controls and hyperlipidaemic patients (both treatment naive and treated) in the (1)H NMR study. Two hyperlipidaemic patients showed a lactate peak and one had a lipid peak. The SPECT study was abnormal in seven hyperlipidaemic patients. In the pooled data, 50% subjects with high serum triglyceride (TG) levels as opposed to 14% subjects with normal serum TG levels showed cerebral hypoperfusion. The choline/creatine (Cho/Cr) ratio of the occipital region of the brain showed correlation with the excess percentage of body fat (%BF) and low levels of high density lipoprotein cholesterol (HDL-C) compared to those with normal %BF and normal HDL-C levels, respectively, in pooled data of all subjects. The N-acetyl aspartate (NAA)/Cho ratio also showed correlation with hypercholesterolaemia. Serum TG levels were positively correlated with the NAA/Cr ratio (r = 0.62, P < 0.05) and the Cho/Cr ratio (r = 0.63, P < 0.05) in the parieto-temporal area in group 1 patients. CONCLUSION: The study revealed no difference in the brain metabolite ratios between controls and hyperlipidaemic patients, while some hyperlipidaemic patients showed abnormalities of cerebral blood flow. Brain metabolite ratios were also influenced by certain parameters of body composition and lipids. As abnormal body composition, hypertriglyceridaemia and low levels of HDL-C are prevalent in Asian Indians, such data are important and indicate a need for further study.     

Lipid risk factor correlates of ischemic heart disease as diagnosed by myocardial perfusion scintigraphy

Patients with known coronary artery disease frequently change their lifestyles (e.g., diet, exercise, and smoking habit) after the diagnosis is made. Such changes can alter lipid risk factor levels and obscure etiologic risk factor associations with the presence of coronary artery disease. It is therefore preferable to determine the contribution of potential risk factors before the diagnosis of coronary artery disease has been established. In this trial, we used stress nuclear myocardial perfusion imaging to diagnose coronary artery disease in patients presenting for evaluation of chest pain. Two groups of age- and sex-matched patients were identified: a normal group (patients with no evidence of coronary artery disease), and an abnormal group (patients whose scans indicated the presence of significant coronary artery disease due to either fixed or reversible perfusion defects). Blood samples were drawn before scanning and analyzed for lipid risk factors. Compared to the normal group, the abnormal group had higher levels of triglycerides (189±91 vs. 135±51 mg/dL, p =0.003), lower levels of high density lipoprotein cholesterol (39±9 vs. 45±14 mg/dL, p =0.037), and higher levels of small, dense low density lipoprotein (LDL₃) (42±18 vs. 32±13 mg/dL, p =0.007). Total cholesterol, low density lipoprotein, and lipoprotein(a) levels were similar between groups. These findings suggest that ischemic heart disease, as assessed by myocardial perfusion scintigraphy, is more closely associated with the low high density lipoprotein/high triglyceride syndrome than with increased low density lipoprotein or total cholesterol levels.     

Lipid profiles of Thai adult HIV-infected patients receiving protease inhibitors

Dyslipidemia is a common metabolic complication among HIV-infected patients who receive protease inhibitor (PI)-based antiretroviral therapy (ART). In order to assess the prevalence of lipid abnormalities and related factors, a cross-sectional analytic study of the lipid profiles of 170 Thai adult HIV-infected patients receiving PI-containing HAART who attended the HIV-clinic, King Chulalongkorn Memorial Hospital, Bangkok, Thailand between January and August 2005 was conducted. Studied subjects had a median age of 40 years with a median duration of taking PIs of 22.1 months. The mean serum total cholesterol (TC), high density lipoprotein cholesterol (HDL-c), low density lipoprotein cholesterol (LDL-c), and triglyceride (TG) levels were 259.7, 43.7, 135.2, and 506.8 mg/dl, respectively, and the mean TC:HDL-c ratio = 6.4. According to the US National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) guidelines, high TC, low HDL-c, high TC:HDL-c ratio, high LDL-c, and high TG were found in 52.4, 36.5, 18.8, 44.1, and 42.9%, respectively. Seventy-five subjects (44.1%) were taking lipid-lowering drugs. Only 54 subjects (31.8%) had baseline serum lipid profiles tested before beginning PI. There was statistically significant association between group of PI with serum TC and TG. Subjects taking double boosted and single boosted PI had significantly higher serum TC and TG levels than unboosted PI. Males had significantly higher serum TG levels, while females had significantly higher serum HDL-c levels. Age was significantly associated with serum TC, LDL-c levels, and TC:HDL-c ratios. Serum TC and LDL-c levels were also significantly higher in subjects taking efavirenz.