高血脂对血清低密度脂蛋白胆固醇测定的影响

目的观察并分析高血脂对血清低密度脂蛋白胆固醇测定的影响。方法采用分析仪器对200例不同浓度血清中甘油三酯、总胆固醇、高密度脂蛋白胆固醇以及低密度脂蛋白胆固醇进行测定,并通过相应的计算公式对测量中的低密度脂蛋白胆固醇值进行分析。结果血清中甘油三酯4.51mmol/L,两种测定方法测定的数值相差不大,P0.05,不具有统计学意义,4.51mmol/L时有显著差异,P0.05,具有统计学意义。总胆固醇浓度6.21mmol/L时,测定结果没有较大的差异,P0.05,不具有统计学意义,6.21时,有显著差异,P0.05,具有统计学意义。不同浓度血清高密度脂蛋白胆固醇对低密度脂蛋白胆固醇测定结果没有影响,P0.05,不具有统计学意义。结论对高血脂等心血管疾病进行诊断时,需要对多个指标进行分析,这样可以保证低密度脂蛋白胆固醇测定的准确性,帮助高血脂病人进行治疗。     

血清总胆固醇与低密度脂蛋白胆固醇水平的相对关系

临床上以总胆固醇水平大致估计低密度脂蛋白胆固醇比较简便，本文根据我们调查的实际数据对此作简单讨论。从2001年北京某些政府机关工作人员年度体检资料中选取40-59岁中年人2817例(男1725人，女1091人)，已除外甘油三酯水平≥4．mmol/L(400mg/dL)者，以基本健康对象的空腹血脂数据作统计。血脂测定按标准化要求进行。低密度脂蛋白胆固醇以Friedewald公式计算。以线性回归统计总胆固醇与低密度脂蛋白胆固醇的相对关系。结果显示男女总胆固醇与低密度脂蛋白胆固醇水平呈直线相关，本文计算值与我国血脂异常防治建议中总胆固醇与低密度脂蛋白胆固醇关系的数据符合。而在相同的总胆固醇水平下，美国制定的低密度脂蛋白胆固醇数值比较高。     

低密度脂蛋白胆固醇免疫比浊法与计算法结果比较

目的了解低密度脂蛋白胆固醇(LDL_C)免疫比浊法与Friedewald公式计算法(计算法)结果有无差异.方法分别用免疫比浊法,计算法测定LCD_C的值.结果取69例甘油三酯(TG)<4.52mmol/L,无溶血,无黄疸,无浑浊血清标本,分别用免疫比浊法及计算法测定计算其LCD_C值,免疫比浊法结果2.24 士1.10mmol/L,计算法结果2.57士1.48mmol/L,配对t检验t=4.887>t=1.995,P<0.05,计算法相对免疫比浊法偏差14.73%. 结论两法结果有显著差异.     

糖尿病患者血清低密度脂蛋白胆固醇和总胆固醇水平的改变

糖尿病患者血清低密度脂蛋白胆固醇和总胆固醇水平的改变卢新梅（空军石家庄医院石家庄０５００００）近年来的临床观察表明，糖尿病不仅有糖代谢紊乱，而且往往伴有脂类代谢异常。血清低密度脂蛋白是促成动脉粥佯硬化的主要因素之一，与冠心病发生率呈正相关，而血清胆固...     

氧化型低密度脂蛋白胆固醇与动脉粥样硬化

动脉粥样硬化(AS)的形成过程复杂,其发病机制涉及炎症反应、脂质代谢失调及氧化应激等多种病理生理机制。其中,低密度脂蛋白(LDL)经氧化修饰后形成氧化型低密度脂蛋白(oxLDL)被认为是AS发生的关键启动因素。大量研究表明,oxLDL的细胞毒性作用可引起血管内皮细胞功能和结构改     

左主干支架术后血清总胆固醇及低密度脂蛋白胆固醇与原发病变的相关性

目的探讨经皮冠状动脉介入术(PCI)后左主干病变患者1个月随访期间血清总胆固醇(TC)、低密度脂蛋白(LDL)水平与原发病变的相关性。方法选择2010年1月至2013年11月于北京安贞医院心内科住院经PCI患者901例,记录一般情况及病史,根据冠状动脉(冠脉)造影将患者分为左主干病变组(LMD)和非左主干病变组(NLMD),随访两组出院后1个月体格检查及血清生化常规等指标。用独立样本t检验分析LMD组与NLMD组病史资料,生命体征及化验检查参数的差异,Pearson相关分析及多元逐步回归分析术后1个月血清LDL与原发左主干病变程度的相关性。结果LMD组年龄较NLMD组小。两组术后1个月随访血压,心率、TC、LDL较术前显著降低(P<0.05)。LMD组术前三酰甘油(TG)、TC、LDL及高密度脂蛋白(HDL)及体格检查数据、其他化验指标较NLMD组无明显差异(P>0.05)。术后第1个月复查血清TC、LDL水平明显高于NLMD(P<0.05)。术后1月患者血清TC、LDL与LM病变程度呈正相关(r值分别为0.712、0.670,P<0.05)。多元逐步回归分析显示,术后1月血清LDL与原LM病变程度呈正相关(r值0.291,P<0.05)。结论PCI后1个月左主干病变患者血清LDL较非左主干病变患者高,术后LDL水平与左主干变程度呈正相关。     

低密度脂蛋白胆固醇自动分析测定与间接计算法结果的比较

目的:探讨F riedew a ld公式的准确性及其在临床中的应用价值。方法:随机选297例不同浓度低密度脂蛋白胆固醇(LDL-C)患者,将其分为三组;TG<4.52 mm o l/L者171例,2.25~4.51 mm o l/L者78例,TG>4.52 mm o l/L者48例,比较自动分析测定法与应用F riedew a ld方法计算的结果。结果:当TG水平<2.25 mm o l/L,2.25~4.51mm o l/L时,测定法与计算法高度相关(r分别为0.97,0.89,P均<0.01),当TG>4.52 mm o l/L时,计算结果与测定的结果相比有比较显著差别,计算偏差接近15%,其r仅为0.78,P<0.05。结论:按F riedew a ld公式计算血LDL-C浓度在低TG浓度条件下有一定的临床应用价值。     

冠心病患者血清低密度脂蛋白胆固醇测定值是否应以脂蛋白（a…

血清低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）与脂蛋白（ａ）［（Ｌｐ（ａ）］增高是相互独立的冠心病重要脂类危险因素。目前各种ＬＤＬ－Ｃ定量法（包括Ｆｒｉｅｎｄｅｗａｌｄ公式计算法）所测出的数值都包括Ｌｐ（ａ）胆固醇在内，因此存在是否需要对ＬＤＬ－Ｃ测定值作校正的问题。作者分析１２２例经冠状动脉造影证实的冠心病，以生活情况相似、性别与年龄相匹配的正常人１２２例为对照组，结果示冠心病组的Ｌｐ（ａ）〉３００ｍｇ／     

低密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值与急性冠脉综合征及冠脉病变程度相关性研究

目的探讨血清低密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值（LDL-C/HDL-C值）与急性冠脉综合征（ACS）以及冠状动脉病变程度之间的关系。方法对我院冠状动脉造影118例患者临床资料进行回顾分析。结果 ACS患者的LDL-C/HDL-C值与冠状动脉病变的程度具有良好的相关性,两级之间的LDL-C/HDL-C值差异有统计学意义（P〈0.05）结论ACS患者LDL-C/HDL-C值可作为判断ACS的严重程度的生化指标之一。     

老年人低密度脂蛋白受体基因多态性的分布及其与血清胆固醇的关系

一、对象及方法　　解放军总医院门诊部和干休所１９９７年健康查体人员１６３例，其中男性７７例，年龄６０～７５岁，平均（６４．９±４．８）岁；女性８６例，年龄５５～７１岁，其中５５～５９岁３３例，６０～７１岁５３例，平均（６０．８±５．３）岁，均为绝经后妇女。以血清总胆固醇（ＴＣ）≥５．７２ｍｍｏｌ／Ｌ为高胆固醇血症组，共５８例，ＴＣ＜５．７２ｍｍｏｌ／Ｌ为对照组，共１０５例。入选者生活水平近似，均排除糖尿病、肾脏疾病等与脂代谢有关的疾病。　　采用酶法测定ＴＣ水平。常规苯酚－氯仿法提取白细胞基因组Ｄ…     

Comparison of low-density lipoprotein cholesterol/high-density lipoprotein cholesterol and total cholesterol/high-density lipoprotein cholesterol for the prediction of thin-cap fibroatheroma determined by intravascular optical coherence tomography

BackgroundThe correlation among the ratios of low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-C/ HDL-C), total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) and thin-cap fibroatheroma has not yet been established.MethodsIt was a single center, retrospective observational study. In total, we recruited 421 patients (82.4% men; mean age 65.73 ± 10.44 years) with one culprit vessel which determined by intravascular optical coherence tomography (OCT). The thinnest-capped fibroatheroma (TCFA) group was defined as lipid contents in > 2 quadrants, with the thinnest fibrous cap measuring less than 65 μm. Univariate and multivariate logistic regression were carried out to explore the relationship between lipoprotein ratios, TCFA and other characteristics of plaque. To compare different ratios, the area under curve (AUC) of receiver-operating characteristic (ROC) curve was assessed.ResultsOCT was performed in 421 patients (TCFA group (n = 109), non-TCFA group (n = 312)). LDL-C/HDL-C in the TCFA group was significantly higher than in the non-TCFA group (2.95 ± 1.20 vs. 2.43 ± 0.92, P < 0.05), as was TC/LDL in TCFA and non-TCFA group (4.57 ± 1.58 vs. 4.04 ± 1.13, P < 0.05). Both LDL-C/HDL-C (OR: 1.002 (1.002-1.003), P < 0.05) and TC/HDL-C (OR: 1.001 (1.001-1.004), P < 0.05) were considered independent factors for the prediction of TCFA according to the logistic regression. Based on the AUC comparison, LDL-C/ HDL-C and TC/HDL-C had no significant difference statistically (LDL-C/HDL-C AUC: 0.63; TC/HDL-C AUC: 0.61; P = 0.10) for the prediction of TCFA.ConclusionsLDL-C/HDL-C and TC/HDL-C could be the independent factors for predicting the presence of TCFA, indicating coronary plaque vulnerability in CAD patients. Moreover, TC/HDL-C also showed a comparative performance for the prediction of TCFA as LDL-C/HDL-C.     

糖尿病患者低密度脂蛋白与内皮细胞受体结合的研究

用荧光法检测正常组、糖尿病HbA1C<7.0%组和HbA1C>7.0%组的低密度脂蛋白(LDL)糖化值分别为(17.7±2.31)、(34.29±5.73)和(48.79±7.82)Glycogroups/LDL,用酶联免疫受体法检测上述3组LDL与人内皮细胞LDL受体的特异结合活性分别为(37.65±5.20)、(27.36±4.34)和(15.07±2.23)ng/mg细胞蛋白,2组糖尿病的LDL糖化值均高于对照组(P<0.01),HbA1C>7.0%组高于HbA1C<7.0%组(P<0.01),而LDL与其受体结合的结果相反.

Abstract：

The levels of low-density lipoprotein(LDL)glycation from control group,diabetic HbA1C < 7.0%,and HbA1C>7.0% groups were(17.7±2.31),(34.29±5.73),and(48.79±7.82)Glycogroups/LDL by fluorimetry.The LDL binding to its receptor in three groups were(37.65±5.20),(27.36±4.34),and(15.07± 2.23)ng/mg cell protein measured by enzyme-linked immunoreceptor assay.The glycated levels in two diabetic groups were higher than that in control group,and higher in HbA1C>7.0% group than in HbA1C<7.0% group(all P< 0.01).The results of LDL binding capacity to its receptor were just the opposite.     

新疆牧区哈萨克族与蒙古族低密度脂蛋白胆固醇水平调查与影响因素分析

目的 调查新疆牧区哈萨克族、蒙古族低密度脂蛋白胆同醇(LDL-C)水平,观察其差异,分析其影响因素.方法 采用整群随机抽样的方法选取新疆和丰县牧区年龄≥30岁的牧民632人为调查对象,其中哈萨克族325人,蒙古族307人;抽取空腹12 h静脉m 3ml,采用日立7600全自动生化分析仪测定血浆总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)的浓度,并根据公式计算出LDL-C的浓度,对资料进行汇总,并采用t检验、方差分析或协方差分析的方法观察两民族间血浆LDL-C水平的差异,并进一步采用多元逐步同归分析的统计方法研究其影响因素.结果 哈萨克族、蒙占族的LDL-C平均水平分别为(3.68±1.16)mmol/L和(3.29±1.23)mmol/L,两民族间LDL-C平均水平存在明显的差异(P<0.001);哈萨克族人群中LDL-C水平主要与平均动脉压相关,而蒙占族主要与体质指数密切相关.结论 血浆LDL-C水平受多种因素的影响,存在明显的民族差异,即便是主要劳动方式和生活习惯十分相似的民族问LDL-C水平的主要影响凶素也各不相同.     

依泽替米贝通过上调甾醇调控元件结合蛋白2、低密度脂蛋白受体促进肝细胞摄取低密度脂蛋白胆固醇

目的探讨依泽替米贝对肝脏低密度脂蛋白胆固醇(LDLC)摄取的影响及其机制。方法使用5 mg/(kg·d)依泽替米贝灌胃高脂模型小鼠,4个月后测定其血液中总胆固醇(TC)、LDLC和高密度脂蛋白胆固醇(HDLC)的含量;HE染色观察肝脏组织形态。依泽替米贝(30μmol/L)与低密度脂蛋白(25 mg/L)共同孵育肝脏Hep G2细胞24 h,油红O染色观察细胞的脂滴分布情况;酶学方法检测细胞内TC、游离胆固醇(FC)和胆固醇酯(CE)的含量;采用Di I-LDL检测细胞对LDLC的摄取情况;实时荧光定量PCR和Western blot分别检测甾醇调控元件结合蛋白2(SREBP-2)和低密度脂蛋白受体(LDLR)在mRNA及蛋白水平的表达;流式细胞术检测肝细胞膜上LDLR含量。结果依泽替米贝降低小鼠血浆中TC和LDLC的含量,升高HDLC含量,减少肝脏脂质沉积;提升Hep G2细胞摄取LDLC的能力,促进FC向CE转化;上调Hep G2细胞中SREBP-2和LDLR的表达水平,并增加LDLR在细胞膜上的分布。结论依泽替米贝通过上调SREBP-2、LDLR促进肝细胞摄取LDLC。     

State of the art of low-density lipoprotein apheresis in the year 2003

Low-density lipoprotein (LDL) apheresis is a last-resort treatment for hypercholesterolemic patients resistant to conservative lipid-lowering therapy. In the extracorporeal circuit, LDL, Lp(a) and coagulation factors are selectively eliminated, while the beneficial proteins like high-density lipoprotein, albumin and immunoglobulins are returned to the patient. Clinical effects of LDL apheresis comprise improvement of symptoms like angina and exercise tolerance, reduction of clinical coronary events like unstable angina, need for angioplasty or bypass operation, myocardial infarction and ultimately coronary mortality. The reduction of atherogenic lipoproteins and of coagulation factors by LDL apheresis (LA) positively influences hemorheology, endothelial function and coronary reserve. In the controlled LAARS, LA significantly improved the electrocardiographic signs of myocardial ischemia in the treadmill test. In angiographically controlled trials such as LARS and L-CAPS, a reduction of progression of coronary lesions was observed; in favorable cases, regression of the stenoses could be documented. In addition, in the LDL apheresis coronary morphology trial, LA decreased the coronary plaque area. The Hokuriku trial documented a 72% decrease of coronary events (MACE) in the LA group vs. controls treated only by statins. In longitudinal studies, the incidence of MACE after regular LA decreased compared with the preapheresis period in the same patients. Apart from coronary heart disease, recent studies indicate a positive effect of LA also on carotid artery stenoses and peripheral vascular disease. Prospective randomized studies showed the beneficial effects of cascade filtration on age-related macular degeneration and of heparin-induced LDL precipitation apheresis on acute inner ear deafness.     

不同体重指数和腰围水平与血清高密度脂蛋白胆固醇的关系

目的 探讨不同体重指数(BMI)和腰围(WC)水平对人群血清高密度脂蛋白胆固醇(HDL-C)水平和低HDL-C患病率的影响。方法 将于1992—1994年和1998年在我国不同地区中年人群中进行的2次心血管病危险因素调查资料合并共32834人，比较不同BMI和WC分组的平均HDL-C水平、低HDL-C患病率及患病危险。结果 随着BMI和(或)WC的增加，人群HDL-C水平明显降低，低HDL-C患病率及患病危险明显上升。结论 BMI和WC均与HDL-C有相互独立的负关联。保持BMI和WC均在正常范围是重要的。     

Influence of apolipoprotein E genotype on the reliability of the Friedewald formula in the estimation of low-density lipoprotein cholesterol concentrations

Lipoprotein data and apolipoprotein (apo) E genotype from 1302 participants, covering a wide range of total plasma cholesterol levels, were used to examine the impact of apo E genotype on the estimation of low-density lipoprotein cholesterol (LDL-C0 concentrations by the Friedewald formula using high-density lipoprotein cholesterol and triglyceride (TG) concentrations as compared with the beta -quantification reference procedure. The results showed that participants with apo E2/E2 genotype had significantly higher very low-density lipoprotein cholesterol (VLDL-C) concentrations and VLDL-C/TG ratio as well as lower LDL-C concentrations than participants with other apo E genotypes. Heterozygous carriers of the epsilon 2 allele had significantly higher VLDL-C than participants with apo E3/E3 and E4/E3 genotypes. The mean absolute error and the mean percentage of bias in calculated LDL-C according to all apo E genotypes, except E2/E2 genotype, were less than 0.16 mmol/L and 4.4%, respectively. Indeed, the mean error and the mean percentage of bias associated with the LDL-C calculated by the Friedewald formula in the apo E2/E2 group were 0.93 mmol/L and 40.6%, respectively. However, participants with the apo E2/E2 genotype and a type III phenotype showed a mean error and a mean percentage of bias reaching 1.53 mmol/L and 63.5%, respectively, whereas E2/E2 participants with a non-type III phenotype had a mean error and a mean percentage of bias of 0.18 mmol/L and 11.0%, respectively. Moreover, 41.9% to 57.1% of the participants had an absolute bias higher than 5% according to the apo E genotype, except for the apo E2/E2 genotypic group where 88.6% of the participants had an absolute bias higher than 5%. Stepwise multiple linear regression analyses revealed that the apo E genotype contributed to 39.0% of the VLDL-C/TG ratio variance, whereas sex, age, and high-density lipoprotein cholesterol explained between 0.5% and 3.2% of the variance. These results indicate that the apo E genotype exerts a significant influence on the estimation of LDL-C concentrations by the Friedewald formula as compared with the beta-quantification.     

Interleukin 28B polymorphisms are the only common genetic variants associated with low-density lipoprotein cholesterol (LDL-C) in genotype-1 chronic hepatitis C and determine the association between LDL-C and treatment response

Low-density lipoprotein cholesterol (LDL-C) levels and interleukin 28B (IL28B) polymorphism are associated with sustained viral response (SVR) to peginterferon/ribavirin (pegIFN/RBV) for chronic hepatitis C (CHC) infection. IL28B has been linked with LDL-C levels using a candidate gene approach, but it is not known whether other genetic variants are associated with LDL-C, nor how these factors definitively affect SVR. We assessed genetic predictors of serum lipid and triglyceride levels in 1604 patients with genotype 1 (G1) chronic hepatitis C virus (HCV) infection by genome-wide association study and developed multivariable predictive models of SVR. IL28B polymorphisms were the only common genetic variants associated with pretreatment LDL-C level in Caucasians (rs12980275, P = 4.7 × 10(-17), poor response IL28B variants associated with lower LDL-C). The association was dependent on HCV infection, IL28B genotype was no longer associated with LDL-C in SVR patients after treatment, while the association remained significant in non-SVR patients (P < 0.001). LDL-C was significantly associated with SVR for heterozygous IL28B genotype patients (P < 0.001) but not for homozygous genotypes. SVR modelling suggested that IL28B heterozygotes with LDL-C > 130 mg/dL and HCV RNA ≤600 000 IU/mL may anticipate cure rates >80%, while the absence of these two criteria was associated with an SVR rate of <35%. IL28B polymorphisms are the only common genetic variants associated with pretreatment LDL-C in G1-HCV. LDL-C remains significantly associated with SVR for heterozygous IL28B genotype patients, where LDL-C and HCV RNA burden may identify those patients with high or low likelihood of cure with pegIFN/RBV therapy.     

Effects of lipoprotein(a) and low density lipoprotein on growth of mitogen-stimulated human umbilical vein endothelial cells

We investigated the effects of lipoprotein(a) (Lp(a)) and low density lipoprotein (LDL) on proliferation of human umbilical vein endothelial cells (HUVECs). Both Lp(a) and LDL stimulated the growth of HUVECs synergistically with basic fibroblast growth factor and insulin in a dose-dependent manner. The potency of Lp(a) to promote the cell proliferation was 40% less than that of LDL. Addition of anti-transforming growth factor-β 1 neutralizing antibody into the medium could not diminish the difference of HUVECs proliferation by Lp(a) and LDL. However, addition of anti-LDL receptor antibody suppressed HUVECs proliferation to the same level and sequestered the difference by the two lipoproteins. Moreover, cholesteryl ester content incubated with Lp(a) was 50% less than that with LDL. These results suggest that Lp(a) has less effect on HUVECs proliferation and cholesterol delivery to the cells than LDL. Therefore, Lp(a) may play a role as an atherogenic lipoprotein by delaying the repair of endothelium after injury.