Serum lipid, lipoprotein and apolipoprotein changes in gestational diabetes mellitus: a cross-sectional and prospective study.

AIMS: To compare serum lipid, lipoprotein and apolipoprotein concentrations during and six to 12 months after pregnancy in control and diabetic women. METHODS: The serum lipid, lipoprotein and apolipoprotein concentrations were measured in 20 women with gestational diabetes mellitus (GDM) and 22 women with normal glucose tolerance (controls) during the third trimester of pregnancy and six to 12 months after delivery. RESULTS: During pregnancy the women with GDM had higher serum triglyceride (mean (95% confidence interval (CI)), 2.91 (2.22-3.51) v 2.1 (1.75-2.52)) but lower low density lipoprotein (LDL) cholesterol concentrations compared with controls (mean (SD), 3.08 (1.2) v 4.01 (1.1). Total cholesterol, high density lipoprotein (HDL) cholesterol and apolipoprotein concentrations were not significantly different between the two groups. After pregnancy, total cholesterol, HDL cholesterol, triglyceride, and apolipoprotein A1 and B decreased in a parallel manner, resulting in lower concentrations, comparable between the two groups. LDL cholesterol concentrations decreased after pregnancy in the controls (mean (SD), 4.01 (1.1) v 2.69 (0.6)) but not in those with GDM (3.08 (1.2) v 2.72 (0.7)). The change in lipid concentrations was not related to change in weight. CONCLUSION: Development of diabetes during pregnancy induces a state of dyslipidaemia characterised by elevated triglyceride concentrations, as seen in other insulin resistance states. However, GDM seems to blunt the increase in LDL cholesterol during pregnancy and this requires further investigation. Whether the changes in lipoprotein metabolism in GDM are significant for the health status of the mother and the foetus requires further study.     

Serum lipids, lipoproteins and apolipoproteins in pregnant non-diabetic patients.

AIMS--To investigate the effect of pregnancy on serum concentrations of lipids, lipoproteins, and apolipoproteins. METHODS--Fasting serum concentrations of total cholesterol, triglyceride, low density lipoprotein cholesterol (LDL), high density lipoprotein cholesterol (HDL), apolipoproteins AI, AII, and B, and lipoprotein (a) were measured in 178 women with normal glucose tolerance in the second and third trimesters of pregnancy and in a control group of 58 non-pregnant women of similar age. Data were analysed using the unpaired t test and by one-way analysis of variance. RESULTS--The pregnant women had significantly higher concentrations of total cholesterol, triglyceride, LDL cholesterol, HDL cholesterol, and apolipoproteins AI and B (p < 0.001) and apolipoprotein AII (p = 0.003) than the control women. The ratio of apolipoprotein B:apolipoprotein AI was significantly higher in the pregnant women than in the controls (p < 0.001), but the total cholesterol:HDL cholesterol ratio was not significantly different. No significant difference was found in the concentration of lipoprotein (a). CONCLUSIONS--Hyperlipidaemia is common in the second half of pregnancy. This may be a purely physiological response to pregnancy or it may be indicative of pathology in some women. These results warrant a follow up study to investigate whether the hyperlipidaemic response to pregnancy is variable and if so, whether it can predict future hyperlipidaemia in a manner analogous to that of impaired glucose tolerance during pregnancy, predicting non-insulin dependent diabetes in later life.     

Correlation of P-selectin and lipoprotein(a), and other lipid parameters in preeclampsia

Preeclampsia is a pregnancy specific disorder and is thought to be associated with generalized endothelial dysfunction. P-selectin, an adhesion molecule, mediates the interaction of monocytes, platelets, and endothelial cells. Increased P-selectin levels and altered lipid and lipoprotein metabolism were reported in preeclampsia and during pregnancy. In order to investigate the relationship between serum P-selectin and lipoprotein(a), and other lipid parameters, 28 preeclampsia [13 severe (group I) and 15 mild preeclampsia (group II), 15 healthy pregnant (group III) and 20 non-pregnant (group IV)] women were investigated. Serum P-selectin, lipoprotein(a), total cholesterol, triglyceride, and high density lipoprotein cholesterol were measured and low-density lipoprotein cholesterol was derived. Serum P-selectin concentrations were consistently and significantly higher in the severe preeclampsia group than in the mild preeclampsia, healthy pregnancy, and non-pregnant control groups (P<0.0001, for all). The mild preeclampsia group also had increased serum P-selectin concentrations compared with the healthy pregnancy group and non-pregnant controls (P<0.05 and P<0.0001, respectively). Serum P-selectin and lipoprotein(a) levels revealed a significant and linear increase with the severity of preeclampsia. There were also significant (in groups I and II) and borderline (in groups III and IV) correlations between P-selectin and total cholesterol. The present study suggests that P-selectin may be an additional risk marker for preeclampsia, and may be useful in distinguishing women with mild and severe preeclampsia and normal pregnancy. Received: 9 November 2001 / Accepted: 6 February 2002     

Relationship of blood rheology to lipoprotein profile during normal pregnancies and those with intrauterine growth retardation.

AIMS--The effects on fetal growth of hyperlipidaemia in pregnancy are not well understood at present. In this study the different lipid fractions in normal pregnancies and pregnancies complicated by intrauterine growth retardation (IUGR) were determined and related to changes in plasma and serum viscosity. METHODS--Two groups of pregnant women were studied. Group 1 consisted of 35 healthy pregnant women aged between 21 and 38 years with no previous pathology and a normal pregnancy to term. Group 1 patients were studied at four periods defined at the start of the study: (1) < or = 17 weeks; (2) 18-24 weeks; (3) 25-32 weeks, (4) > or = 33 weeks. Group 2 consisted of 24 pregnant women aged between 16 and 34 years with ultrasound diagnosed IUGR confirmed after birth. Plasma lipids and plasma and serum viscosity were measured. RESULTS--Plasma triglycerides, low density lipoprotein cholesterol, and total cholesterol increased progressively throughout pregnancy, with significantly higher values after week 25. Apolipoprotein A (ApoA) and triglyceride concentrations were significantly lower in the IUGR group than in the normal group. The HDL/ApoA ratio was greater in the IUGR group than in the control group, as was the ApoB/ApoA ratio. There were no differences in the other lipids. Plasma and serum viscosity was higher in the IUGR group than in the normal group. CONCLUSIONS--Haemorheological modifications in the IUGR group are partly secondary to changes in high density lipoprotein metabolism and the competitive inhibition of fibrinolysis by ApoB, which is increased in pregnancies with IUGR. Changes in ApoA, and more specifically in the ApoB/ApoA ratio, could be good markers for the early detection of IUGR.     

妊娠期糖尿病孕妇血脂水平测定

目的研究妊娠期糖尿病孕妇的血脂变化。方法选择正常孕妇4O例（对照组）,妊娠期糖尿病孕妇75例,测定空腹静脉血清胆固醇（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A（ApoA）、载脂蛋白B（ApoB）、脂蛋白a（Lp（a））水平。结果妊娠期糖尿病组与对照组相比,TC、TG、LDL-C、ApoB测定值升高（P〈0.05）,HDL-C、ApoA测定值降低（P〈0.05）,Lp（a）无统计学意义（P〉0.05）。结论血脂代谢异常可能在妊娠期糖尿病的发病中起一定作用。     

2型糖尿病患者血清瘦素、NSF-1与血脂的关系研究

目的 研究2型糖尿病患者血清瘦素、NSF-1、载脂蛋白及血脂水平的相关性.方法 选择2016年6月至2017年1月我院收治的2型糖尿病患者64例作为观察组,于同期选择在我院健康体检的健康人群58例为对照组,抽取两组晨起空腹静脉血,比较两组血清总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、载脂蛋白A1、载脂蛋白E、瘦素、摄食抑制因子-1水平,并采用Pearson相关分析以上指标的相关性.结果 观察组与对照组血清总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、载脂蛋白E、瘦素、摄食抑制因子-1水平差异具有统计意义(P＜0.05),载脂蛋白A1比较无统计学差异.血清总胆固醇与甘油三酯、低密度脂蛋白胆固醇、载脂蛋白E呈正相关(r =0.341,P＜0.001;r=0.836,P＜0.001;r =0.337,P＜0.001),与摄食抑制因子-1呈负相关(r=-0.303,P＜0.001).甘油三酯与载脂蛋白E呈显著正相关(r =0.678,P＜0.001),低密度脂蛋白胆固醇与瘦素呈明显负相关(r=-0.266,P＜0.001),高密度脂蛋白胆固醇与载脂蛋白A1呈明显正相关(r=0.335,P＜0.001),载脂蛋白A1与载脂蛋白E呈显著正相关(r=0.318,P＜0.001).结论 2型糖尿病患者存在血脂代谢异常情况,且与血清载脂蛋白、瘦素、摄食抑制因子-1之间存在一定相关性.     

Effects of nicotinic acid on concentrations of serum apolipoproteins B, C-I, C-II, C-III and E in hyperlipidemic patients

Twenty-four patients with Type IIa, IIb, III and IV hyperlipoproteinemia (HLP) were treated with 4 g of nicotinic acid daily with the purpose to study its effect on serum apolipoprotein B, C-I, C-II, C-III and E concentrations. Triglyceride and total cholesterol concentrations of whole serum and of different serum lipoprotein fractions were also determined. Analyses were performed prior to and after a drug treatment period of 6 weeks, during which all the patients were weight stable. Treatment caused a decrease in serum concentrations of apolipoproteins C-I, C-II, C-III and E. These highly significant reductions were all positively correlated to a reduction of very low density lipoprotein triglyceride levels of serum (r-values greater than 0.76, p less than 0.001). There were highly significant decreases in serum levels of apolipoprotein B and low density lipoprotein total cholesterol. These reductions were positively intercorrelated (r = 0.55; p less than 0.01). Similar effects were observed in the different HLP types and in both sexes. Treatment resulted in normolipidemia in 12 patients, who were hypercholesterolemic (7 type IIa, 3 type IIb, 2 type III hyperlipoproteinemia) prior to treatment. The serum apolipoprotein B concentrations of these 12 patients fell after therapy to values which, however, remained abnormally high. We suggest that serum lipid adjusting treatment should aim at a normalization not only of serum lipid concentrations but also of the serum apolipoprotein B concentration in order to achieve a maximal antiatherogenic effect.     

Variations in plasma lipid concentration during examination stress

The effect of psychological stress on plasma lipids was studied in 40 law students (20 men and 20 women). Plasma cholesterol, triglyceride, and apolipoprotein concentrations were examined at the beginning of the quarter and during the week before final examinations. Cortisol, blood pressure, and heart rate, and self-reports of stress and workload were also measured to verify that examinations were associated with increased stress levels. Perceived stress, perceived workload, and cortisol increased before examinations. Low density lipoprotein cholesterol (LDL-C) increased 5.8 +/- 13.9 mg/dL, and apolipoprotein B (apo B) increased 2.9 +/- 4.0 mg/dL. High density lipoprotein cholesterol decreased in women only. These changes were not due to changes in dietary intake or indexes of plasma volume. However, changes in cortisol and changes in LDL-C and apo B were associated, suggesting a neuroendocrine component to the effects. These results suggest that episodic, stressful situations may lead to potentially atherogenic changes in lipid and lipoprotein concentrations.     

Serum lipid and lipoproteins in gallstone patients

Serum lipid and lipoprotein concentrations were determined in a group of thirty two gallstone patients and compared to the values obtained in thirty two healthy control subjects. The serum levels of high density lipoprotein cholesterol and lipoprotein(a) in gallstone patients were found to be lower than that of the control group. Total cholesterol, triglyceride, low density lipoprotein cholesterol, apoprotein-A and apoprotein-B concentrations were observed to be higher in gallstone patients than the controls. The differences in triglyceride and low density lipoprotein cholesterol concentration were statistically significant. However, there was no significant difference in high density lipoprotein cholesterol, lipoprotein(a), apoprotein-A, apoprotein-B, and total cholesterol concentrations between groups. It is concluded that gallstone formation may be related to a disturbance in lipid and lipoprotein metabolism.     

妊娠期糖尿病孕妇血清视黄醇结合蛋白4水平与糖脂代谢相关性的初步研究

目的了解妊娠期糖尿病孕妇血清视黄醇结合蛋白4（RBP4）水平与糖脂代谢的关系。方法采用酶联免疫吸附试验（ELISA）测定50例孕晚期妊娠期糖尿病孕妇及50例正常孕晚期孕妇血清RBP4水平;同时测定两组孕妇空腹血糖（FPG）、糖化血红蛋白（HbAlC）、血清总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL—C）、低密度脂蛋白（LDL—C）、栽脂蛋白A—I（ApoA-1）、载脂蛋白B（ApoB）水平。结果（1）妊娠期糖尿病组孕妇血清RBP4水平为（18．48±4．6）ng／ml,明显高于正常孕妇血清RBP4水平（13．26±2．35）ng／ml,差异有统计学意义（P〈0．01）。（2）妊娠期糖尿病组孕妇FPG、HbAlCs水平分别为（5．40±0．57）mmol／L、（5．68±0．58）％,明显高于正常孕妇血清水平（4．99±0．27）mmol／L、（4．75±0．51）％,差异有统计学意义（P〈0．01）。（3）妊娠期糖尿病组孕妇血清TC、TG、ApoB、分别为（5．70±0．88）mmol/L、（3．17±1．06）mmol／L、（0．3l±0．13）异／L,明显高于正常孕妇血清水平（5．25±0．75）mmol／L、（1．26±0．31）mmol／L、（0．20±0．09）∥L,差异有统计学意义（P〈0．01或P〈0．05）;妊娠期糖尿病组孕妇血清ApoA—Ⅰ水平为（2．12±0．30）g／L,明显低于正常孕妇血清水平（2．62±0．70）g／L,差异有统计学意义（P〈0．01）;妊娠期糖尿病组孕妇血清LDL—C血清水平为（3．51±0．75）mmol／L,高于正常孕妇血清水平（3．16±0．76）mmol／L,但差异无统计学意义（P〉0．05）。（4）Pearson相关分析结果显示,两组孕妇血清RBP4水平分别与TG、HbAlC呈显著正相关性（r=0．27,0．39,P〈0．05,P〈0．01）;与FPG、TC、HDL—C、LDL—C、ApoA-1、ApoB、孕晚期体质指数（bodymassindex,BMO无明显相关性（r=,0．063,0．075,0．127,0．046,－0．159,0．085,－0．3,P〉0．05）。结论妊娠期糖尿病孕妇糖脂代谢紊乱,血清RBP4水平明显升高,RBP4可能参与了妊娠期糖尿病孕妇糖脂代谢紊乱机制。     

Alterations in serum lipids and lipoproteins profile of pregnant camels (Camelus dromedarius) at term

Concentration of serum lipids and lipoproteins was determined on 32 pregnant camels (Camelus dromedarius) at term and was compared with those of 31 non-pregnant camels. Variations in the serum concentrations of total cholesterol, triglycerides, total lipid, and some lipoproteins such as high-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDL-C), and very low-density lipoprotein were investigated. Sera from pregnant group had significantly higher mean triglycerides and very low-density lipoprotein concentrations. However, total cholesterol and high-density lipoprotein showed significantly low concentrations. Total lipid and LDL-C did not differ significantly.     

正常妊娠及妊娠期糖尿病患者血脂代谢特点

目的观察妊娠期糖尿病（gestational diabetes mellitus,GDM）孕妇和正常妊娠孕妇不同孕期的血脂代谢特点,探讨妊娠早中期血脂变化与GDM的关系。方法选择在我院门诊就诊的正常健康孕妇（A组）及GDM孕妇（B组）,两组分别于孕14-19周、28-34周抽取空腹静脉血测定血浆总胆固醇（TC）、甘油三脂（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、载脂蛋白AI（APOAI）、载脂蛋白B（APOB）、脂蛋白A（LPA）。结果 （1）正常妊娠组与GDM组孕妇随着孕周的增加,TC、TG、APOB、LDL值显著升高（P〈0.01）,APOAI值明显升高（P〈0.05）,正常妊娠组中LPA值随孕周增加明显升高（P〈0.05）;（2）GDM组孕妇在孕14-19周及孕28-34周,TG值较同孕周的正常妊娠组显著升高（P〈0.01）,APOB值在GDM组孕14-19周时明显高于同期正常妊娠组（P〈0.01）;（3）TC、LDL、HDL、APOAI、LPA在两组不同孕周间比较均无显著性差异（P〉0.05）,HDL值随两组孕周增加升高不明显（P〉0.05）。结论GDM孕妇在不同孕周的甘油三酯水平均高于正常妊娠孕妇;GDM孕妇在孕早中期较正常妊娠孕妇存在更早期、更明显的脂代谢紊乱。在孕早中期监测血糖、血脂水平,及时制定合理的饮食计划,可减少GDM的发生和尽早防治其可能带来的母婴危害。     

XbaI polymorphism of apolipoprotein B gene in a Tunisian population: alleles frequencies and relationship with plasma lipid parameters

Apolipoprotein B (Apo B) is a component of chylomicrons, low-density lipoproteins (LDL), very low density lipoproteins (VLDL), and intermediate-density lipoproteins (IDL) and is the ligand for the LDL receptor. Thereby, Apo B plays a central role in lipoprotein metabolism and in maintaining the normal homeostasis of serum cholesterol levels. Several Apo B restriction fragment length polymorphisms (XbaI, EcoRI, MspI) have been reported to be associated with variation in lipid levels, obesity and/or coronary artery disease. To date, no data are available on relationship between XbaI Apo B polymorphism and lipid levels in Tunisian population. Here, we report frequencies of the XbaI polymorphism of the Apo B gene and we assess the effect of this polymorphism on lipid and lipoprotein concentrations in Tunisian population. Blood samples from 296 Tunisian individuals (112 women and 184 men, aged 51.4+/-9.6 years), were analysed for total cholesterol, triglycerides, HDL-cholesterol and apolipoproteins A1 and B. In parallel, genotyping by means of polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) was performed. The XbaI polymorphism was associated with differences in plasma cholesterol (p=0.04), triglyceride (p=0.02) and apolipoprotein A1 (p=0.004), individuals with the genotype X1X1 have the lowest mean levels and those with the genotype X2X2 have the highest, with the individuals heterozygous for the polymorphism having intermediate levels. According to sex, the XbaI polymorphism effect was only observed for triglyceride in men. Thus, the results demonstrate an influence of XbaI polymorphism of Apo B gene on serum total-cholesterol, triglycerides and apolipoprotein A1 concentrations among Tunisian population.     

妊娠糖尿病患者血脂检验在临床诊断中的应用分析

目的 研究妊娠糖尿病孕妇血脂检验在临床诊断中的应用效果。方法 选择2016年1月~12月收治的50例妊娠糖尿病孕妇,纳入干预组,同时选择同时段来我院体检的健康孕妇50名,纳入常规组,评价两组孕妇血脂监测结果及不同年龄段孕妇血脂水平。结果 干预组孕妇低密度脂蛋白、三酰甘油、总胆固醇等血脂水平均高于常规组,高密度脂蛋白值低于常规组,差异有统计学意义（P＜0.05）。不同年龄段的孕妇血脂各指标水平结果不同,LDL-C、TG、TC等水平随着孕妇年龄增大而增加,而HDL-C水平则因孕妇年龄增大而减少。结论 妊娠糖尿病患者体内血脂水平均异常,且血脂水平与孕妇年龄存在一定联系。     

Lipid metabolic changes during hormonal treatment of endometriosis

Three groups of patients with pelvic endometriosis were treated with medroxyprogesterone acetate (MPA) 50 mg/day (n = 10), lynestrenol (LYN) 10 mg/day (n = 25) and danazol (DAN) 600 mg/day (n = 25) respectively. Total cholesterol, triglycerides, alpha-lipoprotein, prebetalipoprotein, beta-lipoprotein cholesterol, high-density (HDL) and low-density (LDL) lipoprotein and apolipoprotein A1 and B concentrations were determined before treatment and after 3 and 6 mth of therapy. Whereas lipid, lipoprotein and apolipoprotein levels did not change in the MPA group, the patients on LYN and in particular those on DNA showed marked changes in lipoportein patterns. Alpha-lipoprotein, HDL and apolipoprotein A1 levels fell, while beta-lipoprotein, LDL and apolipoprotein concentrations rose, these changes being statistically significant. No alterations were seen in the serum levels of cholesterol, triglycerides or prebetalipoprotein cholesterol. In view of a possible relationship between high LDL and low HDL levels and a risk of accelerated coronary arteriosclerosis in women it was concluded that progestogen-induced alterations in lipoprotein patterns should be avoided as far as long-term treatment is concerned and where additional risk factors are present.     

Further evidence for the heterogeneity of high density lipoprotein isolates: HDL2:HDL3 cholesterol ratios and the presence of apolipoprotein B

The ratios were compared of HDL2 to HDL3 cholesterol and the quantitation of apo B in high density lipoprotein (HDL) isolated by the heparin manganese, dextran sulfate, and phosphotungstate precipitation procedures. Thirty-two sera with varied HDL cholesterol concentration were analyzed. Heparin manganese isolates had the highest HDL cholesterol concentrations and the lowest HLD2:HDL3 cholesterol ratios, which differed further from the other isolates at higher HDL concentrations. The corresponding values for dextran sulfate isolates did not differ significantly from phosphotungstate isolates. Heparin manganese and phosphotungstate isolates did not contain apo B, but dextran sulfate isolates contained an average of nine percent of the corresponding serum concentrations of apo B, with no dependence on HDL cholesterol concentration. These differences in HDL2:HDL3 cholesterol and apolipoprotein concentrations are further evidence for the marked heterogeneity of the lipid fraction isolated by various precipitation procedures.     

An increase in lipoprotein oxidation and endogenous lipid peroxides in serum of obese women

Endogenous malondialdehyde and diene conjugate levels, the susceptibility of apolipoprotein B-containing lipoproteins to copper-induced lipid peroxidation, and antibody titer against oxidized low-density lipoproteins were increased, but serum antioxidant activity was unchanged in obese women. Serum cholesterol, low-density lipoproteincholesterol, and trigliceride levels were also elevated, but high-density lipoprotein-cholesterol levels remained unchanged in obese women. In vitro, oxidation of apolipoprotein B-containing lipoproteins and levels of antibody against oxidized low-density lipoprotein correlated with body mass index, serum total cholesterol, and low-density lipoproteincholesterol levels in obese women. These results indicate that obesity is associated with increases in endogenous lipid peroxides, oxidation of low-density lipoproteins, and lipids in serum. Received: 14 May 2002 / Accepted: 27 November 2002 Correspondence to ü. Mutlu-Türkoğlu     

Changes in lipid and lipoprotein profile in postmenopausal women receiving low-dose combinations of 17beta-estradiol and norethisterone acetate

OBJECTIVE: To evaluate the modification of lipid and lipoprotein by use of low doses of continuous-combined formulations of 17beta-estradiol (E ) and norethisterone acetate (NETA) in healthy postmenopausal women. DESIGN: The study was designed as a double-blind, randomized, placebo-controlled trial. A total of 120 healthy postmenopausal women were randomized to one of three treatment arms: (1) placebo group ( = 40); (2) E /NETA 0.25-mg group-subjects receiving oral continuous-combined E 1 mg and NETA 0.25 mg ( = 40); (3) E /NETA 0.5-mg group-women who were treated with E 1 mg and NETA 0.5 mg ( = 40). The duration of study was 12 months. Plasma levels of total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and very low-density lipoprotein (VLDL) cholesterol, triglycerides, lipoprotein(a), apolipoprotein A and apolipoprotein B were determined on four occasions (i.e., baseline, 3-, 6-, and 12-month visits). RESULTS: There were no differences in the baseline characteristics among the three groups. A total of 102 women completed the study, resulting in a compliance rate of 85%. There was a significant reduction of total cholesterol, LDL cholesterol, and lipoprotein(a) in both combined groups when compared with placebo. The level of apolipoprotein B declined significantly only in the E /NETA 0.25-mg group. Decrements were observed within 3 months of treatment and maintained thereafter. No significant changes were found in triglycerides, VLDL cholesterol, HDL cholesterol, apolipoprotein A, and LDL/HDL ratio. Between the two active combined groups, no statistically significant differences were noted. CONCLUSION: Favorable changes in lipids and lipoproteins were associated with the low dose of E /NETA combinations. These effects may contribute to the reduction or prevention of atherogenesis in postmenopausal women.     

不同类型肿瘤患者的血脂水平分析

为探讨肿瘤病人血脂水平变化及其临床价值,用日立7600全自动生化分析仪对163例不同肿瘤病人与45名健康人的血脂水平进行检测。检测项目包括三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）、载脂蛋白A1（ApoA1）、载脂蛋白B（ApoB）和血清脂蛋白（a）[Lp（a）]。结果显示,消化道肿瘤组血清ApoA1和HDL-C水平显著低于正常对照组（P〈0.01）,Lp（a）水平显著高于正常对照组（P〈0.01）;肺癌组血清ApoA1和Lp（a）水平分别显著低于和高于正常对照组（P〈0.01,P〈0.05）;妇科肿瘤组只有血清Lp（a）水平显著低于正常对照组（P〈0.05）。对于位于不同位置的消化道肿瘤,胃癌组和结直肠癌组血清ApoA1和HDL-C水平都显著低于正常对照组（P〈0.01）,Lp（a）高于正常对照组（P〈0.01）;而食管癌组只有血清TG水平显著低于正常对照组（P〈0.05）。结论：血脂水平检测对肿瘤的诊断和预后有重要作用。     

Effects of apolipoprotein A-IV genotype on glucose and plasma lipoprotein levels

The effects of apolipoprotein (apo) A-IV genotype on serum glucose, total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, triglyceride and glucose concentrations were ascertained in a population of 373 men and 361 women with a mean age of about 57 years. Subjects were evaluated at entry into a lifestyle intervention program. Apolipoprotein A-IV genotype variations at residues 347 and 360 were examined, as these mutations affect the sequence of apo A-IV, a major protein constituent of intestinal triglyceride-rich lipoprotein and HDL. With regard to the apo A-IV 360 mutation, 16.4% of the females and 13.4% of the males carried the apo A-IV 2-allele, almost entirely in the heterozygous state. No effect of the apo A-IV 1/2 genotype was observed in either men or women on total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride, the total cholesterol (TC)/HDL ratio, or on A-I, A-IV and apo B levels. This was also the case for the apo A-IV 347 mutation. However, women with the apo A-IV 360 1/2 genotype had significantly (p < 0.005) higher glucose levels (105.5 mg/dl) compared with the 1/1 wild-type (94.0 mg/dl). All analyses were also adjusted for age, body mass index, medications, alcohol use and cigarette smoking. The prevalence of the 347 mutation was somewhat higher than the 360 mutation, with 29% of the females and 32.0% of the males being heterozygous for this mutation, and 3.9% of the females and 5.4% of the males being homozygous for this mutation. These data are consistent with the concept that the apo A-IV 360 and 347 genotypes have no significant effect on apo A-IV levels and other lipid parameters in either gender. However, apo A-IV 360 1/2 genotype did have a significant effect on serum glucose levels in women.