早发冠心病患者合并高甘油三酯腰围表型的临床意义

目的：回顾性地分析高甘油三酯腰围表型（HTWP）在早发冠心病患者中的临床意义。 方法：收集本院经临床及冠状动脉造影确诊的早发冠心病患者123例,其中合并HTWP组71例,无HTWP组52例。测定低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、C反应蛋白（CRP）、空腹血糖、尿酸、血压等指标。结果：合并HTWP组的LDL-C、空腹血糖、CRP显著高于无HTWP组（P<0.05）;合并HTWP组急性冠脉综合征（ACS）发生率高于无HTWP组（39.44%比19.23%,P<0.05）,冠脉病变Gensini评分高于无HTWP组［（36.61±31.22）比（25.31±27.44）,P<0.05］。结论：HTWP在早发冠心病患者可作为评估冠心病的危险因素;合并HTWP与ACS发生率及冠状动脉病变严重程度有关。     

2型糖尿病患者高甘油三酯血症-腰围表型与甲状腺功能异常的关系

目的 探讨2型糖尿病患者高甘油三酯血症-腰围表型(HTWC)与甲状腺功能的关系.方法 选取2型糖尿病患者808例,以血甘油三酯≥1.7 mmol/L、腰围男性≥85 cm或女性≥80 cm为切点,分为4组:正常组(n=162)、单纯高甘油三酯组(n=112)、单纯腹型肥胖组(n=262)、HTWC组(n=272).测量所有患者身高、体重、腰围、血压;检测血糖、血脂、促甲状腺激素、游离T3、游离T4、甲状腺过氧化物酶抗体水平,计算体重指数以及稳态模型评估-胰岛素抵抗指数(HOMA-IR).结果 HTWC组体重指数、收缩压、腰围、HOMA-IR、促甲状腺激素、甲状腺过氧化物酶抗体均高于其他3组(F=5.537～53.038,P均＜0.05),而高密度脂蛋白-胆固醇、游离T4显著低于其他3组(F=8.561,4.399,P均＜0.05),且HTWC组亚临床甲状腺功能减退症和甲状腺抗体阳性发生率较其余3组明显升高(x2=4.348,4.774,P均＜0.05).Logistic回归分析显示HTWC是2型糖尿病发生亚临床甲状腺功能减退症的危险因素(优势比=1.461,95％CI:1.073 ～ 1.990,P=0.016).结论 在2型糖尿病患者中,HTWC与甲状腺功能异常存在相关性,并可增加亚临床甲状腺功能减退症的患病风险.     

不同程度高甘油三酯血症对于急性胰腺炎病情严重性的影响

背景体内过多的游离脂肪酸可损伤胰腺腺泡细胞、产生大量炎症因子,导致多器官功能损伤.本研究通过观察不同程度高甘油三酯血症(hypertriglyceridemia,HTG)对急性胰腺炎(acute pancreatitis, AP)病情严重性的影响,从而证实随着血脂水平升高,重症化风险亦随之增加.目的探讨在发病初期不同程度的HTG对于高脂血症型急性胰腺炎(hyperlipidemic acute pancreatitis, HLAP)病情严重性的影响.方法回顾性分析2016-06/2019-12我院收治的87例HLAP患者临床资料,根据患者入院时血清甘油三脂(triglyceride,TG)水平,分为三组:(1)中度HTG组(TG5.65-11.30m m o l/L);(2)重度H T G组(T G11.3-22.3mmol/L);(3)极重度HTG组(TG≥22.4mmol/L),对比观察三组患者各项生化指标、改良CT严重指数(modifiedCTseverityindex,MCTSI)评分、病情严重程度的变化.结果与中度H T G组相比,重度、极重度H T G组患者MCTSI评分、C反应蛋白(C-reactiveprotein,CRP)明显增加,中度重症急性胰腺炎(moderately sever acute pancreatitis, MSAP)/重症急性胰腺炎(sever acute pancreatitis,SAP)的发生率显著上升;但MCTSI评分、CRP在重度、极重度HTG组之间的差异无统计学意义.结论在发病24 h内血清TG的水平影响HLAP的病情严重程度,中度HTG诱发AP的病情程度轻,出现重症化转变的风险较低;而重度/极重度HTG可能是HLAP重症化的高危因素之一.     

急性胰腺炎合并高甘油三酯血症的发病类型和预后

目的　分析急性胰腺炎合并高脂血症 (高甘油三酯血症 )的患者临床特点 ,旨在加强对高脂血症影响急性胰腺炎发病类型和预后的认识。方法　随机选择 2 0 0 12 0 0 3年上海第二医科大学附属新华医院住院 4 3例急性胰腺炎患者 ,分为高脂血症 (11例 )和胆源性急性胰腺炎两组。结果　 4 3例患者中 ,7例为急性坏死型胰腺炎 (高脂血症组 5例 ) ,计数相关分析显示 ,急性坏死型胰腺炎的发病比例增高与高脂血症呈正相关 (χ2 =6 5 8,P <0 0 5 ,r =0 4 6 )。高脂血症组患者中酗酒者、体重超重 (BMI>2 4 )合并有糖尿病者明显高于胆源性胰腺炎组 ;2例重症患者血淀粉酶正常 ;多器官功能衰竭等并发症显著多于胆源性组。结论　高甘油三酯血症与急性坏死型胰腺炎发病呈显著正相关。教育患者饮食控制、减轻体重或应用降脂药物等 ,有助于防治急性胰腺炎复发。     

2型糖尿病患者高甘油三酯血症-腰围表型与颈动脉粥样硬化相关

对2625例2型糖尿病患者的研究发现,高甘油三酯血症-腰围表型(HTWC)组患者体重指数、收缩压、HbA1C、甘油三酯、载脂蛋白(Apo)B、血尿酸、超敏C反应蛋白、肿瘤坏死因子α、颈总动脉内中膜厚度等指标均高于非HTWC组(均P＜0.05),而高密度脂蛋白胆固醇和ApoA1低于非HTWC组(P＜0.05).HTWC是2型糖尿病患者合并颈动脉粥样硬化的独立危险因素(OR 1.45,95％CI 1.07～1.96).     

腰围甘油三酯指数与胸痛患者代谢综合征相关性的研究

目的 研究胸痛患者腰围甘油三酯（WT）指数与代谢综合征（MS）的关系。方法 回顾性分析在我院就诊的胸痛患者。比较MS组和非MS组基线资料的差异,分析WT指数与代谢综合征组的相关性。结果 共有309例患者入选,其中女性115例。MS的检出率为71.1%。MS组的体重、腰围、低密度脂蛋白胆固醇、甘油三酯、空腹血糖、体重指数和腰WT指数均高于非MS组（P<0.05）;高密度脂蛋白胆固醇低于非聚集组（P<0.05）。多因素Logistic回归表明,WT指数是代谢综合征的独立预测因素（OR=1.075,95%CI：1.028~1.124）。WT指数在全部研究人群、男性人群及女性人群, ROC曲线下面积分别为0.839（95%CI：0.793~0.878）、0.877（95%CI：0.803~0.931）和0.858（95%CI：0.801~0.904）;其预测心血管危险因素聚集的最佳切点分别为143.0、142.0和139.1。结论 WT指数是胸痛患者代谢综合征的独立预测因素, 适合于基层医疗机构对高危心血管病人群进行筛查。     

非ST段抬高型急性冠脉综合征合并高甘油三酯血症腰围表型的冠状动脉评分

目的 研究非ST段抬高型急性冠脉综合征合并高甘油三酯血症腰围表型（HTWP）患者的临床特征和冠状动脉评分。方法 回顾性分析2014年4月至2015年12月在秦皇岛市第一医院心内科就诊的非ST段抬高型急性冠脉综合征患者的临床特征和冠状动脉评分及其危险因素。结果 共入选226例患者,年龄（60.5±9.6）岁,男性155例,HTWP组99例（43.8%）。HTWP组腰围、甘油三酯、总胆固醇、低密度脂蛋白胆固醇和空腹血糖均高于无HTWP组（98.7±9.0比93.2±10.1、2.71±1.46比1.31±0.46、4.78±1.03比4.07±1.00、3.16±0.98比2.55±0.84和6.79±2.74比6.06±1.75,所有P<0.05）,高密度脂蛋白胆固醇则低于无HTWP组（1.05±0.66比1.15±0.30,P<0.05）,而冠状动脉评分高于无HTWP组（18.3±15.5比15.2±14.3,P<0.05）。多元回归分析显示,冠状动脉评分与HTWP、空腹血糖和甘油三酯相关,其标准化回归系数分别为0.192、0.179和0.143（P<0.05）。结论 非ST段抬高型急性冠脉综合征合并HTWP患者冠状动脉评分较高,且冠状动脉病变评分与HTWP、空腹血糖和甘油三酯相关。     

妊娠期高甘油三酯血症性胰腺炎的诊治分析

目的探讨妊娠期高甘油三酯血症性胰腺炎(HPP)的临床诊治分析。方法回顾性收集并分析榆林市中医医院2005年6月-2015年6月收治的29例HPP孕产妇患者的临床资料。结果 29例HPP患者中,孕早期5例(17.2%),孕晚期24例(82.8%);轻型胰腺炎8例(27.6%),中型胰腺炎14例(48.3%),重型胰腺炎7例(24.1%)。血清TG平均水平为15.5 mmol/L。孕产妇无死亡,胎儿死亡率为17.2%(5/29),均为胎死宫内。结论妊娠期HPP虽然少见,但其发病率逐年升高,多见于孕晚期。HPP常导致较高的胎儿死亡率,因此应及时诊断和治疗以改善母婴预后。     

高甘油三酯血症所致急性胰腺炎

高甘油三酯所致急性胰腺炎（HTGP）占胰腺炎发病的1％～4％。HTGP和其他原因引起的急性胰腺炎起病表现相似,但并发症发生率更高。美国学者泉（Tsuang）对HTGP的临床表现和治疗进行了综述（Am J Gastroenterol,2009,104：984）。     

女性高甘油三酯血症腰的临床特征

目的探讨女性高甘油三酯血症腰（HTGW）的临床特征。方法根据血清甘油三酯（TG）和腰围（WC）、空腹血糖（FPG）〈5．6mmol／L,将395例女性患者分为HTGW（TG≥1．70mmol／L和腰围≥80cm）组和非HTGW组,FPG≥5．6mmol／L 82例为高FPG组,采用HOMA-IR指数评价胰岛素抵抗。结果①多元逐步回归分析显示腰围、TG和年龄与HOMA-IR指数独立相关;②HTGW组HOMA-IR与高FPG组比较差异无显著性;③与高FPG组比较,HTGW组体重指数、腰围、血压、TG升高,高密度脂蛋白胆固醇（HDL-C）降低,与非HTGW组比较,HTGW组上述指标变化更为明显。结论女性HTGW患者有与高FPG相似的胰岛素抵抗程度,有肥胖、血压高、血脂紊乱（TG升高、HDL-C降低）的临床特征。     

Association of visceral adipose tissue on the incidence and severity of acute pancreatitis: A systematic review

BackgroundWith the rising prevalence of obesity, there is a plethora of literature discussing the relationship between obesity and acute pancreatitis (AP). Evidence has shown a possible correlation between visceral adipose tissue (VAT) and AP incidence and severity. This systematic review explores these associations.MethodsEligible articles were searched and retrieved using Medline and Embase databases. Clinical studies evaluating the impact of VAT as a risk factor for AP and the association of the severity of AP and VAT were included.ResultsEleven studies, with a total of 2529 individuals were reviewed. Nine studies showed a statistically significant association between VAT and the severity of AP. Only four studies found VAT to be a risk factor for acute pancreatitis. Two studies showed VAT to be associated with an increased risk of local complications and two studies showed a correlation between VAT and mortality.ConclusionThis is the first systematic review conducted to study the association between VAT and AP. The existing body of evidence demonstrates that VAT has a clinically relevant impact and is an important prognostic indicator of the severity of AP. However, it has not shown to be an independent risk factor to the risk of developing AP. The impact of VAT on the course and outcome of AP needs to be profoundly explored to confirm these findings which may fuel earlier management and better define the prognosis of patients with AP. VAT may need to be incorporated into prognostic scores of AP to improve accuracy.     

The association of hypertriglyceridemic waist phenotype with hypertension: A cross‐sectional study in a Chinese middle aged‐old population

The present study aimed to evaluate the relationship between the hypertriglyceridemic waist (HTGW) phenotype and hypertension. We undertook a cross‐sectional study with a sample of 9015 adults from China. The HTGW phenotype was defined as elevated waist circumference (WC) and elevated triglyceride (TG) concentration. Logistic regression analysis was used to evaluate the association between the HTGW phenotype and hypertension. The prevalence of hypertension was significantly higher in individuals with the HTGW phenotype, than in those with the normal waist normal triglyceride (NWNT) phenotype (89.9% vs 75.3%, respectively, P < .001). After adjusting for age, sex, BMI, current smoker, and current alcohol consumption, the HTGW phenotype was associated with hypertension (Odds Ratio (OR)1.53; 95% CI 1.25–1.87). After further adjustment for potential confounders, the HTGW phenotype was still significantly associated with hypertension (adjusted OR1.28; 95% CI 1.04‐1.58) regardless of sex. The subgroup analyses generally revealed similar associations across all subgroups. This study indicated that the HTGW phenotype was strongly associated with hypertension, and blood pressure should be clinically monitored in individuals with the HTGW phenotype. We suggested a combined use of hypertriglyceridemia waist phenotype in identifying participants who are at high risk of hypertension.     

Low-grade inflammation for predicting severe acute pancreatitis in patients with hypertriglyceridemic acute pancreatitis

Objectives

We aimed to evaluate the association between low-grade inflammation (LGI) and the severity of hypertriglyceridemic acute pancreatitis (HTG-AP).

Methods

We retrospectively reviewed 311 patients with HTG-AP who were admitted to the Department of Gastroenterology, Fujian Provincial Hospital between April 2012 and March 2021. Inpatient medical and radiological records were reviewed to collect the clinical manifestations, disease severity, and comorbidities. C-reactive protein (CRP) level, white blood cell (WBC) count, platelet (PLT) count, and neutrophil-to-lymphocyte ratio (NLR) were considered LGI components and were combined to calculate a standardized LGI score. The association between the LGI score and the severity of HTG-AP was analyzed using univariate and multivariate logistic regression analyses.

Results

Of the 311 patients with HTG-AP, 47 (15.1%) had mild acute pancreatitis (MAP), 184 (59.2%) had moderately severe acute pancreatitis (MSAP), and 80 (25.7%) had severe acute pancreatitis (SAP), respectively. Patients with MSAP and SAP had a higher LGI score than those with MAP (1.50 vs −6.00, P < 0.001). Univariate logistic regression analysis revealed that patients with LGI scores in the fourth quartile were more likely to have MSAP and SAP (odds ratio [OR] 21.925, 95% confidence interval [CI] 5.014–95.867, P < 0.001). The multivariate logistic regression analysis confirmed that low calcium (OR 0.105, 95% CI 0.011–0.969, P = 0.047) and high LGI score (OR 1.253, 95% CI 1.066–1.473, P = 0.006) were associated with MSAP and SAP. When predicting the severity of acute pancreatitis, the LGI score had the highest area under the receiver operating characteristic (ROC) curve (0.7737) compared to its individual components.

Conclusion

An elevated LGI score was associated with a higher risk of SAP in patients with HTG-AP.     

Associations of vitamin D status and metabolic dyslipidemia and hypertriglyceridemic waist phenotype in apparently healthy adults

Background

Recent studies have shown that Vitamin D deficiency is very common globally. Vitamin D deficiency is associated with lipid metabolism. A relationship between vitamin D levels and waist circumference (WC) has been observed. The purpose of this study is to evaluate the relationship between vitamin D status and metabolic dyslipidemia and the hypertriglyceridemic waist phenotype.

Association between the hypertriglyceridemic waist phenotype and hyperuricemia: a cross-sectional study

The present study aimed to evaluate the relationship between the hypertriglyceridemic waist (HTGW) phenotype and hyperuricemia. We undertook a cross-sectional study with a sample of 11,576 adults from China. The HTGW phenotype was defined as elevated waist circumference (WC) and elevated triglyceride (TG) concentration. Logistic regression analysis was used to evaluate the association between the HTGW phenotype and hyperuricemia. The prevalence of hyperuricemia was significantly higher in individuals with the HTGW phenotype, as compared to those with the normal waist normal triglyceride (NWNT) group (25.9 vs. 6.1%, respectively, P < 0.001). After adjusting for age, sex, and race, the HTGW phenotype was associated with hyperuricemia (OR 6.09; 95% CI 5.18–7.17). Further adjusted for potential confounders, the HTGW phenotype was still significantly associated with hyperuricemia (adjusted OR 4.54; 95% CI 3.37–5.54). Moreover, the association between the HTGW phenotype and hyperuricemia was stronger in men (adjusted OR 4.59; 95% CI 3.53–5.98) than in women (adjusted OR 3.55; 95% CI 2.60–4.86). This study indicated that the HTGW phenotype was strongly associated with hyperuricemia, and uric acid should be clinically monitored in individuals with the HTGW phenotype. We can speculate that the HTGW phenotype might be a marker for identifying individuals at high risk of hyperuricemia.     

Hypertriglyceridaemic waist phenotype criteria and prevalent metabolic triad in women

BACKGROUND: To assess the metabolic profile and the prevalence of the metabolic triad (i.e. hyperinsulinaemia, hyperapobetalipoproteinaemia, and decreased low-density lipoprotein particle size) in women characterized by the hypertriglyceridaemic waist (HTGW) phenotype and to identify cut-off values for triglycerides and waist circumference, effectively discriminating women with the metabolic triad. METHODS: Two hundred and twenty-eight female subjects without any history of vascular disease or diabetes mellitus attending an Outpatient Lipid Clinic setting at the University Hospital of Ioannina, Greece were studied. RESULTS: Currently available HTGW criteria for women were unable to detect any significant differences in the metabolic profile either in the pre- or post-menopausal women, and proved similar in terms of sensitivity and specificity in identifying women with the metabolic triad. A cut-off value of 1.26 mmol/L for triglycerides and 84.5 cm for waist circumference were determined by Receiver-operating Curve evaluation. Women with both triglycerides and waist circumference above these thresholds had four-fold higher odds of presenting with the metabolic triad compared with women with non-HTGW phenotype. CONCLUSIONS: A HTGW phenotype definition of 1.26 mmol/L for triglycerides and 84.5 cm for waist circumference may effectively identify Mediterranean women with the atherogenic metabolic triad. Whether these criteria are also associated with a higher incidence of vascular disease and/or new-onset diabetes in women remains to be investigated.