高密度脂蛋白与高密度脂蛋白胆固醇的区别

高密度脂蛋白(HDL)是血浆脂蛋白的一种,主要由胆固醇、磷脂和蛋白质等物质组成。临床检测HDL主要依据胆固醇来测量计算,用高密度脂蛋白胆固醇(HDL-C)表示,但HDL-C是否能够全面反映HDL的生理功能目前尚无统一定论,笔者以此为切入点,通过大量查阅国内外文献,对上述进行系统的阐述,以期对后来学者的研究提供一定的帮助。     

天津市和平区新兴街社区老年人肾功能变化影响因素调查分析

目的随着我国人口老龄化,慢性肾脏病成为研究热点。本研究探讨社区老年人群肾脏功能随增龄变化特点及其影响因素。方法回顾2012年及2016年天津市新兴街社区老年人健康体检数据,筛选出具有完整查体数据的老年人2 110名,以2012年估算肾小球滤过率(estimated glomerular filtration rate,eGFR)为基线值,分析基线水平eGFR增龄变化;计算2016年和2012年eGFR值下降速率(ΔeGFR),分析5年间eGFR增龄变化。使用线性回归分析年龄、性别、高血压病、糖尿病和血脂紊乱对eGFR增龄变化影响。结果横断面研究发现,老年人eGFR平均每年下降0.8～0.9mL/(min·1.73m~2);纵向研究发现,老年人eGFR平均每年下降(2.96±0.36)mL/(min·1.73m~2),ΔeGFR平均每年下降速率约为3%。不同性别(t=8.896,P=0.003)、年龄(F=72.793,P0.001)和疾病(F=6.282,P0.001)eGFR水平差异有统计学意义;不同性别(t=4.898,P=0.027)、年龄(F=42.823,P0.001)和疾病(F=4.351,P0.005)ΔeGFR水平差异有统计学意义。线性回归分析发现,影响eGFR变化的危险因素为年龄(t=-12.098,P0.001)、空腹血糖(t=4.087,P0.001)、高血压病(t=-3.475,P=0.001)、三酰甘油(t=-2.979,P=0.003)和性别(t=2.643,P=0.008)。影响5年后ΔeGFR危险因素为年龄(t=-9.104,P0.001)、高血压病(t=-3.229,P=0.001)、空腹血糖(t=3.358,P=0.001)和三酰甘油(t=-2.545,P=0.011)。结论年龄、空腹血糖、高血压和三酰甘油是影响eGFR基线水平与5年后ΔeGFR危险因素。     

代谢综合征之高血压、低高密度脂蛋白对肾功能影响分析

目的分析代谢综合征(MS)之高血压、高密度脂蛋白(HDL)下降对肾功能影响。方法对1518例体检者及肾脏病患者测定肾功能、血脂、血压等,通过t检验及F检验分析MS高血压HDL正常(A组)、MS高血压低HDL(B组)、非MS高血压HDL正常(C组)、非MS血压正常HDL正常(E组),非MS血压正常低HDL(F组)之肾小球滤过率(GFR)差异。对影响肾功能的各种因素进行logistic回归分析。结果 1E组GFR最高,依次为C组、A组、F组、B组[(91.1±19.3)、(84.3±23.1)、(78.4±25.2)、(68.4±20.6)、(45.5±2=32.9)ml·min-1·(1.73 m2)-1,P均0.05];2纠正了年龄、SBP后MS高血压高尿酸HDL降低组GFR低于HDL正常组[(42.2±22.9)、(67.3±21.7)ml·min-1·(1.73m2)-1,P=0.000];3经logistic回归分析,HDL降低是导致GFR下降的危险因素。结论在MS各种群集因子中HDL下降是导致肾功能损害的主要危险因素。     

血尿酸与非高密度脂蛋白胆固醇关系的分析

目的探讨血尿酸和非高密度脂蛋白胆固醇之间的关系。方法将我院进行体检的人群分为高血尿酸组与正常对照组,对两组的血脂指标进行比较研究。结果高血尿酸组与正常组比较,非高密度脂蛋白胆固醇(non-HDL-C)、总胆固醇(TG)有明显的差异(P<0.05),高密度脂蛋白胆固醇(HDL-C)也具有明显的差异(P<0.01),两组甘油三酯(TC)相比没有明显的差异(P>0.05)。结论患者高血尿酸和血脂异常关系十分密切,并且血尿酸和非高密度脂蛋白胆固醇为正相关的关系。因而在防治心血管疾病时应该紧密关注尿酸浓度,尿酸与血脂的关系要在临床治疗中充分重视。     

老年人发生心血管事件与肾功能及尿蛋白的相关性分析

目的探讨老年人发生心血管事件与肾功能及尿蛋白的相关性。方法选择我院2012年1月至2012年12月就诊和健康查体的老年人共405例,根据肾小球滤过率(e GFR)将研究对象分为肾功能正常组[e GFR≥60 m L/(min·1.73 m2)]和肾功能下降组[e GFR<60 m L/(min·1.73 m2)];另外,根据研究对象的尿常规检查结果将其分为尿蛋白阴性组和尿蛋白阳性组。对患者进行至少为期3年的随访,分析老年人发生心血管事件与肾功能及尿蛋白的相关性。结果随访期间发生心血管事件75例,肾功能正常组发生心血管事件27例,发生率为10.2%(27/264),肾功能下降组发生心血管事件48例,发生率为34.0%(48/141),差异有统计学意义(χ~2=34.547,P<0.05)。尿蛋白阴性组发生心血管事件55例,发生率为15.2%(55/362),尿蛋白阳性组发生心血管事件20例,发生率为46.5%(20/43),差异有统计学意义(χ~2=24.983,P<0.05)。经多因素Cox回归分析表明,尿蛋白阳性、e GFR水平下降是心血管事件的独立危险因素。结论对于老年人群,加强肾小球滤过率及尿蛋白的监测,发现异常者及早进行干预,可减少心血管事件的发生。     

贵州省居民低密度脂蛋白胆固醇、高密度脂蛋白胆固醇及比值与高血压发病关系的前瞻性队列研究

目的 分析低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）及比值（LDL-C/HDL-C）对高血压发病风险的影响,为高血压防治提供参考。方法 本研究的数据来源于2010年建立,2016—2020年开展随访的贵州省自然人群队列。使用SPSS20.0对数据进行t检验、χ2检验,采用Cox等比例风险回归模型分析LDL-C、HDL-C及LDL-C/HDL-C对高血压发病的影响,计算校正后风险比（adjusted hazard ratio, aHR）及其95%可信区间（95%confidential interval, 95%CI）,采用限制性立方样条法描述其剂量反应关系。对不同性别和年龄人群进行亚组分析。结果 共纳入5 388例研究对象,累积随访37 475.37人年,随访期间新发1 160例高血压,发病密度为30.96/千人年。Cox等比例风险回归模型分析结果显示,调整相关因素后,全人群LDL-C、LDL-C/HDL-C每增加1个单位,高血压发病风险增加17%(aHR=1.17,95%CI:1.09～1.26)和6%(aHR=1.06,95%CI:1.02～1.11),将L...     

老年人肾功能的评估:问题与挑战

我国目前已进入老龄化社会,尤其是近10年来,老年人口激增,预计至2020年老年人将占全国总人口的17％以上。由于受到衰老和各种疾病的多重影响,老年人通常需要长期服用各种药物,     

老年人肾功能的评估：问题与挑战

我国目前已进入老龄化社会,尤其是近10年来,老年人口激增,预计至2020年老年人将占全国总人口的17％以上。由于受到衰老和各种疾病的多重影响,老年人通常需要长期服用各种药物,     

高密度脂蛋白胆固醇与肝癌发病的孟德尔随机化研究

目的 验证高密度脂蛋白胆固醇与肝癌发生之间是否存在因果关联。方法 本研究基于公开的全基因组关联分析（GWAS）数据库,其暴露因素为高密度脂蛋白胆固醇（HDL-C）,来源于为期随访12年的韩国基因组与流行病学研究队列（Ko GES）,其结局变量为肝癌,来源于为期随访10年的日本生物样本库（BBJ）。分别用IVW、MR-Egger、WME三种方法对其进行两样本孟德尔随机化分析,并利用Cochran Q检验和MR PRESSO进行MR前提假设验证,以及leave-one-out法进行敏感性分析。结果 两样本孟德尔随机化的IVW显示,HDL-C与肝癌发生（OR=0.938, 95%CI:0.779～1.129, P=0.496）无统计学意义。MR-Egger回归法（OR=1.167, 95%CI:0.858～1.587, P=0.329）、加权中位数（OR=0.921, 95%CI:0.722～1.175, P=0.508）分析也有相似的结果。经检验得分析结果中未发现存在多效性偏倚（截距项为-0.019, P=0.089）,异质性较小;敏感性分析显示MR分析结果稳健。本次所选的52个工具变量均...     

我国中老年人血清低HDL-c血症与膳食关系研究

目的 分析我国中老年人血清低高密度脂蛋白胆固醇（high density lipoprotein cholesterol,HDL-c）血症与膳食的关系。方法 数据来源于2010-2012年中国居民营养与健康状况监测。对我国城乡150个监测点45岁及以上居民共28 092名进行基本情况问卷调查及连续3 d的24 h膳食调查,采用直接法测定调查对象空腹血清HDL-c水平,按《中国成人血脂异常防治指南（2016年修订版）》标准判断低HDL-c血症。结果 我国中老年人低HDL-c血症患病率男性高于女性（χ²=202.144,P<0.001）;低HDL-c血症患病率随年龄增加呈下降趋势（χ²=9.782,P=0.002）;随收入增加（χ²=16.143,P<0.001）和文化程度提高（χ²=95.129,P<0.001）呈现上升趋势;大城市、中小城市、普通农村和贫困农村血清低HDL-c血症患病率分别为36.5%,32.4%,33.5% 和34.0%,地区间差异有统计学意义（χ²=7.314,P=0.007）。城乡男性低HDL-c血症与HDL-c正常人群水果、蛋类和奶类摄入量差异均有统计学意义（均有P<0.05）;城乡女性低HDL-c血症与HDL-c正常人群红肉类和禽肉类摄入量差异均有统计学意义（均有P<0.05）。调整其他因素后Logistic回归分析显示,低HDL-c血症与粮谷类、水果和红肉摄入有关,其OR（95% CI）值分别为1.06（1.03~1.09）、1.12（1.06~1.19）和0.91（0.89~0.93）。结论 我国城乡中老年人血清低HDL-c血症患病率较高,低HDL-c血症与粮谷类、水果和红肉摄入量有关。     

甘油三酯与高密度脂蛋白胆固醇比值和H型高血压的相关性研究

目的 探讨在原发性高血压患者中甘油三酯与高密度脂蛋白胆固醇比值与H型高血压的关系。方法 采取多阶段整群随机抽样的方法,以湖南省6个城市的社区人群作为研究对象。采取问卷调查、体格检查、实验室检查的方式来收集研究对象的资料。采用回归分析的统计学方法分析甘油三酯与高密度脂蛋白胆固醇比值与H型高血压的效应值大小。结果 本研究共纳入1 538名高血压患者,其中H型高血压患者共有1 311人（85.24%）,男性766人（49.80%）。TG/HDL - C与H型高血压的关系呈现倒U型的曲线关系。通过阈值效应分析得出:模型1与模型2的对数似然比检验结果具有统计学意义（P = 0.003）,进一步证实了TG/HDL - C与H型高血压之间是曲线关系。在模型2中可知:在拐点2.22之前,TG/HDL - C每增加一个单位发生H型高血压的风险增加52%（OR = 1.52, 95% CI = 1.16, 2.00, P = 0.002）;在拐点2.22之后,TG/HDL - C每增加一个单位发生H型高血压的风险降低3%（OR = 0.97, 95% CI = 0.90, 1.04, P = 0.401）。结论 在原发性高血压的患者中TG/HDL - C与H型高血压呈现倒U型的曲线关系,并存在饱和阈值效应。     

High carbohydrate intake was inversely associated with high-density lipoprotein cholesterol among Korean adults

The traditional Asian diet, which is characterized as being high in carbohydrate with an abundance of vegetables, may be beneficial for preventing metabolic syndrome abnormalities within the Asian population. However, the prevalence of metabolic syndrome is increasing in Asian countries. This study explored the association between dietary carbohydrates and low high-density lipoprotein cholesterol (HDL-C) prevalence, one of the abnormalities of metabolic syndrome in Korean adults. We used the data from the Fourth Korea National Health and Nutrition Examination Survey and evaluated a total of 9947 Korean adults older 20 years. To measure carbohydrate quality and quantity, total carbohydrate intake (g/d), percentage of energy from carbohydrate, glycemic index, and glycemic load were divided into quintiles. Mean levels of HDL-C significantly decreased across the quintiles for all types of dietary carbohydrate intake except glycemic index after adjusting for potential variables in both men and women. Odds ratios for having low HDL-C in the highest quintile were 1.66 (95% confidence interval, 1.24-2.22) for total carbohydrate, 1.34 (1.02-1.75) for percentage of energy from carbohydrate, and 1.54 (1.17-2.03) for glycemic load in men as compared with the second quintile as a reference. Odds ratio for low HDL-C was 1.38 (1.12-1.71) for percentage of energy from carbohydrate in women. In conclusion, our study indicates that low HDL-C is associated with high carbohydrate intake without regard to energy or fat intake. Further studies would be necessary to optimize carbohydrate intake quantitatively on dyslipidemia for Asian population.     

中老年人心脑血管危险因素相关物质浓度及与高密度脂蛋白胆固醇的关系

目的 研究中老年人心脑血管危险因素相关物质:血清瘦素、脂联素、白细胞介素-6(IL-6)及纤溶酶原激活物抑制物-1(PAI-1)与高密度脂蛋白胆固醇(HDL-C)的关系,探讨其在传统心脑血管危险因索中的作用.方法 在广州市生物库第3期注册登记的10027名中老年人中随机抽取1 996名中老年人进行问卷调查和健康体检.以酶联免疫吸附双抗夹心法(ELISA)测定瘦素、脂联素、IL-6、PAI-1,以直接法测定血清脂类.其中共1 520名受检者参与血瘦素、脂联素和PAI-1的测定,1 293名参与IL-6的测定.结果 广州市中老年人脂联素随年龄增加而升高,差异有统计学意义(男:P=0.044,女:P＜0.01),随着年龄的增加,瘦素水平在男性中升高(P=0.036).校正年龄和性别因素后,瘦素、脂联素、IL-6、PAI-1和HDL-C之间均呈明显的相关(P＜0.01).结论 瘦素、脂联素、IL-6、PAI-1与HDL-C密切相关.     

Exercise attenuates the increase in plasma monounsaturated fatty acids and high-density lipoprotein cholesterol but not high-density lipoprotein 2b cholesterol caused by high-oleic ground beef in women

We hypothesized that dietary monounsaturated fatty acids (MUFA) and exercise increase high-density lipoprotein cholesterol (HDL-C) by independent mechanisms, so there would be additive effects between a single, intensive session of exercise and high-MUFA ground beef on HDL-C and blood risk factors for cardiovascular disease. Seventeen postmenopausal women completed a 2-way crossover design in which they consumed five 114-g ground beef patties per week for two 6-week periods separated by a 4-week washout (habitual diet) period. The ground beef patties contained 21% total fat with either 9.97 (low-MUFA) or 12.72 (high-MUFA) g total MUFA. Blood was taken at entry, at the end of each 6-week diet period, after the 4-week washout period, and 24 hours after aerobic exercise sessions (75% VO_2peak, 2.07 MJ). After the ground beef intervention, the high-MUFA ground beef increased plasma palmitoleic acid and oleic acid, low-density lipoprotein (LDL) particle density, HDL-C, and HDL_2b-C (all P < .05), whereas the low-MUFA ground beef increased LDL density. After the washout (habitual diet) period, the single exercise session increased serum LDL cholesterol, HDL-C, and HDL_2a and decreased TAG and oleic acid. After the low-MUFA ground beef diet, exercise increased LDL size and HDL density and decreased LDL density and very low-density lipoprotein cholesterol, but had no effect on HDL-C fractions. After the high-MUFA ground beef intervention, exercise decreased palmitioleic acid, oleic acid, HDL-C, and HDL_2a-C, but not HDL_2b-C. Contrary to our hypothesis, the effects of exercise and a high-MUFA diet were not additive; instead, exercise attenuated the effects of the high-MUFA ground beef on HDL-C and plasma MUFAs. The differential effects of high-MUFA ground beef and exercise on HDL_2a-C and HDL_2b-C indicate that diet and exercise affect HDL-C by different mechanisms.     

Association of the low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio and concentrations of plasma lipids with high-density lipoprotein subclass distribution in the Chinese population

Background  

To evaluate the relationship between the low-density lipoprotein cholesterol (LDL-C)/high-density lipoprotein cholesterol (HDL-C) ratio and HDL subclass distribution and to further examine and discuss the potential impact of LDL-C and HDL-C together with TG on HDL subclass metabolism.     

老年高血压及血脂与低密度脂蛋白受体基因的关系

目的：探讨老年高血压及血脂与低密度脂蛋白受体（LDLR）基因HineⅡ多态性的关系。方法：采用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）方法测定高血压组126例，对照组150例的LDLR基因型。结果：LDLR包括CC、CT、TT三种基因型。高血压组C等位基因频率高于对照组（P〈0．01）。结论：高血压组C等位基因频率高于对照组，提示低密度脂蛋白受体基因可能与老年高血压相关。     

Correlates of high-density lipoprotein cholesterol in black and white women.

The relationships of high-density lipoprotein (HDL) cholesterol with body composition, leisure-time physical activity, cigarette smoking, and education were examined in a community-based sample of 480 Black and 1337 White women. Univariate and multivariate analyses indicated inverse associations of HDL with body mass index and waist-to-hip ratio in both groups, and with cigarette smoking and low educational attainment among White women only. Since correlates of HDL cholesterol differ for Black and White women, further investigation of the differences in these correlates is warranted.     

Nationwide survey of high-density lipoprotein cholesterol among farmers in Japan

A total of 2,134 blood samples (788 from men and 1,346 from women), were collected nationwide from adult farmers in Japan (44 regions in 21 prefectures) during the winters of 1978 through 1981. They were analyzed in a single laboratory for high-density lipoprotein cholesterol (HDL) by means of a precipitation method. The serum HDL level was 47.3 +/- 14.2 mg/100 ml (mean +/- SD; n = 788) in men and 47.4 +/- 12.8 mg/100 ml (n = 1,346) in women. Sex and age differences in HDL were not statistically significant (P greater than 0.10). Alcohol consumption was associated with elevated HDL levels in both sexes; the association was statistically significant only in men (P less than 0.05) and was positively correlated with daily alcohol consumption (P less than 0.05). Conversely, smoking habits were negatively (P less than 0.05) associated with HDL in men. The comparison of HDL in the nondrinking and nonsmoking population revealed that HDL in women (47.0 +/- 12.8 mg/100 ml; n = 900) did not differ significantly (P greater than 0.10) from the male values (45.3 +/- 12.5 mg/100 ml; n = 60). When 23 nondrinking and nonsmoking married couples were selected from 348 couples, for whom information on drinking and smoking habits was available, the HDL (+/- SD) was essentially the same in husbands (44.2 +/- 12.8 mg/100 ml) and in wives (43.7 +/- 9.5 mg/100 ml). In the blood samples collected from 535 subjects once in winter and once in summer, HDL concentration was significantly higher in summer than in winter (P less than 0.01 in both men and women); the HDL means (+/- SD) in winter and in summer were 48.1 +/- 14.3 and 50.9 +/- 11.3 mg/100 ml, respectively, for men, and 47.0 +/- 12.0 and 50.3 +/- 11.0 mg/100 ml, respectively, for women. The mean HDL distributed across a fairly wide range depending on the 44 regions studied. Maximum-minimum mean values were 58.3-33.1 mg/100 ml in men and 59.7-37.4 mg/100 ml in women, and the regional difference was statistically significant (P less than 0.01) both in men and women. Furthermore, a significant inverse relation (P less than 0.05) was observed in men between the mean regional HDL values and standardized regional ratios of mortality from coronary heart diseases.     

肾病病人营养状况与肾功能的关系分析

目的 :探讨肾病病人营养状况与肾功能的关系。　方法 :对 110例住院肾病病人的身高、体重、血生化和血常规结果进行分析。　结果 :肾功能不全组病人体重分布与肾功能正常组比较有显著差异 ,低于理想体重者明显增加 ;红细胞、血红蛋白、总淋巴细胞计数水平显著降低 (P <0 .0 1) ,血肌酐、尿素氮、尿酸 (P <0 .0 1)、血磷 (P <0 .0 5 )水平显著升高 ;血肌酐、尿素氮与红细胞、血红蛋白水平间呈负直线相关关系 (P <0 .0 1)。　结论 :肾功能减退与热能 蛋白质营养不良、贫血、高血磷、高尿酸等营养障碍表现有关 ,采取合理饮食有可能延迟肾功能减退的进展