What is a good marker for serum cholesterol to identify high-risk patients at general health checks?

Conventional measurement of lipid concentrations includes total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), and triglycerides (TG). Several guidelines for cardiovascular diseases recommend using LDL-C as the primary target of therapy in conjunction with assessing risk factors for cardiovascular diseases (CVD); however, emerging findings have revealed that lowering LDL-C to the goal with statins is not enough to prevent primary and secondary CVD. Thus, we need new parameters to better integrate residual risks into CVD risk stratification. Recently, non-HDL-C, apolipoprotein B (apoB), and LDL-C/HDL-C have been suggested. Non-HDL-C, indicating the cholesterol contents of all atherogenic lipoproteins and retaining continuity with the concept of cholesterol, is quickly computed by subtracting HDL-C from TC, needs no additional costs, and includes atherogenic TG-rich lipoproteins, called remnant lipoproteins. In addition, non-HDL-C has been shown to be an excellent predictor of CVD, free from dietary variations. ApoB, the number of atherogenic lipoproteins, is also a valuable parameter with slightly better performance than non-HDL-C in epidemiological studies, but it costs more and takes longer than conventional lipid examinations. Several lipid parameters, such as TC/HDL-C, non-HDL-C/HDL-C, LDL-C/HDL-C, are also available in clinical practice and epidemiological study; however, we should note that LDL-C/HDL-C is not reliable in cases of high TG. Thus, in general health checks, we should first pay attention to the absolute values of LDL-C, HDL-C, and TG for the diagnosis and subsequently use non-HDL-C, apoB, and other parameters, considering the pathophysiological condition, convenience, and costs.     

Intra-individual variation of plasma lipids and lipoproteins in prepubescent children

Estimates of the average intra-individual biological variability for plasma lipids and lipoproteins differs substantially among published studies. Moreover, this topic does not appear to have received consideration in exercise and health literature with normal, healthy children as subjects. The purpose of this study was, therefore, to determine the short-term, day-to-day variability of the lipid-lipoprotein profile from 19 children [mean?(SD), 11.5 (0.8) years] from 3 separate venous blood samples. Intra-individual standard deviations, variances and coefficients of variance were determined for total cholesterol (TC), triacylglycerol (TG), high-density lipoprotein-cholesterol (HDL-C), HDL-C sub-fractions HDL₂ and HDL₃, and low-density lipoprotein-cholesterol (LDL-C). The intra-individual variation for TC and LDL-C was used to calculate the 95% confidence intervals (CIs) around the National Cholesterol Education Programme (NCEP 1991) cut-off points. The main finding was that all of the measured blood analytes including TC, TG, HDL-C, HDL₂, HDL₃, and LDL-C varied considerably from day-to-day. Coefficients of total variation ranged from 3.5% for HDL₃ to 25.4% for TG. Classification of individuals using NCEP guidelines was difficult based on only one or two blood samples. The magnitude of variation for LDL-C meant that a 95% CI could not be constructed around the NCEP borderline-high classification from either one or two samples. However, averaging three TC and LDL-C measurements increased the likelihood of classification within the 95% CI. The results indicate that when using the NCEP guidelines for children and adolescents, true concentrations for TC and LDL-C should be based on the mean of multiple samples.     

The effects of long-term low intensity aerobic training and detraining on serum lipid and lipoprotein concentrations in elderly men and women

The effects of long-term low intensity aerobic training and detraining on serum lipid and lipoprotein concentrations were examined in 30 elderly men and women. These subjects were randomly divided into two groups. The training group [n=15; 7 men and 8 women; mean age 75.5 (SD 5.6) years] agreed to take part in physical training using a treadmill with an exercise intensity at the blood lactate concentration threshold for 30 min 3–6 times a week for 9 months. The other group [n=15; 7 men and 8 women; mean age 73.7 (SD 4.4) years] did not perform any particular physical training and was followed as the control. Following this training period the high density lipoprotein-cholesterol (HDL-C) had increased significantly (P<0.01) while the total cholesterol (TC) : HDL-C ratio had decreased significantly (P<0.01) in the training group after 9 months but had not changed in the control group. The TC, triglyceride (TG) and low density lipoprotein-cholesterol (LDL-C) had not changed significantly in either group. No significant difference was seen between the groups throughout the period for TC, LDLC or TG. There was, however, a significant correlation between the initial TC:HDL-C ratio and the change in the TC:HDL-C ratio following 3 months of training (P <0.05). After 1 month of detraining in 5 patients, the HDL-C had decreased significantly (P < 0.05) while the TC:HDL-C had increased significantly in the training group (P<0.01). These results suggested that long-term low intensity aerobic training improved the profile of serum lipid and lipoprotein concentrations, while detraining returned the profile to that of the pretraining levels in elderly persons.     

Relationship between smoking habits and low-density lipoprotein-cholesterol,high-density lipoprotein-cholesterol,and triglycerides in a hypercholesterolemic adult cohort,in relation to gender and age

Elevated total cholesterol, the related low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, triglycerides, and smoking habits are risk factors for cardiovascular disease. The objective of this study was to investigate the influence of habitual smoking on these parameters in 492 hypercholesterolemic men and women, aged between 26 and 66 years. Relative differences between smokers and non-smokers in the mean values of total cholesterol, low-density and high-density lipoprotein-cholesterol, and triglycerides were 2.2%, 5.5%, −8.1%, and 13.7%, respectively. These differences were statistically significant (P<0.04). Over the entire cohort, including men and women, age did not affect the mean values significantly, except for total cholesterol and triglyceride values in smoking women, which were significantly higher in women over 50 years than in the younger women (P=0.011 and P=0.004). In both men and women, regardless of smoking habits, 43%–59% of subjects exceeded the upper reference range value for low-density lipoprotein-cholesterol (4.9 mmol/l), while 38%–59% exceeded the upper reference range value for triglycerides (2.0 mmol/l) and 82%–91% had values below the lower reference range value for high-density lipoprotein-cholesterol (0.9 mmol/l for men, 1.2 mmol/l for women). Smoking habits hardly influenced the extent to which reference values were exceeded, except for low-density lipoprotein-cholesterol in all subjects (higher percentage for smokers, P=0.041). Similar results were obtained for age, except for triglycerides in smoking women, which showed high values in 26% of women <50 years versus 50% of women ≥50 years (P=0.026). In conclusion, smoking has an adverse effect on low-density and high-density lipoprotein-cholesterol, and triglycerides in a hypercholesterolemic population of men and women, regardless of age. Received: 9 November 2001 / Accepted: 4 May 2002     

2型糖尿病视网膜病变患者超敏C反应蛋白、血脂指标变化及相关危险因素分析

目的:观察2型糖尿病视网膜病变(DR)患者超敏C反应蛋白(hs-CRP)、血脂代谢相关指标变化,并分析其危险因素。方法:回顾性分析2018-02—2019-08本院收治的161例2型糖尿病(T2DM)患者,将其分成A组(Ⅰ型,未发生视网膜病变,62例);B组[Ⅱ、Ⅲ型,非增殖性的糖尿病性视网膜病变(NPDR),43例];C组[Ⅳ、Ⅴ型,增殖性的糖尿病性视网膜病变(PDR),56例],以同期体检健康者52例作为对照组。比较各组hs-CRP、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)及TG/HDL-C、TC/HDL-C、LDL-C/HDL-C比值水平变化差异,采用Spearman分析hs-CRP与各检测指标的相关性,Logistic回归分析DR可能的危险因素。结果:除LDL-C,hs-CRP、血脂代谢(TG、TC、HDL-C)及比值(TG/HDL-C、TC/HDL-C、LDL-C/HDL-C)在各组间比较,差异有统计意义(均P<0.05)。DR患者血液hs-CRP与TG(r=0.505)、TC(r=0.236)、LDL-C(r=0.313)、TG/HDL-C(r=0.50)、TC/HDL-C(r=0.385)、LDL-C/HDL-C(r=0.405)水平均呈正相关(均P<0.05),Logistic回归模型分析发现除了TC外其余各项指标均为T2DM患者发生DR的可能危险因素。结论:DR患者hs-CRP和血脂代谢指标对评估DR患者风险具有预测价值。     

Dyslipidaemia in hypertensive obese type 2 diabetic patients in Jamaica

Introduction

Hypertension and obesity are common problems among diabetic patients accelerating progression of vascular diabetic complications.

Materials and methods

A two-stage stratified random sampling design was used, and individuals aged 15 years and over were interviewed. This cross-sectional study evaluated lipid abnormalities of 117 obese type 2 diabetic patients (28 males and 89 females), and 56 hypertensive obese type 2 diabetic patients (22 males and 34 females). Total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), very-low-density lipoprotein cholesterol (VLDL-C) and high-density lipoprotein cholesterol (HDL-C) concentrations were assayed using standard biochemical methods.

Results

Hypertensive obese type 2 diabetic females had significantly higher mean serum concentrations of TC (p = 0.043), TG (p = 0.046), LDL-C (p= 0.040), TC/HDL-C ratio (p = 0.001) and LDL-C/HDL-C ratio (p = 0.003) compared with hypertensive obese non-diabetic females. Similar results were found in hypertensive obese type 2 diabetic males compared with hypertensive obese non-diabetic males. Hypertensive obese type 2 diabetic females had significantly higher serum TC, TG and TC/HDL-C ratio (p < 0.05) than hypertensive obese type 2 diabetic males. Hypertensive obese type 2 diabetic females had significantly higher mean serum concentrations of TG (p = 0.03) and TC (p = 0.01) than obese type 2 diabetic females. There was a significant association between blood glucose and LDL-C concentrations in type 2 diabetic subjects (r = 0.36; p< 0.05).

Conclusion

Obese hypertensive type 2 diabetic females are exposed more profoundly to risk factors including atherogenic dyslipidaemia compared with males.     

Atherogenic index of plasma as useful predictor of cardiovascular risk among postmenopausal women in Enugu, Nigeria

Background

Menopausal health in our environment has received little attention. As an independent risk factor for dyslipidaemia, the degree and pattern of derangement, though difficult to assess may adversely affect the cardiovascular health of our women.

Objectives

To estimate the serum lipid profile and the atherogenic index of plasma in normal post menopausal women.

Methods

This is a cross sectional study involving 80 apparently healthy women voluntarily recruited from staff of the University of Nigeria and the Teaching Hospital (UNTH) located in Enugu. They include 50 postmenopausal subjects aged between 50 and 70 years and 30 premenopausal controls aged between 25 and 49 years. Total cholesterol (TC), and the various subfractions; high density lipoprotein cholesterol (HDL-C), very low density lipoprotein cholesterol (VLDL-C), low density lipoprotein cholesterol (LDL-C) and triglycerides (TG) were determined. Atherogenic index of plasma (AIP); log (TG/HDL-C) was calculated.

Results

There were statistically significant increases (P< 0.0001) in TC, TG, LDL-C, VLDL-C and AIP but a statistically significant decrease (P<0.0001) in HDL-C in postmenopausal women when compared with the premenopausal subjects. Except HDL-C that showed insignificant reduction, there were statistically significant derangement of other lipid subfractions as the duration of menopause increased.

Conclusion

Menopause, no doubt alters lipid profile. A triglyceride based index (AIP) can significantly add value when assessing the risk of developing atherosclerosis in Nigeria.     

Duration of menopause and behavior of malondialdehyde, lipids, lipoproteins and carotid wall artery intima-media thickness.

AIM: our study assessed whether minor or major hormonal deficiency influenced oxidative status and vascular wall structure in menopausal women. METHODS: the study series was made up of 62 non hypertensive non diabetic menopausal women (mean age 52.3+/-4.7 years) divided into two groups depending on duration of menopause (group 1 duration 0-5 years; group 2 duration over 5 years). Total cholesterol (TC), LDL cholesterol (LDL-C), HDL-cholesterol (HDL-C), triglycerides (TG), malondialdehyde (MDA) and common carotid artery wall intima-media thickness (IMT) were determined in the entire series. RESULTS: mean TC, LDL-C, TG, MDA and IMT values were higher in group 2 than group 1. The intergroup difference between MDA (P<0.007) and IMT values (P<0.006) values was statistically significant. CONCLUSIONS: the study revealed a close temporal correlation between plasma oxidative stress and carotid wall IMT, jeopardizes vascular wall status as menopause proceeds.     

Comparison of metabolic profile and abdominal fat distribution between karyotypically normal women with premature ovarian insufficiency and age matched controls

Objective

We designed a prospective case-control study in order to investigate the lipid profiles, insulin sensitivity, presence of metabolic syndrome (MetS) and the abdominal fat distribution in karyotypically normal women with premature ovarian insufficiency (POI).

Methods

Anthropometric measurements, FSH, estradiol, total testosterone (T), sex hormone binding globulin (SHBG), free androgen index (FAI), fasting glucose and insulin, homeostatic model for insulin resistance (HOMA-IR), lipid profile, the prevalence of MetS and ultrasonographic abdominal fat measurements were assessed in 56 women with POI and 59 healthy controls at the same age range.

Results

Serum levels of T, SHBG and FAI were not significantly different between both groups. Total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) were higher in women with POI. There were no differences in glucose, insulin, HOMA-IR, low-density lipoprotein cholesterol (LDL-C), triglyceride levels between the two groups. A significant positive correlation was identified between T and TG and also between FAI and LDL-C; SHBG levels were correlated inversely with FSH, and positively with HDL-C in women with POI. The presence of MetS was significantly higher in women with POI. The subcutaneous, preperitoneal and visceral fat thicknesses were not significantly different between the groups.

Conclusions

Early cessation of ovulatory function may associated with higher levels of serum TC and HDL-C, but does not seem to cause differences in abdominal fat distribution in women with POI. POI is associated with higher risk of MetS.     

Osteopenia is associated with glycemic levels and blood pressure in Chinese postmenopausal women: a cross-sectional study

The aim of present study was to explore the relationships between osteopenia and dyslipidemia, glycemic levels or blood pressure in postmenopausal Chinese women. A total of 4080 women aged 42–85 years were enrolled in this cross-sectional study, which was nested in an ongoing longitudinal (REACTION) study. Calcaneus quantitative ultrasound (QUS) was performed and QUS T score was calculated to assess bone mineral density. Osteopenia was defined as a T score ≤?1.0. The relationship between osteopenia and dyslipidemia, glycemic levels or blood pressure was investigated. The prevalence of osteopenia was significantly lower in subjects with systolic blood pressure (SBP) ≥140 mmHg, fasting blood glucose (FBG) ≥8.0 mmol/L, postprandial blood glucose (PBG) ≥15.0 mmol/L, hemoglobin A1c (HbA1C) 6.5–7.5 %, HbA1C ≥7.5 %. These relationships remained significant after controlling for multiple factors. Moreover, significant trend between osteopenia and SBP, FBG, PBG and HbA1C was observed in women. In contrast, no significant associations between osteopenia and diastolic blood pressure (DBP), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) were found, and no significant trend relationship between osteopenia and DBP, TC, TG, HDL-C, LDL-C was found in postmenopausal Chinese women. The present study showed a relationship between SBP, FBG, PBG, HbA1C and osteopenia in postmenopausal Chinese women, while no significant relationship was observed between dyslipidemia, DBP and osteopenia, even after controlling for multiple confounding factors.     

Serum pro-oxidant-antioxidant balance and low-density lipoprotein oxidation in healthy subjects with different cholesterol levels

Abstract. In this study, we investigated serum pro-oxidantantioxidant balance in 210 healthy subjects divided into groups with low and high atherogenic risk according to the levels of serum total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C) and high-density lipoprotein- cholesterol (HDL-C). Diene conjugate (DC), malondialdehyde (MDA), polyunsaturated fatty acid (PUFA), vitamin E, and vitamin C levels and antioxidant activity (AOA) were determined in the serum. Endogenous DC and copperinduced MDA levels were also measured in the LDL fraction isolated by precipitation with buffered heparin from plasma in 80 healthy subjects with different serum LDL-C levels. Subjects with a high atherogenic risk had significantly higher plasma DC, MDA, and PUFA levels, but lower vitamin E/TC values and AOA than subjects with low atherogenic risk. Endogenous DC and copper-induced MDA levels in the LDL fraction were increased in subjects with serum LDL-C levels higher than 4.14 mM compared with those with normal LDL-C levels. In conclusion, this study clearly indicates that a disturbance in serum pro-oxidant-antioxidant balance and an increase in LDL oxidation are concomitant with higher TC and LDL-C and lower HDL-C levels in the serum.     

精神分裂症共病代谢综合征患者血清同型半胱氨酸的对照研究

目的对精神分裂症共病代谢综合征(MS)患者血清同型半胱氨酸(Hcy)水平进行对照研究。方法 33例首次确诊为MS的精神分裂症患者作为观察组,33例不伴有MS的精神分裂症患者作为对照组,分别测定其空腹血清Hcy水平;同时测定腰围、体质量指数(BMI)、空腹血糖(FBG)、血脂[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)]、血压[收缩压(SBP)/舒张压(DBP)]等MS相关指标。结果①观察组血清Hcy水平显著高于对照组,两组比较差异有统计学意义(t=-2.775,P0.01);②观察组高Hcy血症的发生率显著高于对照组,两组比较差异有统计学意义(χ2=6.061,P0.05);③观察组的血清Hcy水平与HDL-C、LDL-C具有相关性(r=-0.346,0.373;P0.05),而与腰围、BMI、FBG、TC、TG、SBP、DBP均无显著的相关;对照组的血清Hcy水平与腰围、BMI、FBG、TC、TG、HDL-C、LDL-C、SBP、DBP均无显著的相关性。结论与不伴发MS的精神分裂症患者相比,伴发MS的精神分裂症患者血清Hcy水平显著增高;伴发MS的精神分裂症患者的血清Hcy水平与HDL-C、LDL-C有关。     

A genome-wide association study for blood lipid phenotypes in the Framingham Heart Study

Background

Blood lipid levels including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) are highly heritable. Genome-wide association is a promising approach to map genetic loci related to these heritable phenotypes.

Methods

In 1087 Framingham Heart Study Offspring cohort participants (mean age 47 years, 52% women), we conducted genome-wide analyses (Affymetrix 100K GeneChip) for fasting blood lipid traits. Total cholesterol, HDL-C, and TG were measured by standard enzymatic methods and LDL-C was calculated using the Friedewald formula. The long-term averages of up to seven measurements of LDL-C, HDL-C, and TG over a ~30 year span were the primary phenotypes. We used generalized estimating equations (GEE), family-based association tests (FBAT) and variance components linkage to investigate the relationships between SNPs (on autosomes, with minor allele frequency ≥10%, genotypic call rate ≥80%, and Hardy-Weinberg equilibrium p ≥ 0.001) and multivariable-adjusted residuals. We pursued a three-stage replication strategy of the GEE association results with 287 SNPs (P < 0.001 in Stage I) tested in Stage II (n ~1450 individuals) and 40 SNPs (P < 0.001 in joint analysis of Stages I and II) tested in Stage III (n~6650 individuals).

Results

Long-term averages of LDL-C, HDL-C, and TG were highly heritable (h² = 0.66, 0.69, 0.58, respectively; each P < 0.0001). Of 70,987 tests for each of the phenotypes, two SNPs had p < 10^-5 in GEE results for LDL-C, four for HDL-C, and one for TG. For each multivariable-adjusted phenotype, the number of SNPs with association p < 10^-4 ranged from 13 to 18 and with p < 10^-3, from 94 to 149. Some results confirmed previously reported associations with candidate genes including variation in the lipoprotein lipase gene (LPL) and HDL-C and TG (rs7007797; P = 0.0005 for HDL-C and 0.002 for TG). The full set of GEE, FBAT and linkage results are posted at the database of Genotype and Phenotype (dbGaP). After three stages of replication, there was no convincing statistical evidence for association (i.e., combined P < 10^-5 across all three stages) between any of the tested SNPs and lipid phenotypes.

Conclusion

Using a 100K genome-wide scan, we have generated a set of putative associations for common sequence variants and lipid phenotypes. Validation of selected hypotheses in additional samples did not identify any new loci underlying variability in blood lipids. Lack of replication may be due to inadequate statistical power to detect modest quantitative trait locus effects (i.e., <1% of trait variance explained) or reduced genomic coverage of the 100K array. GWAS in FHS using a denser genome-wide genotyping platform and a better-powered replication strategy may identify novel loci underlying blood lipids.

     

肝硬化患者上消化道出血与血脂水平相关性分析

目的分析肝硬化患者上消化道出血与血脂水平的相关性。方法选取2017年7月至2019年6月126例肝硬化合并上消化道出血患者作为病例组,选取同期100例未发生上消化道出血的肝硬化患者作为对照组。收集患者一般资料,并测定三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)、载脂蛋白E(ApoE)。进行单因素分析、Spearman秩相关分析、Logistics回归分析,并作ROC曲线。结果病例组患者的TG、TC、HDL-C、LDL-C、ApoA1、ApoB、ApoE水平均低于对照组(P<0.05)。Spearman秩相关分析显示,TC、HDL-C、LDL-C、ApoA1、ApoB水平与上消化道出血呈负相关(P<0.05),TG、ApoE水平与上消化道出血无显著相关性(P>0.05)。Logistics回归分析显示,TC、LDL-C低水平是上消化道出血的危险因素。LDL-C作为上消化道出血预测因子的准确性高于TC,当LDL-C水平低于2.565 mmol/L时(AUC=0.861,灵敏度82%,特异性73%),及TC水平低于3.995 mmol/L时(AUC=0.736,灵敏度75%,特异性64%),上消化道出血风险明显增加。结论血脂代谢异常与肝硬化患者上消化道出血密切相关,TC、LDL-C低水平是上消化道出血的危险因素,当LDL-C水平低于2.565 mmol/L、TC水平低于3.995 mmol/L时,上消化道出血风险明显增加。     

Association of the Trp316Ser variant (rs1801690) near the apolipoprotein H (β2-glycoprotein-I) gene and serum lipid levels

The objective of the present study was to detect the association of the Trp316Ser variant (rs1801690) near the apolipoprotein H (β2-glycoprotein-I) gene and serum lipid levels in the Mulao and Han populations. A total of 879 subjects of Mulao and 844 subjects of Han Chinese were included. The levels of serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and ApoA1 in Mulao, and triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), ApoA1 and the ratio of ApoA1/ApoB in Han were different among the three genotypes of the rs1801690 SNP (P < 0.05-0.01). Subgroup analyses showed that the levels of TC, TG, LDL-C, and ApoA1 in Mulao males; ApoA1 in Mulao females; TC, TG, HDL-C and ApoB and the ApoA1/ApoB ratio in Han males; and HDL-C, ApoA1 and the ApoA1/ApoB ratio in Han females were associated with the genotypes of rs1801690 (P < 0.05-0.001). Serum lipid parameters were also associated with several environmental factors (P < 0.05-0.001). The Trp316Ser variant (rs1801690) near the apolipoprotein H (β2-glycoprotein-I) gene was associated with some serum lipid parameters in the two ethnic groups, but the trends of association suggest that the Trp316Ser variant (rs1801690) near the apolipoprotein H (β2-glycoprotein-I) gene might have racial/ethnic-and/or gender-specificity.     

Lipid, glucose and homocysteine metabolism in women treated with a GnRH agonist with or without raloxifene

BACKGROUND: Although GnRH analogues are widely used to treat a variety of sex hormone-related diseases, little is known about their effect on metabolism. Therefore, we have evaluated the effect of a GnRH analogue, administered with or without raloxifene, on serum levels of lipoproteins, glucose, insulin and homocysteine (Hcy). METHODS: One hundred premenopausal women with symptomatic uterine leiomyomas were initially enrolled and randomized to receive 3.75 mg/28 days leuprolide acetate depot associated with 60 mg/day raloxifene hydrochloride (group A) or 1 placebo tablet/day (group B) for six cycles of 28 days. At entry and at cycle 6, subjects underwent anthropometric measurements, including body mass index and waist-to-hip ratio measurements, and blood chemistry assays for serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), glucose, insulin, Hcy, vitamin B(12) and folate concentrations. Insulin resistance was evaluated with the homeostasis model assessment (HOMA) score. RESULTS: Baseline parameters were similar in the two groups. At cycle 6, TC, HDL-C, LDL-C and TG levels were significantly increased (P < 0.05) in group B. In group A, LDL-C levels were unchanged, and TC, HDL-C and TG levels were increased (P < 0.05). Serum TC and LDL-C levels differed (P < 0.05) between the groups. Glucose levels were unchanged between and within groups, whereas insulin levels and HOMA scores increased (P < 0.05) versus baseline in group B. Post-treatment Hcy levels were higher (P < 0.05) versus baseline in group B; they were unchanged in group A. Serum vitamin B(12) and folate concentrations were unchanged in both groups. CONCLUSIONS: GnRH analogues alter serum lipoprotein and Hcy levels and increase insulin resistance. These acute metabolic changes may be prevented or reduced by raloxifene.     

血脂异常与老年冠心病患者冠脉病变程度的相关性研究

目的 探讨血脂异常与老年冠心病患者冠脉病变程度的相关性。方法 选取2015年5月~2017年1月本院心内科住院的明确诊断为冠状动脉粥样硬化性心脏病（CHD）的150例老年患者设为CHD组。选取同期收治的150例非CHD患者为对照组。比较两组血清中总胆固醇（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）水平,并计算N-HDL-C、LDL-C/N-HDL-C、LDL-C/HDL-C、TC/HDL-C、TG/HDL-C值。比较不同冠脉病变支数、不同病情严重程度的CHD患者的血脂及其比值。对血脂与冠脉病变支数、病情严重程度积分进行相关性分析。结果 CHD组患者LDL-C、TG、TC、N-HDL-C水平、LDL-C/HDL-C、TC/HDL-C、TG/HDL-C值均高于对照组,HDL-C水平低于对照组,差异均有统计学意义（P＜0.05）;不同冠脉病变支数各亚组间的TC、TG、N-HDL-C水平、TC/HDL-C比值差异存在统计学意义（P＜0.05）;TC、TG、N-HDL-C水平、TC/HDL-C比值均与冠脉病变支数均呈正相关（P＜0.05）;不同病情严重程度亚组间的LDL-C、TC、TG、N-HDL-C水平、LDL-C/HDL-C、TC/HDL-C、TG/HDL-C比值差异存在统计学意义（P＜0.05）;CHD患者LDL-C、TC、TG、N-HDL-C水平、LDL-C/HDL-C、TC/HDL-C、TG/HDL-C比值与冠状动脉病变积分均呈正相关（P＜0.05）。结论 可以通过对血脂指标的监测,并计算N-HDL-C、TC/HDL-C、LDL-C/HDL-C、TC/HDL-C、TG/HDL-C值,来评估CHD病情的临床进展。     

Plasma triglyceride concentrations are rapidly reduced following individual bouts of endurance exercise in women

It is known that chronic endurance training leads to improvements in the lipoprotein profile, but less is known about changes that occur during postexercise recovery acutely. We analyzed triglyceride (TG), cholesterol classes and apolipoproteins in samples collected before, during and after individual moderate- and hard-intensity exercise sessions in men and women that were isoenergetic between intensities. Young healthy men (n = 9) and young healthy women (n = 9) were studied under three different conditions with diet unchanged between trials: (1) before, during and 3 h after 90 min of exercise at 45% VO₂peak (E45); (2) before, during and 3 h after 60 min of exercise at 65% VO₂peak (E65), and (3) in a time-matched sedentary control trial (C). At baseline, high-density lipoprotein cholesterol (HDL-C) was higher in women than men (P < 0.05). In men and in women, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), HDL-C, apolipoprotein A-I (apoA-I), apolipoprotein B (apoB), and LDL peak particle size were unaltered by exercise either during exertion or after 3 h of recovery. In women, but not in men, average plasma TG was significantly reduced below C at 3 h postexercise by approximately 15% in E45 and 25% in E65 (P < 0.05) with no significant difference between exercise intensities. In summary, plasma TG concentration rapidly declines following exercise in women, but not in men. These results demonstrate an important mechanism by which each individual exercise session may incrementally reduce the risk for cardiovascular disease (CVD) in women.     

Increase in Standard Cholesterol and Large HDL Particle Subclasses in Antiretroviral-Naïve Patients Prescribed Efavirenz Compared to Atazanavir/Ritonavir

Abstract

Background: Cardiovascular risk in HIV-infected patients is related, at least in part, to serum lipid alterations before and after HAART. Lipoprotein-particle subclasses may also have an effect, but comparative data after standard HAART regimens are limited.Methods: This was a substudy of a trial in 91 antiretroviral-naïve patients randomized to tenofovir + emtricitabine + atazanavir/ritonavir (ATV/r) or efavirenz (EFV). Over-time trends from baseline to week 48 in total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), HDL particles (HDLp), and TC:HDL-C and TG:HDL-C ratios were analyzed by analysis of covariance (ANCOVA). Furthermore, confidence intervals for differences between the 2 groups at week 48 were calculated. Indications for lipid-lowering interventions and low HDL-C were also studied.Results: ANCOVA showed that, with respect to patients receiving ATV/r, those prescribed efavirenz (EFV) had greater increases reported as mean differences in lipid values at week 48: 14 mg/dL (95% CI, 0.2 to 27) for TC, 14 mg/dL (95% CI, 4 to 25) for LDL-C, 5 mg/dL (95% CI, 2 to 9) for HDL-C, and 2.2 mg/dL (95% CI, 0.4 to 4) for large HDLp. Proportions of subjects with indications for lipid-lowering interventions and with HDL-C <40 mg/dL did not differ significantly.Conclusions: Patients prescribed EFV had greater increases in TC, LDL-C, and HDL-C. Although no significant differences were detected between the 2 groups for the TC:HDL ratio and for indications to start lipid-lowering interventions, large HDLp increased more in the EFV group compared to the ATV/r group, suggesting a protective effect associated with EFV use.     

毛南族绝经和未绝经女性体成分与血脂的相关性

目的研究毛南族绝经与未绝经女性的体成分和血脂的差异,探讨绝经后脂肪含量和分布的变化与血脂的相关性。方法随机抽取广西环江毛南族绝经和未绝经女性200人,追溯其3代均为毛南族,采用生物电阻抗法测定体成分,抽血检测总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)和低密度脂蛋白(LDL-C)。结果绝经女性的内脏脂肪等级(面积)、腰臀比、左(右)下肢的脂肪量、TC、TG、LDL-C等均大于未绝经女性,且差异具有统计学意义(P0.01);绝经女性的高胆固醇血症、混合型高脂血症及血脂异常的检出率均高于未绝经女性(P0.01);血脂4项与腰臀比和内脏脂肪含量密切相关(P0.05或P0.01),除TC外,TG、HDL-C、LDL-C均与体脂率、BMI和皮下脂肪含量显著相关(P0.05或P0.01)。结论毛南族女性绝经后脂肪在内脏和腰腹部的堆积增多可能是血脂异常的主要影响因素之一。与BMI和BF%相比,WHR能更好地反映血脂水平。