A STUDY OF LIPID PROFILE BEFORE AND AFTER CORONARY ARTERY BYPASS GRAFTING

SUMMARY This study was undertaken to establish the variability in the levels of total cholesterol (TC), total triglyceride (TG), low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol before and after coronary artery bypass graft (CABG) surgery, in order to determine postoperatively when an accurate assessment can be made of the lipid status. During a prospective study over 4 months, fasting venous samples were taken pre- and postoperatively on day 5, and in the 4th, 8th and 12th weeks. Ninety-six patients admitted to the cardiothoracic and cardiac wards for CABG were recruited to the study. The mean preoperative levels were: TC 5.94 (± 0.1 mmol/l), LDL cholesterol 4.02 (± 0.09mmol/l) and HDL cholesterol 1.00 (± 0.03mmol/l). These were significantly different (p<0.01) from the levels on the 5th postoperative day when the mean level of TC was 4.14 (± 0.084mmol/l), LDL cholesterol was 2.45 (± 0.07mmol/l) and HDL cholesterol was 0.74 (±0.03mmol/l). By the 4th postoperative week, mean TC (5.73±0.13mmol/l), LDL cholesterol (3.79 ±0.14mmol/l) and HDL cholesterol (1.03 ± 0.04mmol/l) did not vary significantly from the mean preoperative values. There was no significant difference in the mean TG levels pre- and postoperatively. The mean TC, LDL cholesterol and HDL cholesterol rise to preoperative levels by the 4th week after CABG. Thus, an accurate assessment of patients' lipid status can be made from this period. An earlier postoperative assessment may be falsely reassuring.     

An evaluation of pharmaceutical treatment of dyslipidaemia among patients without diagnosed atherosclerotic disease in Belgium

The aim of this study was to assess the lipoprotein levels in patients without diagnosed atherosclerotic disease but treated with lipid-lowering drugs. During February and March 2002 all demands for continuation of reimbursement of lipid-lowering drugs were recorded at two regional offices of health insurance associations. A total of 1973 patients without diagnosed atherosclerotic disease were included (mean age 66 years). Mean total cholesterol (TC) was 5.39 mmol/l, high-density lipoprotein cholesterol (HDL-C) 1.50 mmol/l, low-density lipoprotein cholesterol (LDL-C) 3.16 mmol/l and triglycerides (TG) 1.59 mmol/l. Thirty-four per cent of the treated patients reached the TC target of 5.0 mmol/l or less. The LDL-C target level of 3.0 mmol/l or less was reached by 45% of the patients. Of the patients receiving a statin, 61% were not treated with the optimal doses. The treatment was adjusted in 15% of the patients who did not reach the combined endpoint.     

Are women discriminated against for lipid lowering therapy? Results from a prospective cohort of women with coronary artery disease

The objective of the study was to compare the lipid management of men and women with documented coronary artery disease in 587 patients (433 men and 154 women) undergoing coronary angiography between 1991 and 1995. A fasting total cholesterol (TC) was measured in all patients on the morning of angiography. A postal/telephone follow-up was carried out one year after angiography in a subpopulation of 278 patients (194 men and 84 women) who were not taking lipid-lowering therapy (LLT) or whose TC was > 5.2 mmol/l at the time of angiography. At baseline, mean TC was 5.89 mmol/l (SE 0.06) in the men and 6.47 mmol/l (SE 0.09) in the women (p = < 0.0001). Action or recommendation to institute LLT was taken in 141 (32.7%) men and 62 (40.3%) women (p = 0.09). In the follow-up population, comparing men with women, 74 (38.3%) vs 39 (46.4%) were taking LLT (p = 0.21); 56 (28.9%) vs 26 (31.0%) had not undergone repeat TC testing (p = 0.73); when performed, repeat TC was 5.75 (0.09) mmol/l vs 5.64 (0.16) mmol/l (p = 0.53); mean decrease in TC between baseline and follow-up was 0.86 (0.10) mmol/l vs 1.01 (0.21) mmol/l (p = 0.51). There was no significant gender difference in lipid management either at the time of coronary angiography or subsequent follow-up, although the level of lipid-lowering drug use remained inadequate in both sexes.     

Diagnosis of heterozygous familial hypercholesterolaemia in children

Background: Most children with familial hypercholesterolaemia (FH) are diagnosed by raised blood chloesterol levels, but the test lacks sensitivity and specificity. As such children have evidence of vascular dysfunction at an early age, correct identification of affected individuals is important so that treatment can be started. Aim: To determine levels of total cholesterol (TC) and low‐density lipoprotein cholesterol (LDL‐C) in children with genetically proven FH and their unaffected siblings, in order to identify a diagnostic cut‐off point if possible. Design: Retrospective case‐note survey. Methods: We studied the notes of 115 children aged 3–16 years, 69 proven FH and 46 unaffected sibs, 65 boys and 50 girls, from 31 families and 21 different mutations. Data recorded were age, sex, TC, and (when available) LDL‐C. Results: The lowest TC level in an affected individual was 4.7 mmol/l and the highest in normal individual was 6.05 mmol/l. This overlap range included 21 children (18% of the total). The corresponding figures for LDL‐C were 3.0 and 3.7 mmol/l, which included eight children (8%). Conclusion: TC is not an effective test for differentiating affected and unaffected children with FH. LDL‐C is better, but genetic testing remains the method of choice, especially if treatment decisions are to be taken.     

Hypolipidemic effects of alisat and lipostabil in patients with diabetes mellitus

AIM: To study a hypolipidemic action of alisat and lipostabil in patients with non-insulin-dependent diabetes mellitus (NIDDM). MATERIAL AND METHODS: Changes in blood lipids were studied in 121 NIDDM patients aged 36-66 years with compensated or subcompensated carbohydrate metabolism on sugar-reducing therapy. The latter consisted of a 52-week course of alisat (600 mg/day) or lipostabil (900 mg/day) in baseline levels of total cholesterol (TC) under 6.5 mmol/l and above 6.5 mmol/l, respectively. RESULTS: Alisat and lipostal treatments reduced TC levels from 5.4 +/- 25 to 4.77 +/- 0.12 mmol/l and from 7.07 +/- 0.24 to 5.92 +/- 0.30, LDLP cholesterol from 4.0 +/- 0.31 to 2.98 +/- 0.15 mmol/l and 5.54 +/- 0.25 to 4.04 +/- 0.34 mmol/l, respectively. Lipostabil changed LDLP cholesterol and triglycerides from 0.51 +/- 0.05 to 0.33 +/- 0.03 mmol/l and from 2.54 +/- 0.25 to 1.66 +/- 0.15 mmol/l, respectively, while HDLP cholesterol rose from 1.22 +/- 0.10 to 1.55 +/- 0.07 mmol/l. Alisat did not change significantly. CONCLUSION: Adjuvant lipostabil is recommended in combined treatment of NIDDM in marked dyslipidemia, alisat--in moderate dyslipidemia.     

Coronary atherosclerosis and total serum cholesterol in men and women

The study shows that the extent of atherosclerotic changes in the coronary arteries, revealed during coronaroangiography, has a significant correlation with the serum level of total cholesterol (TC). In patients with normal (less than 5.2 mmol/ l) TC the number of involved arteries and the number of stenotic segments are significantly smaller than those in patients with a TC level higher than 6.5 mmol/l.     

A ONE-YEAR MULTICENTRE STUDY OF SIMVASTATIN IN THE TREATMENT OF HYPERCHOLESTEROLEMIA

SUMMARY A 1-year prospective study was conducted in 475 hypercholesterolaemic men and women who received simvastatin monotherapy 10–40 mg daily for 3 months followed by additional lipid-lowering medication after this period, if necessary, to reach a target of plasma cholesterol <5.3 mmol/l. Of these, 403 subjects completed 1 year of follow-up. By the end of the 3-month monotherapy period, the following percentage mean changes were seen (with 95% confidence intervals): total cholesterol (TC) -31% (-30 to -32%), low-density lipoprotein cholesterol -39% (-38 to -40%), triglycerides -14% (-11 to -17%) and high-density lipoprotein cholesterol +12% (+11 to +14%). These levels were maintained for the remainder of the study. When subjects with a baseline TC of 6.5–7.8 mmol/l were considered (n=89), 42.7% achieved the target TC levels on simvastatin monotherapy alone. Additional hypolipidaemic medication had no significant impact on plasma lipid and lipoprotein levels. Simvastatin was well tolerated both as monotherapy and in combination.     

The estimation of total serum lipids by a completely enzymatic 'summation' method

Expressing serum organic toxicant concentrations per weight of total lipid rather than by volume of serum is often advantageous, but it requires a reliable and convenient method for determining the total serum lipids. We compared a completely enzymatic 'summation' method for estimating serum total lipids with a traditional gravimetric analysis. Serum total cholesterol (TC), nonesterified cholesterol (FC), triglycerides (TG), and phospholipids (PL) were assayed by automated, enzymatic methods and total lipids (TL) were calculated from the expression TL = 1.677 * (TC-FC) + FC + TG + PL. Examining three reference serum pools by both summation and gravimetric methods yielded results that agreed within 1-3%. The evaluation of thirty serum samples resulted in similar mean total lipid values (697 mg/dl gravimetric; 675 mg/dl summation) with excellent correlation between the two methods (r2 = 0.978). We conclude that the enzymatic summation procedure is a useful method for routinely estimating serum total lipid content.     

Pharmacokinetics and pharmacodynamics of combined use of lopinavir/ritonavir and rosuvastatin in HIV-infected patients

BACKGROUND: Lopinavir/ritonavir-containing antiretroviral therapy can cause hyperlipidaemia. However, most statins are contraindicated due to drug-drug interactions. Rosuvastatin undergoes minimal metabolism by CYP450, so no CYP450-based interaction with lopinavir/ritonavir is expected. This study explored the lipid-lowering effect of rosuvastatin and assessed the effect of lopinavir/ritonavir on the pharmacokinetics of rosuvastatin and vice versa. METHODS: HIV-infected patients on lopinavir/ritonavir (viral load < 400 copies/ml) with total cholesterol (TC) > 6.2 mmol/l were treated with rosuvastatin for 12 weeks, starting on 10 mg once daily. If fasting target values (TC < 5.0 mmol/l, high-density lipoprotein-cholesterol > 1.0 mmol/l, low-density lipoprotein-cholesterol [LDL-c] < 2.6 mmol/l and triglycerides < 2.0 mmol/l) were not reached, rosuvastatin was escalated to 20 mg or 40 mg at week 4 and 8, respectively. Plasma lopinavir/ritonavir trough levels (C(min)) were determined at week 0, 4, 8 and 12 and rosuvastatin C(min), at week 4, 8 and 12. RESULTS: Twenty-two patients completed the study. Mean reductions in TC and LDL-c from baseline to week 4 (on rosuvastatin 10 mg once a day) were 27.6% and 31.8%, respectively. Lopinavir/ritonavir concentrations were not influenced by rosuvastatin (P = 0.44 and 0.26, repeated-measures analysis). Median (interquartile range) rosuvastatin C(min) for 10 mg, 20 mg and 40 mg once daily were 0.97 (0.70-1.5), 2.5 (1.3-3.3) and 5.5 (3.3-8.8) ng/ml, respectively. CONCLUSIONS: Rosuvastatin appeared to be an effective statin in hyperlipidaemic HIV-infected patients. Lopinavir/ritonavir levels were not affected by rosuvastatin, but rosuvastatin levels unexpectedly appeared to be increased 1.6-fold compared with data from healthy volunteers. Until safety and efficacy have been confirmed in larger studies, the combination of rosuvastatin and lopinavir/ritonavir should be used with caution.     

Lipoprotein composition in agnogenic myeloid metaplasia

Lipoproteins have previously, been studied in various myeloproliferative disorders. This study focused only on agnogenic myeloid metaplasia (AMM). Total cholesterol (TC), phospholipids (PL) and triglycerides (TG) were measured not only in serum but also in HDL, VLDL and LDL with in the same time total apolipoproteins A1 and B. Besides hypocholesterolemia (p less than 0.01) HDL-TC were significantly diminished in mmol/l (p less than 0.01) and in percentage (p less than 0.01) while LDL.TC was decreased in mmol/l (p less than 0.01). The whole lipid moity (TC + PL + TG) of VLDL was increased (p less than 0.05). Cardiovascular diseases occur frequently in these hypocholesterolemic patients. Atherogenic ratios: LDL.TC on HDL.TC or VLDL.TC + LDL.TC on HDL.TC were not significantly higher than matching age and sex controls. Atherogenic risks could be partly related to the significant decrease of HDL.TC.     

高脂血对不同方法测定血清高密度脂蛋白胆固醇的影响

目的　观察不同浓度血清三酰甘油 (TG)对高密度脂蛋白胆固醇 (HDL C)测定的影响 ,在临床实验室内寻找可靠的HDL -C测定方法以满足临床诊治需求。方法　采用全自动生化分析仪检测血清TG、TC、HDL C以及LDL C并与沉淀法和电泳法测定HDL C进行分组比较。结果　当血清TG <1.6 9mmol/L时 ,3种方法测定值之间无差异 ;当血清TG为 1.6 9～ 4 .0mmol/L范围时 ,各方法测定HDL -C有显著差异 ,但相关性良好。当TG >4 .0mmol/L ,各方法之间的差异程度不一致。结论　对高TG标本HDL C的测定电泳法、沉淀法和直接法之间有显著差异 ,有条件的实验室应尽可能采用电泳法测定高TG标本HDL C。     

Are sodium bicarbonate and potassium bicarbonate fully dissociated under physiological conditions?

In solutions containing 160 mmol/l Na+ and K+, respectively, measurements with an ion-selective electrode system (KNA1, Radiometer), showed apparent falls in the respective Na+ and K+ concentrations when C1- was replaced by HCO3-. After correction for the change in liquid junction potential, the fall was 9.2 mmol/l for Na+ and 7.3 mmol/l for K+. On the basis of these findings we conclude that sodium bicarbonate and potassium bicarbonate are not fully dissociated in solution, and that NaHCO3(0) and KHCO3(0) do exist as chemical components with association constants of 0.72 and 0.55, respectively. Using these association constants, normal plasma will contain 1.2 mmol/l NaHCO3(0) and 0.03 mmol/l KHCO3(0). Thus NaHCO3(0) accounts for virtually the same amount of CO2 as the physically dissolved fraction. A review of all the currently known CO2 species in plasma suggests that there may be a residue of about 2 mmol/l of unknown CO2 species in normal plasma.     

Macrophage-specific transgenic expression of cholesteryl ester hydrolase significantly reduces atherosclerosis and lesion necrosis in Ldlr mice

Accumulation of cholesteryl esters (CEs) in macrophage foam cells, central to atherosclerotic plaque formation, occurs as a result of imbalance between the cholesterol influx and efflux pathways. While the uptake, or influx, of modified lipoproteins is largely unregulated, extracellular acceptor-mediated free cholesterol (FC) efflux is rate limited by the intracellular hydrolysis of CE. We previously identified and cloned a neutral CE hydrolase (CEH) from human macrophages and demonstrated its role in cellular CE mobilization. In the present study, we examined the hypothesis that macrophage-specific overexpression of CEH in atherosclerosis-susceptible Ldlr(-/-) mice will result in reduction of diet-induced atherosclerosis. Transgenic mice overexpressing this CEH specifically in the macrophages (driven by scavenger receptor promoter/enhancer) were developed and crossed into the Ldlr(-/-) background (Ldlr(-/-)CEHTg mice). Macrophage-specific overexpression of CEH led to a significant reduction in the lesion area and cholesterol content of high-fat, high-cholesterol diet-induced atherosclerotic lesions. The lesions from Ldlr(-/-)CEHTg mice did not have increased FC, were less necrotic, and contained significantly higher numbers of viable macrophage foam cells. Higher CEH-mediated FC efflux resulted in enhanced flux of FC from macrophages to gall bladder bile and feces in vivo. These studies demonstrate that by enhancing cholesterol efflux and reverse cholesterol transport, macrophage-specific overexpression of CEH is antiatherogenic.     

Serum lipids and apolipoproteins A-I, A-II and B in primary hypothyroidism before and during treatment

Serum lipids and apolipoproteins (apo) A-I, A-II, and B were measured in twenty-four patients with severe primary hypothyroidism (Thyrotropin above 40 mU/l), before and during 1-thyroxine treatment. Apo A-I, A-II, and B were assayed by immunonephelometry, using monospecific antisera. The serum levels of total cholesterol (TC), of low-density lipoprotein cholesterol (LDLc), and of the major LDL apoprotein, apo B, were markedly increased in the untreated hypothyroid patients compared to the values during therapy (TC: mean +/- SD, 8.87 +/- 2.9 v. 5.48 +/- 1.6 mmol/l; LDLc: 6.66 +/- 2.6 v. 3.78 +/- 1.4 mmol/l; apo B: 1.66 +/- 0.48 v. 1.14 +/- 0.37 g/l; P less than 0.00001 for all variables). High-density lipoprotein cholesterol (HDLc) was slightly higher before than during therapy (1.58 +/- 0.7 v. 1.31 +/- 0.4 mmol/l; P less than 0.05), while the main HDL apoprotein, apo A-I, was significantly elevated (1.49 +/- 0.42 v. 1.13 +/- 0.27 g/l; P less than 0.0002). The increase of the second major HDL apoprotein, apo A-II, was less pronounced (0.33 +/- 0.1 v. 0.30 +/- 0.08 g/l; P less than 0.022). The apo A-I to apo A-II ratio, which reflects the relative concentrations of the HDL subfractions HDL2 and HDL3, was significantly higher before than during treatment (P less than 0.0006). Serum triglyceride levels were moderately elevated in the untreated hypothyroid patients (1.34 +/- 0.6 v. 0.95 +/- 0.4 mmol/l; P less than 0.002). The small decrease in body weight during therapy did not correlate with the changes of the various lipid and apoprotein parameters.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effect of cyclosporin A on serum lipids in primary biliary cirrhosis patients

Hyperlipidemia is a common complication of PBC. Ten patients with serologically and histologically defined PBC were randomized to receive either oral cyclosporin A (CyA) or placebo for one year. Fasting blood samples were obtained from subjects at the beginning, and following one year of treatment, for plasma lipids, apolipoproteins AI (apo AI) and B (apo B), and lecithin-cholesterol acyltransferase (LCAT) activity. On entry to the study there were no significant differences between groups for serum concentrations of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), free cholesterol (FC), total phospholipids (TPL), apo AI, apo B and LCAT activity. Compared to normal laboratory values, baseline TC was elevated in 5/10, LDL-C in 5/10, TPL in 6/10, while LCAT activity was decreased in 8/10 patients. The percent change after one year for CyA group vs the placebo group are as follows: total cholesterol, -22 vs -8%; LDL cholesterol -33 vs -25%; free cholesterol, -39 vs -14%; total phospholipids, -46 vs -23%; and LCAT activity, +/- 236 vs +/- 43%. The decrease in TC, LDL-C, FC, TPL with increase in LCAT activity suggests that CyA administration is associated with improvement in the lipid abnormalities of PBC.     

同型半胱氨酸对THP-1单核细胞源性泡沫细胞形成中ABCA1、ACAT1表达的影响

目的探讨同型半胱氨酸(Hcy)对THP-1单核细胞源性泡沫细胞形成中三磷酸腺苷-结合转运子A1(ABCA1)和酰基辅酶A:胆固醇酰基转移酶(ACAT1)表达的影响。方法将THP-1单核细胞与佛波酯(PMA)、氧化低密度脂蛋白(ox-LDL)共同培养,复制泡沫细胞模型,并分别用50、100、200、500μmol/L Hcy和100μmol/L Hcy+叶酸+维生素B12(Vit B12)干预72 h,并设对照组(不加入Hcy)。采用油红O染色检测泡沫细胞的形成。采用酶终点法测定细胞内总胆固醇(TC)、游离胆固醇(FC)和胆固醇酯(CE)含量的变化,观察Hcy对泡沫细胞CE流出的影响。采用荧光定量逆转录-聚合酶链反应(RT-PCR)测定ABCA1、ACAT1 mRNA表达;免疫印迹法检测ABCA1、ACAT1蛋白表达。结果油红O染色显示Hcy加剧了泡沫细胞的形成,但不呈量效关系。实验组(加入50、100、200、500μmol/L Hcy和100μmol/L Hcy+叶酸+Vit B12)泡沫细胞阳性百分率均高于对照组(P<0.05、P<0.01),以100μmol/L Hcy组效应最为明显(P<0.01)。在Hcy的干预下,泡沫细胞胞内TC、FC、CE流出减少,与对照组比较差异有统计学意义(P<0.05),以100μmol/L Hcy组效应最为明显(P<0.01)。100μmol/L Hcy+叶酸+VitB12组与100μmol/L Hcy组比较,前者泡沫细胞形成减少,胆固醇流出增多。RT-PCR结果显示ABCA1 mRNA表达下调,ACAT1 mRNA表达上调,均以100μmol/L Hcy组效应最为明显(P<0.01);免疫印迹法检测ABCA1、ACAT1蛋白的表达与其mRNA表达一致。结论 Hcy下调了ABCA1的表达,上调了ACAT1的表达,促使了泡沫细胞形成。     

Treatment for dyslipidemias in patients with arterial hypertension

AIM: To evaluate a combination of the effects of non-drug measures and rozuvastatin on the lipid spectrum and blood pressure (BP) in patients with treated arterial hypertension (AH) concurrent with dyslipidemia. MATERIALS AND METHODS: The multicenter open-labeled prospective program included 299 patients from 19 cities and towns of Russia. Two hundred and eighty-eight patients completed phase 1 of the program; out of them 279 patients (149 males and 130 females) aged 58-80 years (56.7 +/- 8.7 years) with a mean AH history of 10.3 +/- 8.4 years. Phase 1 of the program involved 3 visits and it was over 12 weeks after rozuvastatin therapy. Phase 2 (including a visit 12 weeks following the termination of Phase 1) is being continued. RESULTS: Rozuvastatin therapy resulted in a reduction in the levels of total cholesterol (TC) by 2.5 +/- 0.8 mmol/l (p < 0.001), low-density lipoprotein (LDL) cholesterol by 2.2 +/- 0.8 mmol/l (p < 0.001), triglycerides (TG) by 0.8 +/- 0.9 mmol/l (p < 0.001), and atherogenicity index (AI) by 2.8 +/- 1.4 (p < 0.001) and an increase in the content of high-density lipoprotein (HDL) cholesterol by 0.2 +/- 0.2 mmol/l (p < 0.001), which produced the target levels of LDL cholesterol in 61% of the patients, HDL cholesterol in 70%, and TG in 73%. During unaltered antihypertensive therapy there were also decreases in body mass by 1.5 +/- 2.8 mmol/l (p < 0.001), body mass index by 0.5 +/- 1.0 kg/ m2 (p < 0.001), waist circumference by 1.0 +/- 3.2 cm (p < 0.001), and BP by 72 +/- 14.2/4.1 +/- 8.6 mm Hg (p < 0.001). There was an increase in the activity of aspartate aminotransferase and alanine aminotransferase, and creatine phosphokinase; however, this was clinically significant in none patients. CONCLUSION: Rozuvastatin significantly lowers the levels of TC, LDL cholesterol, TG, and AI and elevates the concentration of HDL cholesterol. In the majority (83%) of the patients, rozuvastatin used in a dose of 10 mg/day was sufficient to normalize the lipid profile, which makes it possible to recommend that rozuvastatin therapy should be started from this dose.     

正常(或低)胆固醇冠心病患者的脂蛋白谱特点

目的研究血清总胆固醇（ＴＣ）正常或低于平均水平的冠心病（ＣＨＤ）患者的脂蛋白谱特点。方法观察诊断明确的男性ＣＨＤ２２５例，以年龄配对、生活水平相似的健康男子２２５例为对照。两组中均排除与脂代谢有关的疾病及用药。对血脂作多指标［１４项，包括载脂蛋白（ａｐｏ）８项］综合分析。结果ＣＨＤ患者中ＴＣ高于５．１７ｍｍｏｌ／Ｌ者１０８例（４８％），低于此水平者１１７例（５２％）。高ＴＣ组的血脂特点以低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）和ａｐｏＢ增高为主，低ＴＣ组（ＴＣ平均４．４１ｍｍｏｌ／Ｌ，相应的对照组为４．８１ｍｍｏｌ／Ｌ）的特点是高密度脂蛋白胆固醇（ＨＤＬ－Ｃ）及其亚类明显偏低，尤以ａｐｏＡＩ低下最明显。多数ＨＤＬ－Ｃ低的病例并无甘油三酯增高，部分病例以低ＨＤＬ（包括ＨＤＬ－Ｃ，ａｐｏＡＩ、ＡＩ）为单一的血脂异常。逐步回归分析优选判断ＣＨＤ的指标，在低ＴＣ组首选是ａｐｏＡＩ，其次为脂蛋白（ａ）；但高ＴＣ组以ａｐｏＢ为首选。结论低ＴＣ组在ＬＤＬ致动脉硬化作用明显减弱的情况下，低ＨＤＬ成为主要的（独立的）脂类危险因素     

KCNJ1基因多态性与浙江省宁波地区汉族人群血脂水平相关性分析

目的 探讨KCNJ1基因rs675759、rs675388和rs2846679位点基因型与浙江省宁波地区汉族人群血脂水平和血脂异常发病风险的相关性。方法 以浙江省宁波市鄞州区作为研究现场,选取年龄40岁的汉族常住居民2 330例作为研究对象。流行病学调查收集样本人群一般信息、生活行为方式等资料,采集血液样本。聚合酶链反应-连接酶检测技术检测KCNJ1 rs675759、rs675388和rs2846679位点基因型,Hardy-Weinberg平衡检验样本的遗传平衡状态。采用多重线性回归分析各位点不同基因型对血浆总胆固醇（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）血脂水平的影响。结果 KCNJ1基因的3个位点分型成功率均99%,Hardy-Weinberg平衡检验结果显示均P0.05。rs675759位点每个G等位基因使HDL-C减少0.12 mmol/L;rs675388位点每个T等位基因使TC水平增加0.14 mmol/L,HDL-C增加0.12 mmol/L;rs2846679位点每个A等位基因使TC降低0.09 mmol/L,TG下降0.08 mmol/L。结论 在本研究的样本人群中,KCNJ1基因多态性与TC、TG和HDL-C水平相关。     

SLE患者血清胱抑素C与血脂的相关性分析

目的 探讨系统性红斑狼疮(SLE)患者血清胱抑素C(Cys C)与血脂的相关性及其临床意义。方法 采用全自动生化仪测定136例SLE患者和113例体检健康者的血清胱抑素C(Cys C)、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)和超敏C反应蛋白(hsCRP)浓度。所得数据用SPSS13.0统计软件进行统计分析。结果 SLE患者组与健康对照组比较,血清hsCRP(13.5±4.85 mg/L vs 2.03±0.88 mg/L),Cys C(2.63±1.95mg/L vs 0.85±0.37 mg/L),LDL-C(3.06±1.21 mmol/L vs 2.33±0.41 mmol/L),TC(5.32±2.63 mmol/L vs 4.02±1.67 mmol/L)和TG(1.92±0.83 mmol/L vs 1.44±0.8 mmol/L),显著高于健康对照组,两组比较差异有统计学意义(t=2.45～12.4,P值均＜0.05); 与健康对照组比较,SLE组患者HDL-C(1.12±0.31 mmol/L vs 1.52±0.85 mmol/L)水平降低(P值＜0.01)。SLE患者组血清Cys C与hsCRP水平和TG,TC,LDL-C水平呈正相关(P值＜0.01),和HDL-C水平呈负相关(P值＜0.01),而健康对照组无明显相关性(P值＞0.05)。结论 SLE患者血清Cys C水平升高与血脂水平存在明显相关性,联合检测SLE患者血清Cys C和血脂指标对SLE患者并发心血管疾病和动脉粥样硬化疾病进行预防、早期诊断和治疗有重要意义。