脂蛋白胆固醇用于冠心病筛检试验的评价

至今尚无适于人群筛检冠心病的理想方法。38例心电图踏车运动试验阳性的病例组,与同期试验阴性的71例对照组进行筛检试验评价研究。选择TC/HDL-C、HDL-C/TC、LDL-C/HDL-C、HDL₂-C/HDL₃-C等比值为筛检指标,评价其不同界限值的真实性、预测值等。TC/HDL-C与HDL₂-C/HDL₃-C并联使用可以提高检出率达92%。多元逐步回归分析只有TC/HDL-C选入方程,计算其5个组段的阳性似然比,并以不同的验前概率拟代,结果验后概率以TC/HDL-C≥3.2最大,因此,国内"动脉粥样硬化指标"TC/HDL-C的界限值可定为≥3.2。     

健康人性格类型与血清脂蛋白组分胆固醇相关性的研究

本文报告对1548名健康人性格类型与血清脂蛋白组分胆固醇的关系进行观察,结果表明A型性格者HDL-C、HDL_2-C、HDL_3-C、HDL_2-C/HDL_3-C均明显低于非A型性格者,而LDL-C/HDL-C则相反。性格类型对LDL-C和VLDL-C无明显影响。不同性别、年龄、职业人群观察结果相似。研究结果说明,A型性格易患冠心病的结论是可信的,性格类型影响血清脂蛋白组分胆固醇水平而发生致病作用可能是原因之一。     

1310例体检人群血清脂蛋白胆固醇与年龄、性别及血糖水平的相关性研究

目的探讨成人血清脂蛋白胆固醇与年龄、性别及空腹血糖水平的关系。方法选择1310名体检健康人作为研究对象,根据年龄分为6组,测定其血清脂蛋白胆固醇及空腹血糖,比较各年龄组及性别间脂蛋白胆固醇变化和差异,并行相关分析。结果极低密度脂蛋白胆固醇(VLDL-C)及低密度脂蛋白胆固醇(LDL-C)有随年龄增长而升高的趋势(r=0.19及0.25,均P=0.000),但60岁后男性VLDL-C有所下降。60岁前各年龄段男性VLDL-C结果均显著高于女性(P=0.000),60岁后男女间无差别(P>0.05)。50岁前男性LDL-C水平均高于女性(P<0.05),50岁以后男女间无差别(P>0.05)。高密度脂蛋白胆固醇(HDL-C)随年龄增长变化不明显(P>0.05),但女性各年龄段HDL-C结果均显著高于男性(P=0.000)。相关分析显示随空腹血糖水平升高VLDL-C升高趋势不明显(r=0.08,P=0.004),但LDL-C有所升高(r=0.13,P=0.000)且HDL-C明显降低(r=-0.18,P=0.000)。结论随年龄增长健康人群有发生脂蛋白代谢紊乱的倾向,且男性趋势更明显;空腹血糖增高和脂代谢紊乱有一定的相关性。     

成年人代谢综合征及相关因素的分析

目的观察临沂市成年人代谢综合征（MS）的发生率及相关因素。方法采取多级抽样法抽取30岁以上的I临沂城镇居民1883人,分别检测空腹血糖（FBG）、空腹胰岛素（Fins）、血清总胆固醇（TCH）、甘油三脂（TG）、高密度脂蛋白胆固醇（HDL-C）、高密度胆固醇亚组分（HDL2-C、HDL3-C）、低密度脂蛋白胆固醇（LDL-C）、极低密度脂蛋白胆固醇（VLDL-C）。结果BMI≥25kg／m^2组MS的发生率为20．9％;BMI（25kg／m^2组为5．6％,两组有显著性差异（P〈0．01）。结论超重与肥胖组的MS发生率明显高于正常体重组。超重与肥胖组血清FBG、Fins、TCH、TG、LDL-C、VLDL-C显著增高;BMI与TCH、TG、LDL-C、VLDL-C呈正相关。     

产次对孕妇血脂及妊娠并发症的影响

目的:探讨不同产次对孕妇血脂及妊娠并发症的影响。方法:收集2016年9月—2017年12月在河北省人民医院产检并分娩的孕妇共1 669例,按孕周及年龄分为4组:妊娠中期适龄组527例、妊娠中期高龄组261例、妊娠晚期适龄组636例、妊娠晚期高龄组245例,其中每组根据产次分为初产妇和经产妇,比较各组血脂水平、高密度脂蛋白胆固醇(HDL-C)/总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)/TC、LDL-C/HDL-C比值以及妊娠结局。结果:(1)妊娠中期适龄组经产妇(与初产妇比较)三酰甘油(TG)、TC和极低密度脂蛋白胆固醇(VLDL-C)水平明显升高(P0.05);妊娠中期高龄组经产妇(与初产妇比较)TG、TC、HDL-C、LDL-C、VLDL-C和HDL-C/TC水平呈升高趋势,但仅HDL-C水平差异有统计学意义(P0.05)。(2)妊娠晚期适龄组经产妇(与初产妇比较)LDL-C、VLDL-C、LDL-C/TC和LDL-C/HDL-C水平显著降低,而HDL-C/TC升高(均P0.05);妊娠晚期高龄组经产妇(与初产妇比较)TG、TC、HDL-C、LDL-C、HDL-C/TC和LDL-C/HDL-C水平呈下降趋势,VLDL-C水平升高,但差异均无统计学意义(P0.05)。(3)与初产妇相比,适龄组经产妇胎膜早破及胎儿窘迫的发病率下降,高龄组妊娠期高血压疾病(HDCP)和妊娠期糖尿病(GDM)、胎儿窘迫发生率下降(P0.05);而适龄组经产妇早产儿和巨大儿发生率升高(P0.05)。(4)高龄组GDM和HDCP发生率高于适龄组(P0.05)。结论:产次对血脂有一定程度的影响,可导致妊娠并发症的发生。     

产次对孕妇血脂及妊娠并发症的影响

目的：探讨不同产次对孕妇血脂及妊娠并发症的影响。方法：收集2016年9月-2017年12月在河北省人民医院产检并分娩的孕妇共1 669例,按孕周及年龄分为4组：妊娠中期适龄组527例、妊娠中期高龄组261例、妊娠晚期适龄组636例、妊娠晚期高龄组245例,其中每组根据产次分为初产妇和经产妇,比较各组血脂水平、高密度脂蛋白胆固醇（HDL-C）/总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）/TC、LDL-C/HDL-C比值以及妊娠结局。结果：①妊娠中期适龄组经产妇（与初产妇比较）三酰甘油（TG）、TC和极低密度脂蛋白胆固醇（VLDL-C）水平明显升高（P＜0.05）;妊娠中期高龄组经产妇（与初产妇比较）TG、TC、HDL-C、LDL-C、VLDL-C和HDL-C/TC水平呈升高趋势,但仅HDL-C水平差异有统计学意义（P＜0.05）。②妊娠晚期适龄组经产妇（与初产妇比较）LDL-C、VLDL-C、LDL-C/TC和LDL-C/HDL-C水平显著降低,而HDL-C/TC升高（均P＜0.05）;妊娠晚期高龄组经产妇（与初产妇比较）TG、TC、HDL-C、LDL-C、HDL-C/TC和LDL-C/HDL-C水平呈下降趋势,VLDL-C水平升高,但差异均无统计学意义（P＞0.05）。③与初产妇相比,适龄组经产妇胎膜早破及胎儿窘迫的发病率下降,高龄组妊娠期高血压疾病（HDCP）和妊娠期糖尿病（GDM）、胎儿窘迫发生率下降（P＜0.05）;而适龄组经产妇早产儿和巨大儿发生率升高（P＜0.05）。④高龄组GDM和HDCP发生率高于适龄组（P＜0.05）。结论：产次对血脂有一定程度的影响,可导致妊娠并发症的发生。     

吸烟与冠心病 162例1:2配对研究

本文报告了162例吸烟与冠心病的配对研究，结果表明：1.吸烟，尤其是大量吸烟（≥20支/天）与冠心病有关。2.当血清胆固醇≥250毫克%时，吸烟与冠心病关系非常密切（χ²=9.00，P<0.01，RR=3.11），而血清胆固醇<250毫克%时，吸烟与冠心病无关。3.吸烟组中，高密度脂蛋白胆固醇平均值为61.7毫克%，明显低于不吸烟组的65.1毫克%，差别有显著性（P<0.05）提示吸烟能降低HDL-C水平，促进冠心病的发生。     

正常人群红细胞胆固醇与血浆脂蛋白组分胆固醇水平关系的研究

本文报告了1～90岁2333名正常人群红细胞胆固醇(REC—C)、高密度脂蛋白胆固醇(HDL—C)及亚组(HDL_2—C、HDL_3—C)、低密度脂蛋白胆固醇(LDL—C)、极低密度脂蛋白胆固醇(VLDL—C)水平及相关关系。结果显示RBC—C水平随年龄增长而升高,并呈正相关(r=0.154,P<0.05)。男、女RBC—C与HDL—C呈正相关,RBC—C与HDL_2—C、HDL_3-C、LDL—C、VLDL—C呈负相关。男性RBC-C与LDL—C相关密切(偏相关系数R=0.157,P<0.05),女性RBC—C与VLDL—C相关密切(偏相关系数R=0.153,P<0.05)。RBC—C与HDL-C、HDL_2—C、HDL_3-C、LDL-C、VLDL-C相关方向、相关强度因年龄增加,性别不同而变化。结合有关资料讨论了RBC—C水平变化及RBC—C与血浆脂蛋白组分胆固醇相关关系在动脉硬化形成及预防中的意义。     

120例2型糖尿病患者超敏C反应蛋白的临床分析

目的 探讨2型糖尿病患者血清超敏C-反应蛋白（hs-CRP）水平与甘油三酯（TG）、胆固醇（TC）、低密度脂蛋白-胆固醇（LDL-C）、总胆固醇（TC）/高密度脂蛋白-胆固醇（HDL-C）的关系.方法 采用美国ARCHITECT Ci 8200生化分析仪对120例2型糖尿病患者（A、B、C三组）及40例健康对照的hs-CRP、TG、TC、HDL-C、LDL-C进行测定.结果 120例2型糖尿病患者hs-CRP比对照组明显升高（ P 〈0.001）,C组hs-CRP明显高于B、A组（ P 〈0.001）,B组高于A组（ P 〈0.05）且与TG、TC、LDL-C、TC/HDL-C正相关.结论 hs-CRP可作为2型糖尿病并发症出现的风险预测指标.     

阻塞型睡眠呼吸暂停综合征与脑卒中的临床相关性研究

目的 探讨阻塞型睡眠呼吸暂停综合征(OSAS)与脑卒中(CVD)的相关性.方法 对115例在年龄、身高及体重方面无明显差异的肥胖男性经夜间7 h睡眠多导生理记录仪检测,测定并比较所有患者血中的C反应蛋白(CRP)水平,以及其他血浆成分如高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、极低密度脂蛋白胆同醇(VLDL-C)、三酰甘油、总胆固醇等指标.结果 73例被确诊为OSAS,其中35例合并CVD(OSAS+CVD组),38例无CVD(OSAS组);42例CVD患者未合并OSAS(CVD组).三组间HDL-C、LDL-C、VLDL-C、总胆固醇、三酰甘油比较差异无统计学意义(P>0.05).OSAS组CRP(2.37±5.03)mg/L,OSAS+CVD组CRP(4.68±7.93)mg/L,均高于CVD组的(1.07±5.67)mg/L(P<0.05),CVD、OSAS患者血浆CKP分别与呼吸紊乱指数呈正相关(r=0.60、0.51,P<0.05).结论 OSAS合并CVD与OSAS患者血浆CRP水平升高有关,OSAS是CVD独立的危险因素.     

被动吸烟对不吸烟女性血脂和血液流变学指标的影响

目的 在不吸烟女性中探讨被动吸烟对血脂、纤维蛋白原和血液黏度的影响.方法　在115例冠心病患者(其中52例经冠脉造影确诊)和208名非冠心病者为对照组(83名经冠脉造影排除)中采用国际标准的质控血清进行血脂组分,即血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)及亚组分HDL2-C、载脂蛋白(apo)A1和apoB、纤维蛋白原和血液黏度的测定.被动吸烟暴露的定义是与吸烟的丈夫或同事接触至少5年.结果 在冠脉造影确诊者中被动吸烟者的血脂紊乱、血浆纤维蛋白原水平和血浆黏度的升高较非被动吸烟史者更为严重,且与冠脉病变程度呈正相关.在非冠心病对照组中,127例被动吸烟者与81例非被动吸烟暴露者各变量的调整(年龄、体重指数、既往病史)均值的差异检验P值分别为:TC 0.06、TG 0.30、HDL-C 0.004、HDL2-C＜0.001、apoA1＜0.001、apoB 0.009、apoB/apoA1＜0.001、纤维蛋白原＜0.001、血浆＜0.001及全血的低高两个切变率黏度＜0.001和0.004.被动吸烟量与HDL-C、HDL2-C、apoA1、apoB、apoB/apoA1、纤维蛋白原、血浆及全血的高低两个切变率黏度的多元相关系数分别为-0.25、-0.27、-0.30、0.24、0.31、0.32、0.43、0.51和0.36(P值均＜0.01).结论 无论生理或病理状态下,被动吸烟均可导致机体脂代谢紊乱、血浆纤维蛋白原和血液黏度的升高.     

Determinants of total high density lipoprotein cholesterol and high density lipoprotein subfraction levels among Hispanic and non-Hispanic white persons with normal glucose tolerance: the San Luis Valley Diabetes Study.

Determinants of total high-density lipoprotein cholesterol (HDL-C) and HDL subfractions were assessed in Hispanic and non-Hispanic white persons (n = 932), aged 20-74 years, in the San Luis Valley, Colorado. Using multiple regression, BMI was negatively associated with HDL-C, HDL2-C, and HDL3-C in men and HDL-C and HDL3-C in women. Among females, current smokers had lower HDL-C and subfractions. Women on beta-blockers had lower HDL3-C levels. For both sexes, a positive association was observed between age and HDL-C and subfractions and physical activity with HDL-C and HDL3-C. Drinking alcohol (> or = 50 g/week) was associated with higher HDL-C and HDL3-C in both sexes and HDL2-C in women. The positive association of age and negative associations of the subscapular/triceps ratio and fasting insulin had consistent relationships with HDL-C, HDL2-C, and HDL3-C in men and women. Ethnicity was not significantly associated with HDL-C or subfractions after controlling for body fat distribution or fasting insulin.     

The effects of cessation from cigarette smoking on the lipid and lipoprotein profiles: a meta-analysis

BACKGROUND: Cross-sectional studies revealed that cigarette smokers have lower high-density lipoprotein cholesterol (HDL-C) levels and higher levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) than nonsmokers. But prospective studies on the effects of cigarette smoking cessation on lipid profile have yielded inconclusive results. METHODS: Relevant English articles were retrieved by keyword searches of MEDLINE (1966-October 2000), Cochrane Library (2000, Issue 2), and cited references. Twenty-seven studies met the following inclusion criteria: (1) prospective cohort study including clinical trials, (2) measuring smoking status and lipid profile of HDL-C, TC, LDL-C, and TG, (3) reporting the changes of lipid concentrations in abstinent smokers, and (4) not using adjuvant antihyperlipidemic drugs. RESULTS: Overall Q statistics for net change of HDL-C, TC, LDL-C, and TG showed heterogeneity. Using a random-effects model, HDL-C level increased significantly [0.100 (CI 0.074 to 0.127) mmol/L] after smoking cessation. However, levels of TC [+0.003 (CI -0.042 to 0.048)], LDL-C [-0.064 (CI -0.149 to 0.021)], and TG [+0.028 (CI -0.014 to 0.071)] did not change significantly after smoking cessation. CONCLUSIONS: Cigarette smoking cessation increases serum levels of HDL-C but not of TC, LDL-C, and TG.     

紫苏油和松籽油对大鼠机体脂类和脂质过氧化的影响

在高脂饲料中分别加入６％的紫苏油和松籽油，在实验动物总能量与主要营养素摄入基本相同、脂肪占总能量３２．６％的条件下饲喂Ｗｉｓｔａｒ雄性成年大鼠３周。结果表明，紫苏油和松籽油对高脂血症大鼠均有一定的调整血脂作用。紫苏油和松籽油组大鼠血清甘油三酯（ＴＧ）、总胆固醇（ＴＣ）、低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）、ＬＤＬ－Ｃ与高密度脂蛋白胆固醇（ＨＤＬ－Ｃ）的比值（ＬＤＬ－Ｃ／ＨＤ－Ｌ－Ｃ）、致动脉粥样硬化指数（ＡＩ）的增加值和ＨＤＬ－Ｃ／ＴＣ、卵磷脂胆固醇酰基转移酶（ＬＣＡＴ）活性的下降均不同程度地低于单纯食猪油的高脂对照组。紫苏油尚可提高高脂血症大鼠血清ＨＤＬ－Ｃ、高密度脂蛋白亚组分Ⅱ胆固醇（ＨＤＬ２Ｃ）水平及ＨＤＬ２－Ｃ与高密度脂蛋白亚组分Ⅲ胆固醇（ＨＤＬ３－Ｃ）比值（ＨＤＬ２－Ｃ／ＨＤＬ３－Ｃ）；松籽油未见显著升高ＨＤＬ－Ｃ作用。各组动物血清ＨＤＬ３－Ｃ水平无显著差异。紫苏油和松籽油组大鼠肝体比值低于高脂对照组。紫苏油组大鼠肝脏过氧化脂质（ＬＰＯ）含量高于松籽油和高脂对照组。但与正常组比较，紫苏油、松籽油和高脂对照组大鼠肝体比值、肝脂质含量、肝组织病理学检查显示的肝脂变程度和肝脏ＬＰＯ含量均增高，而肝组织中谷胱?     

Lipoproteins as predictors of ischemic heart disease in non-insulin-dependent diabetic men

In order to determine whether low levels of high-density lipoprotein cholesterol (HDL-C), which are predictive of ischemic heart disease in the general population, can also predict death from ischemic heart disease among diabetic men, we contrasted lipoprotein and other heart disease risk factors in 62 men with non-insulin-dependent diabetes mellitus, 14 of whom died of ischemic heart disease during a 12-year follow-up period. Compared to all other diabetic men, those who died of ischemic heart disease were older, had higher levels of fasting plasma glucose (FPG) total plasma cholesterol, and triglycerides, lower HDL-C levels, and higher low-density lipoprotein cholesterol (LDL-C) levels and were more likely to have been cigarette smokers; only total cholesterol, LDL-C, and the LDL/HDL ratio were statistically significant. Age, FPG, total plasma cholesterol, and LDL-C were all independently predictive of fatal heart disease by multivariate analysis. Neither HDL-C nor the LDL/HDL ratio predicted ischemic heart disease death better than the total plasma cholesterol or LDL-C. The use of HDL-C, LDL-C, or total plasma cholesterol level in the model did not eliminate the significant association with FPG, which suggests that the noxious effect of hyperglycemia is independent of the changes in blood lipids.     

Population frequency distributions of HDL, HDL(2), and HDL(3) cholesterol and apolipoproteins A-I and B in healthy men and women and associations with age, gender, hormonal status, and sex hormone use: the Stanford Five City Project

BACKGROUND: The purpose of this study is to present population-based frequency distribution data for several lipoprotein-related variables and to examine their associations with gender, age, menopausal status, and sex hormone use. METHODS: High-density lipoprotein cholesterol (HDL-C), HDL(2)-C, HDL(3)-C, apolipoprotein (Apo) A-I, and Apo B were measured in a population-based sample of 1, 027 healthy adults from four California cities who participated in the 1989-1990 survey of the Stanford Five City Project. These data were examined cross-sectionally with sociodemographic and other related variables. RESULTS: Relative to men, all of the HDL-related parameters-HDL-C, HDL(2)-C, HDL(3)-C, Apo A-I-were significantly higher and Apo B levels were significantly lower among women (P < 0. 001). Menopausal status was not associated with HDL-related parameters, but Apo B levels were higher in post- versus premenopausal women (P < 0.001). Among women, HDL-C and Apo A-I levels were higher in oral contraceptive and estrogen replacement therapy users (P = 0.003). Most of the significant findings remained statistically significant after adjusting for age, body mass index, smoking, energy expenditure, and alcohol intake. CONCLUSIONS: These population-based data indicate that gender, menopausal status, and the use of sex hormones among women are associated with differential levels of one or more of HDL-C, HDL(2)-C, HDL(3)-C, Apo A-I, and Apo B, independent of age and a broad set of lifestyle factors.     

Acute exposure to environmental tobacco smoke reduces HDL-C and HDL2-C

BACKGROUND: Chronic environmental tobacco smoke (ETS) exposure increases individuals risk of coronary artery disease by reducing high-density lipoprotein cholesterol (HDL-C). Currently, there is limited research on the acute effects of ETS on HDL-C. This study examined the acute influence of ETS on HDL-C and its subfractions. METHODS: Twelve male subjects (25.7 +/- 3.0 years) were examined to determine the influence of an acute 6-h exposure to ETS on lipid and lipoprotein levels. Baseline blood samples were drawn before ETS exposure from an antecubital vein at 6 am, 2 pm, and 10 pm. The following day, subjects were exposed to 6 h of ETS, approximately 4-10 pm. Blood was again collected at 8, 16 and 24 h following ETS exposure. Blood was assayed for total cholesterol (TC), HDL-C and its subfractions HDL(2)-C and HDL(3)-C. RESULTS: As a result of ETS exposure, HDL-C and HDL(2)-C levels were significantly reduced by 18% and 37%, respectively. This effect was sustained, with a decrease in HDL-C of 13% and HDL2-C of 28% still evident at 24-h post-exposure. TC was unchanged (pre- 187.3 +/- 41.6 and post- 187.0 +/- 46.3); however, there were significant decreases in the TC/HDL-C and HDL2-C/HDL3-C ratios by 16% and 29%, respectively, which were sustained for 24 h. CONCLUSIONS: The findings of this study demonstrate that a 6-h exposure has a negative impact on lipid and lipoprotein profiles and that these levels remained depressed for at least 24 h.