高血压患者血浆胰岛素水平与血脂、脂蛋白和载脂蛋白关系

目的 探讨高血压患者血浆胰岛素水平与血脂、脂蛋白和载脂蛋白浓度的关系.方法 按不同体重指数(BMI)和血浆胰岛素浓度将高血压患者进行分组,观察不同BMI的高血压患者血浆、胰岛素水平,血糖和三酰甘油(TG)的改变以及TG与胰岛素浓度的关系.结果 高血压患者体重指数(BMI)、血浆胰岛素水平、血糖、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(apoB)较对照组显著升高.高密度脂蛋白胆固醇(HDL-C)和载脂蛋白AI(apoAl)显著降低.MBI与血浆胰岛素(r=0.357,P<0.0001)和血糖浓度(r=0.240,P<0.002)呈正相关.血浆胰岛素浓度与血糖呈正相关(r=0.388,P<0.0001)二者均随BMI而增加.BMI>30和血浆胰岛素浓度>20mU/L患者TG浓度明显高于≤26和≤20mU/L的患者.结论 (1)血浆胰岛素浓度升高即高胰岛素血症(HIS)是高血压患者血脂异常的原因之一.(2)BMI和TG浓度增加可作为临床判断胰岛素抵抗(IR)的指标.     

原发性肾病综合征患者血脂及载脂蛋白的变化

目的 :研究原发性肾病综合征 （NS）患者血清总胆固醇 （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 （L DL- c）、载脂蛋白 apo A1 ,apo B1 0 0 含量和 apo A1 /apo B1 0 0 及其临床意义。方法 :检测 5 0例原发性 NS患者与 5 0例健康人 （对照组 ）的血脂及脂蛋白 ,并进行比较。结果 :原发性 NS患者血清 TC,TG,L DL- c,apo B1 0 0 较对照组显著升高 （P<0 .0 1） ,而 apo A1 /apo B1 0 0 较对照组显著下降 （P<0 .0 5 ）。结论 :NS患者存在着明显的脂代谢紊乱。     

老年原发性高血压患者血糖及脂质改变对微量白蛋白尿的影响

目的 :探讨老年原发性高血压 (EH)患者微量白蛋白尿 (MAU )的主要影响因素及其意义。方法 :选择不伴有糖尿病及原发性肾脏疾病的老年 EH患者 81例 ,采用放射免疫法测定早晨第 1次尿中微量白蛋白 ,将其分为 MAU阳性及阴性两组 ,并对所有患者测定血清脂质各项指标、空腹血糖 (FBG)、血胰岛素 (FIns)及 C肽(FC- P) ,计算胰岛素敏感性指数 (ISI) ,进行统计分析。结果 :EH伴 MAU阳性组血清甘油三酯 (TG) (2 .35±1.2 3) mm ol/ L、低密度脂蛋白胆固醇 (L DL- C) (3.89± 1.78) mmol/ L、载脂蛋白 B(apo B) (12 8± 5 3) m mol/ L、脂蛋白 (a)〔L p(a)〕(30 7.13± 196 ) m mol/ L 显著增高 (P <0 .0 5 ,P <0 .0 1)。而高密度脂蛋白胆固醇 (HDL- C) (1.2 2± 0 .2 0 ) m mol/ L、载脂蛋白 A(apo A ) (137.2 2± 10 4) mm ol/ L较低 (P <0 .0 5 )。 ISI(- 4.71± 0 .5 2 )显著低于MAU阴性组 (NMAU ) (P <0 .0 5 )。结论 :在不伴有糖尿病及原发性肾脏疾病的 EH患者中 ,脂质代谢紊乱及胰岛素抵抗可能在 MAU的发生过程中有一定作用。     

原发性高血压患者血清瘦素水平与血脂的相关性研究

目的探讨原发性高血压患者血清瘦素(Leptin)与血脂的相关性。方法原发性高血压患者86例,对照组87名,测定其空腹血清瘦素、血糖、胰岛素、胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A-1(ApoA-1)、载脂蛋白B(ApoB)、体重指数(BMI)、腰臂比(WHR),计算胰岛素抵抗指数(HOMA-IR),分析原发性高血压患者血清瘦素水平与血脂的关系。结果高血压组的BMI、WHR、TC、TG、LDL-C、ApoB、HOMA-IR、Leptin显著高于对照组,差异有统计学意义(P<0.05),多元逐步回归分析显示瘦素与甘油三酯(TG)正相关。结论原发性高血压患者血清瘦素水平与血脂有相关性。     

绝经后女性冠状动脉病变与血脂代谢的关系

目的 :研究绝经后女性冠心病 ( CHD)患者血脂特点 ,探讨血脂代谢与冠状动脉病变的关系。方法 :以酶法测定和观察 94例经冠状动脉造影证实有一支以上主要冠状动脉狭窄≥ 5 0 %的绝经后女性 CHD患者的总胆固醇 ( TG)、甘油三酯 ( TC)、高密度脂蛋白胆固醇 ( HDL- C)、低密度蛋白胆固醇 ( L DL- C)、载脂蛋白 A1 、B( apo A1 、apo B) ,并以同期同年龄范围的健康体检女性 10 0例为对照组。结果 :1CHD组的 TG和 L DL- C明显高于对照组 ,HDL- C和 apo A1 明显低于对照组 ,而 TC仅轻度高于对照组 ;2多元逐步回归分析的有价值的判别指标为 apo A1 和 L DL- C;3 CHD组高 TG者 5 4例 ( 5 3 .2 % ) ,高 TG者冠状动脉双支及三支病变 2 9例 ( 5 8% ) ,而TG正常者双支及三支病变 13例 ( 2 9.5 % )。结论 :女性绝经后 CHD患者高 TG,高 L DL - C,低 HDL - C和低 apo A1是 CHD的重要危险因素 ,apo A1 和 L DL - C在致 CHD方面意义更大 ,其中高 TG者冠状动脉病变的严重程度更为明显     

冠心病患者载脂蛋白E基因多态性研究

目的 :探讨载脂蛋白 E(apo E)基因多态性与早发冠心病 (CHD)患者的关系以及对中国人血脂水平的影响。　　方法 :选择 6 8例年龄≤ 5 5岁的 CHD患者为 CHD1 组、136例年龄≥ 6 5岁的 CHD患者为 CHD2 组及 136例健康对照者为对照组 ,测定空腹血清甘油三酯 (TG)、总胆固醇 (TC)和高密度脂蛋白胆固醇 (HDL- C)水平 ;应用聚合酶链反应 ,Hha I内切酶消化及聚丙烯胺疑胶电泳的方法确定 apo E基因多态性。　　结果 :Apo E3/ 4基因型频率和 E4等位基因频率在 CHD1 组明显高于 CHD2 组和对照组 (P<0 .0 1) ,CHD2 组和对照组无差别。 CHD1 组与对照组血脂水平无差别 ,而 CHD2 组的 TC、低密度脂蛋白 (L DL - C)水平明显高于 CHD1 组和对照组 (P<0 .0 1)。不同的 apo E基因型其 TC、L DL- C浓度存在显著性差异。　　结论 :Apo E基因多态性是影响 TC、L DL- C水平的重要遗传因素之一 ;Apo E4与 CHD有明显的相关性 ,即 apo E4可能是早发 CHD独立的易患遗传危险因素。     

老年高血压病患者血胰岛素水平与糖、脂代谢异常的关系

目的：探讨老年高血压患高胰岛素症与血糖、血清脂质水平的关系。方法：对86例老年高血压病患（观察组）及50例老年对照组,进行了血清甘油三酯（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AI（Apo AI)、载脂蛋白B（Apo B)、脂蛋白（a)[Lp(a)]、空腹血糖(FPG）及胰岛素（INS）的测定。结果：观察组血清TG、LDL－C、Lp(a)、INS,FBG含量明显高于对照组;观察组血清HDL－C、Apo AI水平和胰岛素敏感性指数（ISI）明显低于对照组。结论：老年高血压病患胰岛素,血脂和血糖代谢异常的共存是该病发生、发展的危险因素,也是心、脑血管疾病的危险因素,故在降压治疗的同时,应考虑纠正其胰岛素,糖及脂代谢的异常。     

普伐他汀对红细胞膜n-6、n-3脂肪酸成分影响的研究

目的　观察普伐他汀对原发性高脂血症患者红细胞膜 n3、n6脂肪酸成分的影响。方法　 32例原发性高脂血症患者应用普伐他汀 10 m g qd,采用自身对照的方法分别于治疗前、治疗后 6周及 12周时测定患者血浆脂质成分 ,并用气相色谱法测定红细胞膜脂肪酸成分。结果　本组患者经治疗后胆固醇 (TC)、三酰甘油 (TG)、低密度脂蛋白胆固醇 (L DL- C)、载脂蛋白 B10 0 (apo B10 0 )均明显降低 (P<0 .0 5～ 0 .0 0 1) ;高密度脂蛋白胆固醇 (HDL- C)均升高 (P<0 .0 5～ 0 .0 0 1) ,红细胞膜 n- 6脂肪酸 ,以花生四烯酸为代表 (AA )显著降低 (P<0 .0 1) ,n- 3脂肪酸 ,即廿碳五烯酸 (EPA)和廿二碳六烯酸 (DHA )均显著升高 (P<0 .0 1)。 n- 6 / n- 3比值有降低 ,TC、TG、L DL - C下降与红细胞膜 AA / EPA、AA/ DHA比值降低呈显著正相关 (P<0 .0 1)。结论　普伐他汀在有效调节血脂的同时能调节红细胞膜 n3、n6脂肪酸成分     

进食淡水鱼对洞庭湖区人群血脂的影响

目的 :探讨淡水鱼在预防高脂血症中的价值。方法 :以长年生活在渔船上的渔民为试验组 ,当地农民为对照组。采空腹 12 h晨血检测血清胆固醇 (TC) ,甘油三酯 (TG) ,高密度脂蛋白 (HDL) ,载脂蛋白 A(apo A)和载脂蛋白 B(apo B)含量 ,然后对上述各项指标进行 t检验。结果 :试验组 TC、TG、apo B水平较对照组低 (P<0 .0 1) ,而 HDL、apo A及 apo A/ apo B比值较对照组明显升高 (P<0 .0 1)。结论 :长期进食淡水鱼能有效地调节血脂水平 ,这可能不失为一种有待开发的有效的冠心病一级预防措施。     

高血压病患者胰岛素抵抗及其关联因素

目的 :探讨高血压患者同时存在多种代谢异常时胰岛素的敏感性。方法 :高血压组 79例 ,健康对照组 78例 ,分别进行口服葡萄糖耐量试验 （OGTT）、同步血清胰岛素释放试验 ,血清总胆固醇 （TC）、甘油三酯 （TG）、低密度脂蛋白胆固醇 （L DL- C）、高密度脂蛋白胆固醇 （HDL- C）及体质量指数 （BMI）测定 ,以胰岛素敏感性指数 （ISI）和胰岛素曲线下面积 （IS- AU C）作为胰岛素敏感性的判定指标。结果 :高血压组空腹胰岛素 （FINS）及餐后 2 h胰岛素 （15± 7及 70± 10 m U/L）均显著高于正常对照组 （8± 3及 9± 4 m U/L） ,均为 P<0 .0 1;OGTT显示葡萄糖耐量降低 ,P<0 .0 1。 TC、TG、L DL- C显著升高 ,均 P<0 .0 1,HDL- C升高 ,P<0 .0 5 ;ISI（绝对值 ）和 IS- AUC均显著增高 ,分别为 P<0 .0 5与 P<0 .0 1。二组 BMI与 ISI呈显著负相关 ,r分别为 - 0 .4 9,- 0 .37,P<0 .0 5 ;与 FINS呈显著正相关 ,r分别为 0 .5 3,0 .38,P<0 .0 1。结论 :高血压患者存在着高胰岛素血症 ,同时存在着糖代谢及脂蛋白代谢异常。血糖、血脂、体质量指数均影响胰岛素敏感性。     

Total cholesterol/HDL cholesterol ratio vs LDL cholesterol/HDL cholesterol ratio as indices of ischemic heart disease risk in men: the Quebec Cardiovascular Study.

BACKGROUND: Total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C)/HDL-C ratios are used to predict ischemic heart disease risk. There is, however, no consensus on which of these 2 indices is superior. The objective of the present study was to present evidence that the LDL-C/HDL-C ratio may underestimate ischemic heart disease risk in overweight hyperinsulinemic patients with high triglyceride (TG)-low HDL-C dyslipidemia. METHODS: A total of 2103 middle-aged men in whom measurements of the metabolic profile were performed in the fasting state were recruited from 7 suburbs of the Quebec metropolitan area. RESULTS: The relationship of LDL-C/HDL-C to TC/HDL-C ratios was examined among men in the Quebec Cardiovascular Study classified into tertiles of fasting TG levels. For any given LDL-C/HDL-C ratio, the TC/HDL-C ratio was higher among men in the top TG tertile (>168 mg/dL [>1.9 mmol/L]) than in men in the first and second TG tertiles. Adjustment of the TC/HDL-C ratio for LDL-C/HDL-C by covariance analysis generated significant differences in average TC/HDL-C ratios among TG tertiles (P<.001). Greater differences in features of the insulin resistance syndrome (insulinemia, apolipoprotein B, and LDL size) were noted across tertiles of the TC/HDL-C ratio than tertiles of the LDL-C/HDL-C ratio. CONCLUSION: Variation in the TC/HDL-C ratio may be associated with more substantial alterations in metabolic indices predictive of ischemic heart disease risk and related to the insulin resistance syndrome than variation in the LDL-C/HDL-C ratio.     

Low density lipoprotein cholesterol, lipoprotein(a), and apo(a) isoforms in the elderly: relationship to fasting insulin. Associazione Medica Sabin

BACKGROUND AND AIM: Insulin resistance/hyperinsulinemia are often associated with aging and could play an important role in the development of glucose intolerance and dyslipidemia in the elderly. We investigated the relationship between plasma fasting insulin with total cholesterol (TC) and low density lipoprotein LDL cholesterol (LDL-C), triglycerides (TG), lipoprotein(a) [Lp(a)] levels apolipoprotein (a) [apo (a)] isoforms in 100 free-living "healthy" octo-nonagenarians. METHODS AND RESULTS: Fasting insulin was positively correlated with TG, whereas a negative relation was found with TC and LDL-C (r = -0.29 and r = -0.28 respectively; p < 0.01), LDL-C/apo B, HDL-C and apo A-I levels. Fasting insulin was also inversely correlated with Lp(a) levels (r = -0.22; p < 0.03), whereas the latter were significantly related with TC and LDL-C (r = 0.30 and r = 0.31; p < 0.005), TG (r = 0.21; p < 0.05) and apo B (r = 0.26; p < 0.02). There was a negative relation between Lp(a) levels and apo(a) isoforms: the greater the apo(a) molecular weight, the lower the Lp(a) level (p < 0.0001). Fasting insulin increased with apo(a) size, though the difference in insulin levels among apo(a) isoforms was not significant (p = 0.4). Multiple regression analysis showed that fasting insulin was the best predictor of LDL-C (R2 = 0.14; p = 0.002) irrespective of age, gender, BMI, waist circumference and TG, while apo(a) isoform size, BMI and waist circumference were related with Lp(a) irrespective of TC and LDL-C, TG and apo B (R2 = 0.35 to 0.37; p < 0.0001). CONCLUSIONS: These results suggest that fasting insulin levels significantly influence LDL-C metabolism in old age. Lp(a) levels seem to be very strongly related to genetic background, although an indirect relation with insulin through adiposity and/or other associated lipid abnormalities cannot be ruled out.     

女性原发性高血压患者绝经前后脂蛋白(a)及血脂水平变化的研究

目的　观察女性原发性高血压患者绝经前后脂蛋白 (a) [L p(a) ]及血脂水平的变化 ,探讨其对女性冠心病发病情况可能存在的影响。方法　女性原发性高血压患者 12 1例 ,测定 L p(a)、总胆固醇 (TC)、三酰甘油 (TG)、低密度脂蛋白胆固醇 (L DL- C)和高密度脂蛋白胆固醇 (HDL- C)。对比绝经前后 L p(a)及血脂水平的变化 ,并与女性健康体检者 (对照组 )进行对比。结果　高血压组 L p(a)、TC、TG、L DL - C均显著高于对照组 ,而 HDL - C及 HDL - C/TC则明显低于对照组 ,在所有原发性高血压患者中 ,绝经后的患者 L p(a)、TC、TG、L DL - C显著高于绝经前患者 ,而 HDL - C/ TC则前者低于后者。结论　绝经后原发性高血压患者 L p(a)、TC、L DL - C均明显高于绝经前患者 ,而HDL- C/ TC则低于绝经前患者 ,提示绝经后女性原发性高血压患者 L p(a)及血脂水平增高与内源性雌激素水平下降有关 ,是绝经后冠心病发病率明显上升的重要原因。     

新生儿脐血血脂水平及胎心率检测分析

目的探讨新生儿脐血血脂水平及胎心率的变化。方法选取头胎顺产新生儿87例,测定小于胎龄儿(SGA)14例、适于胎龄儿(AGA)63例、大于胎龄儿(LGA)10例脐血血脂水平,记录胎儿娩出前5 min胎心率。并使用全自动生化分析仪测定脐血甘油三酯(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)和载脂蛋白AI(ApoAI)和载脂蛋白B(ApoB)水平。结果SGA组脐血TG、TC、LDL-C、ApoB水平均高于AGA组和LGA组,HDL-C、ApoAI水平低于AGA组和LGA组,差异有统计学意义(P<0.05);新生儿血脂指标与胎心率回归分析未发现明显相关性(P>0.05)。结论不同的宫内环境引起胎儿代谢的改变,胚胎生长受限的新生儿存在血脂代谢障碍。     

Dyslipoproteinemia in patients with active rheumatoid arthritis: effects of disease activity, sex, and menopausal status on lipid profiles

OBJECTIVE: To investigate the lipid profiles in patients with active rheumatoid arthritis (RA) and to assess the relationship of inflammatory disease activity markers, sex, and menopausal status with lipid profiles. METHODS: Three groups of patients with active RA (n = 184) were studied: men (n = 61, mean age 50.8 +/- 4.81 yrs), premenopausal women (n = 58, mean age 39.2 +/- 2.44 yrs), and postmenopausal women (n = 65, mean age 60.4 +/- 2.14 yrs), and healthy controls (n = 161): men (n = 65, mean age 50.9 +/- 3.42 yrs), premenopausal women (n = 47, mean age 40.3 +/- 1.66 yrs), and postmenopausal women (n = 49, mean age 61.3 +/- 3.16 yrs). We measured fasting plasma levels of total cholesterol (TC), triglyceride (TG), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), lipoprotein (a) [LP(a)], apolipoprotein A1 (apo A1), apolipoprotein B (apo B), and erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). RESULTS: Male RA patients had significantly higher apo B/apo A1 and LP(a) and lower HDL-C than male controls. Female RA patients had significantly higher TC, LDL-C, and LP(a) than female controls. Premenopausal RA patients had significantly higher LDL-C, TC/HDL-C, LDL-C/HDL-C, and apo B/apo A1 and lower TG and HDL-C than premenopausal controls. Postmenopausal RA women had significantly higher TG and LP(a) and lower TC than postmenopausal controls. Female RA patients had higher HDL-C, apo A1, and TC/HDL-C and lower apo B/apo A1 than male RA patients. Postmenopausal RA patients had significantly higher TC, TG, TC/HDL-C, apo B, LP(a), and LDL-C/HDL-C than premenopausal RA patients. CRP correlated positively with TC/HDL-C, LDL-C/HDL-C, and apo B/apo A1 and negatively with HDL-C in male RA patients. In female RA patients CRP had positive correlation with TC/HDL-C and LDL-C/HDL-C and negative correlation with HDL-C. CONCLUSION: These findings suggest that patients with active RA have altered lipid profiles and that disease activity, sex, and menopausal status affect lipid profiles, and these would be expected to change the pattern of atherosclerotic events in RA.     

Subclinical hypothyroidism and lipid abnormalities in older women attending a vascular disease prevention clinic: effect of thyroid replacement therapy

The authors evaluated the frequency and type of lipid disorders associated with subclinical hypothyroidism (SH) in older women referred to their university vascular disease prevention clinic. They also assessed the results of thyroid replacement therapy. Fasting serum lipid profiles and thyroid function tests were measured in 333 apparently healthy women (mean age: 71.8 +/- 7 years). These women were divided into 3 groups: group I: 60-69 years old (n = 132); group II: 70-79 years old (n = 153); group III: 80-89 years old (n = 48). SH was defined as a serum thyrotropin concentration higher than 3.20 mlU/mL with a normal free thyroxine concentration. The prevalence of SH was 7.5%. Thyrotropin was higher than 3.20 mU/mL in 25 women; 7 (5.3%), 14 (9.2%), and 4 (8.3%) in groups I, II, and III, respectively. Low-density lipoprotein cholesterol (LDL-C) concentrations were higher in the women with SH (p = 0.037). The mean values of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), TC/HDL-C ratio, lipoprotein (a) (Lp[a]), apolipoprotein A-I (apo AI) apolipoprotein B100 (apo B) and apo B/apo A ratio were higher and triglycerides (TG) were lower, compared with those with normal levels of thyrotropin. However, none of these differences reached significance. Restoration of euthyroid status (thyroxine: 50-100 microg/day) in 17 SH women significantly improved TC (p = 0.017), LDL-C (p = 0.014), TC/HDL-C (p = 0.05), LDL-C/HDL-C (p = 0.03), apo B (p = 0.013), and Lp(a) (p = 0.0005) values. SH is relatively common in older women attending a vascular disease prevention clinic. Thyroid hormone replacement therapy significantly improved serum lipids. In particular, the reduction in LDL-C and Lp(a) concentrations may be of clinical benefit.     

Small dense low-density lipoprotein cholesterol concentration and carotid atherosclerosis

Low-density lipoprotein cholesterol (LDL-C) and the small dense LDL (SdLDL) phenotype are both predictors for ischemic heart disease. We examined whether cholesterol of SdLDL (SdLDL-C) is more closely associated with carotid artery intima-media thickness (CA-IMT), a surrogate measure of atherosclerosis, than LDL-C and other lipid parameters. The subjects were 326 consecutive participants including those with dyslipidemia, diabetes mellitus, hypertension, chronic kidney disease, and smokers. SdLDL-C was quantified by a newly developed precipitation method, and CA-IMT by high-resolution B-mode ultrasound. In univariate analysis, CA-IMT was most strongly correlated with SdLDL-C (Spearman's r=0.441, P<0.001), followed by apolipoprotein (apo) B, LDL-C, non-high-density lipoprotein cholesterol (Non-HDL-C), and plasma triglycerides (TG). HDL-C and apo A-I correlated inversely with CA-IMT. Non-lipid variables that were associated with CA-IMT were age, sex, presence of diabetes mellitus, presence of hypertension, estimate glomerular filtration rate (eGFR), and C-reactive protein (CRP). Even after adjustment for age, sex, diabetes mellitus, hypertension, smoking, eGFR and CRP, the positive association of CA-IMT with SdLDL-C remained significant, and again stronger than the associations with others lipid parameters. Further analyses revealed that the level of SdLDL-C was elevated in subgroups of the subjects including men, older subjects, smokers, those with higher CRP levels, those with diabetes mellitus, and hypertensive patients. These results indicate that SdLDL-C was the best marker of carotid atherosclerosis among the lipid parameters tested, and suggest that quantitative measurement of SdLDL-C gives useful information in the risk assessment for atherosclerotic disease.     

冠心病患者胰岛素抵抗与血脂、载脂蛋白异常的关系

目的探讨冠心病(CHD)患者胰岛素抵抗(IR)与血脂、载脂蛋白异常的关系。方法以空腹胰岛素(FIns)／空腹葡萄糖(FBG)比值和口服葡萄糖负荷之后胰岛素曲线下面积(RIAUC)／葡萄糖曲线下面积(GAUC)比值作为IR指标，与空腹血脂、载脂蛋白进行直线相关分析。结果与正常对照组比较，冠心病组血清甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(apoB)；FIns／FBG比值以及RIAUC、GAUC和RIAUC／GAUC比值均显著增加(P<0．05～0．001)，高密度脂蛋白胆固醇(HDL-C)，HDL2-C，apoAI及apoAI／apoB比值均显著降低(P<0．05～0．001)；冠心病组FIns/FBG比值和RIAUC／FBG比值均分别与TG、LDL-C和apoB呈正相关(P<0．05～0．01)，与HDL2-C、apoAI和apoAI／apoB比值呈负相关(P<0．05～0．001)，正常对照组与上述指标间则无相关(P>0．05)。结论CHD患者IR与血脂、载脂蛋白异常密切相关。     

高脂血症与血清载脂蛋白含量关系的研究

目的　探讨高脂血症与载脂蛋白的关系。方法　对杭州市 6 6 9名高脂血症患者和 2 6 2名健康人 ,用全自动生化分析仪测定TC、TG、HDL -C、LDL -C、ApoAⅠ、AⅡ、B、CⅡ、CⅢ、E。结果　与健康对照组比较 (1)高胆固醇血症组 ,HDL -C、LDL -C明显升高 (P <0 0 1) ,各类载脂蛋白均升高 ,尤以ApoAⅠ升高最明显。 (2 )高甘油三酯血症组 ,HDL-C低于正常对照组 (P <0 0 1) ,LDL -C无显著性差异 (P >0 0 5 ) ,ApoAⅠ降低 (P <0 0 1) ,ApoB、ApoCⅡ、ApoCⅢ、ApoE均有明显升高 (P <0 0 1)。 (3)混合型高脂血症组 ,LDL -C升高 (P <0 0 1) ,ApoAⅡ、ApoB、ApoCⅡ、ApoCⅢ、ApoE升高最明显 (P <0 0 1)。结论　高脂血症ApoAⅡ、B、CⅡ、CⅢ、E水平均升高 ;高胆固醇血症ApoAⅠ、B和HDL -C、LDL -C可同时升高 ;ApoCⅢ是高甘油三酯的重要影响因素 ;混合型高脂血症高甘油三酯伴LDL -C/HDL -C比值升高 ,可视为CHD的高危人群