ApoB/ApoA1比值与代谢综合征的相关性研究

目的 探讨载脂蛋白B(ApoB)/载脂蛋白A1(APOA1)比值与代谢综合征(MS)及其组分的关系. 方法 纳入709例重庆地区成年人,测定体重、身高、血压、腰围、空腹血浆葡萄糖(FPG)、空腹血清胰岛素(FIns)及血脂等,计算ApoB/ApoA1、BMI及胰岛素抵抗指数. 结果 IR或MS患者,其ApoB/ApoA1比值显著增高;与低ApoB/APOA1值人群相比,高ApoB/ApoA1值人群发生MS(OR=3.5)和IR(OR=2.3)的风险显著增加(P<0.001).随MS组分数增加,ApoB/ApoA1比值逐渐增加(P<0.001). 结论 ApoB/ApoA1比值与IR、MS及其组分密切相关,ApoB/ApoA1比值增高是MS发生的重要标志.     

ApoB/ApoA1 ratio and subclinical atherosclerosis.

AIM: It has been demonstrated that an increased apolipoprotein B (ApoB)/apolipoprotein A-I (ApoA1) ratio is associated with atherogenic low density lipoprotein (LDL) particles and the development of clinical cardiovascular disease. The aim of this study was to test the hypothesis that ApoB/ApoA1 ratio is associated with early subclinical atherosclerosis as demonstrated by ultrasonic measurements. METHODS: Both common carotid and common femoral bifurcations have been scanned with high-resolution ultrasound in 767 volunteers over the age of 40. The latter consisted of 95% of the population of two randomly selected areas. IMTcc, IMTmax (including plaques), total plaque thickness (TPT) (the sum of the thickest plaques present at each bifurcation in cm) and black plaque burden (BPB) (TPT means plaque type) using the Widder classification with type 1 being the most hyperechoic and calcified and type 5 the most hypoechoic plaque were recorded. A medical history was taken with emphasis on risk factors present and a fasting lipid profile including ApoB and ApoA1 was determined. RESULTS: In the total population (N.=767) the mean (+/-SD) ApoB/ApoA1 ratio was 0.85 (+/-0.22). In linear regression analysis, the Apob/ApoA1 ratio was significantly associated with all the ultrasonic measurements of early atherosclerosis (intima media thickness, IMTcc, IMTmax, TPT and BPB). These findings remained significant after correcting for age, gender, smoking, hypertension and diabetes (P<0.001 for all). CONCLUSION: The results indicate that a high ApoB/ApoA1 ratio is associated not only with early atherosclerosis but also with hypoechoic (BPB) and by inference unstable plaques.     

急性缺血性脑卒中患者血清 ApoB／ApoA1与 NIHSS 评分的相关性

目的探讨血清载脂蛋白B(Apo B)与载脂蛋白A1(Apo A1)比值Apo B/Apo A1在急性缺血性脑卒中患者病情判断中的价值。方法研究对象为191例缺血性脑卒中急性发作患者,美国国立卫生研究院卒中量表(NIHSS)评分≤6分71例(低评分组)、7~14分58例(中评分组)、≥15分62例(高评分组)。各组均于入院后空腹采集静脉血,检测血清TG、TC、Apo B、Apo A1水平,计算Apo B/Apo A1。分析TC、TG、Apo B/Apo A1与NIHSS评分的相关性。结果 Apo B/Apo A1:高评分组>中评分组>低评分组(P均<0.05)。高评分组血清TG水平低于低评分组(P<0.05)。Apo B/Apo A1与NIHSS评分呈正相关(r=0.242,P<0.05),TG与NIHSS评分呈负相关(r=-0.220,P<0.05),TC与NIHSS评分无相关性(r=0.136,P>0.05)。结论 Apo B/Apo A1是反映缺血性脑卒中患者病情严重程度的较好指标。     

高敏感C反应蛋白与外周动脉疾病的关系

目的探讨高敏感C反应蛋白（hs-CRP）与外周动脉疾病（PAD）的关系。方法2005年7月对攀枝花市某社区年龄〉40岁的符合入选标准的643例居民进行流行病学研究。结果吸烟、高血压、糖尿病、低HDL-C以及心血管疾病史的比例均为PAD组高于非PAD组。高血压、糖尿病和心血管疾病史的比例均呈现CRP高浓度组高于低浓度组。多因素分析发现,CRP中、高浓度组的OR值是低浓度组的2倍多;对hs-CRP进行对数变换后分析,发现Log（hs-CRP）和PAD仍然呈正向关系（P=0．007）。结论hs-CRP和PAD的发生相关,升高的hs-CRP是PAD的独立危险因素。     

尿白蛋白肌酐比和高敏C反应蛋白与血管病变程度的相关性研究

目的研究尿白蛋白肌酐比(urinary albumin creatinine ratio,UACR)和血清高敏C反应蛋白(high-sensieivi-ty C-reactive protein,hs-CRP)与血管病变程度的相关性。方法将125例不同血管病变的2型糖尿病患者分为无血管病变组(24例)、大血管病变组(57例)、微血管病变组(11例)和联合病变组(33例),分别检测UACR和血清hs-CRP,并进行组间比较。结果联合病变组UACR和血清hs-CRP显著高于其他3组(P<0.05),UACR受试者工作曲线下面积0.860大于hs-CRP曲线下面积0.679,UACR与糖化血红蛋白正相关(r=0.345,P=0.043)。结论UACR和hs-CRP都与严重血管病变相关,UACR相关性更大。     

ApoB/A1比值与支架内再狭窄相关性研究

目的 研究ApoB/A1比值与冠状动脉支架内再狭窄发生率的相关性.方法 选取182例行冠状动脉支架置入术并于48～52周后复查冠状动脉造影患者,分别于支架置入术前及1年后复查时检测TC、LDL、HDL、TG、LP（a）、LDL/HDL、ApoB、ApoA1、ApoB/A1比值,并进行比较分析,统计介入治疗所在冠脉病变的最小管腔内径、参考血管内径、管腔狭窄率、管腔病变长度和管腔病变内径.结果 ①1年后随访时支架内再狭窄组的ApoB/A1比值和ApoB水平显著高于无狭窄组[（0.87±0.25）比（0.75±0.23）,P〈0.01,（0.85±0.24）g/L比（0.77±0.24）g/L,P〈0.05）].②高水平ApoB/A1组（ApoB/A1＆gt;1）支架内再狭窄的发生率（67.7%）显著高于中等水平（1.0＆gt;ApoB/A1＆gt;0.7）及低水平（ApoB/A1〈0.7）ApoB/A1组支架内再狭窄发生率（P〈0.05）,其中中等水平组支架内再狭窄发生率为32.7%,低水平组的发生率为11.1%.③多因素回归分析显示,冠心病患者支架置入术后1年随访时高水平ApoB/A1是支架内再狭窄发生的独立危险因素（P〈0.01,风险比2.40,95%可信区间2.206～3.078）.结论 高水平ApoB/A1比值是冠状动脉支架内再狭窄发生的独立危险因素.     

Determinants of ApoB, ApoA1, and the ApoB/ApoA1 ratio in healthy schoolgirls, prospectively studied from mean ages 10 to 19 years: the Cincinnati National Growth and Health Study

The objectives were to prospectively assess determinants of apolipoproteins B (ApoB), A1 (ApoA1), and the ApoB/ApoA1 ratio in 797 healthy black and white schoolgirls from mean ages 10 to 19. There was prospective 9-year follow-up, with measures of ApoB at mean ages 10, 12, 14, 16 and 19, ApoA1 at mean ages 12, 14, 16, and 19, and assessment of annual reports of delayed menstrual cyclicity (≥42 days) from ages 14 to 19. Studies of 402 black and 395 white healthy schoolgirls were done in public and private schools, in urban and suburban Cincinnati. Black girls had lower ApoB, higher ApoA1, and lower ApoB/ApoA1. SHBG at age 14 in white and black girls was inversely correlated with the ApoB/ApoA1. At age 19, ≥3 annual reports of menstrual delay ≥42 days and metabolic syndrome were associated with higher ApoB and a higher ApoB/ApoA1 ratio. From ages 14 to 19, BMI and TG were independently positively associated with ApoB. Menstrual cyclicity ≥42 days, metabolic syndrome, BMI, and TG were independently positively associated with ApoB/ApoA1 ratios, while black race was negatively associated. The atherogenic ApoB/ApoA1 ratio from ages 14 to 19 is lower in black girls, and positively associated with hyperandrogenism, menstrual cyclicity ≥42 days, BMI, TG, and the metabolic syndrome, facilitating an adolescent approach to primary prevention of cardiovascular disease.     

金属蛋白酶9和超敏C反应蛋白与稳定期卒中的相关性

目的 了解缺血性卒中稳定期血基质金属蛋白酶9(MMP-9)和超敏C反应蛋白(hs-CRP)水平及之间的相关性,探讨其可能的临床应用价值.方法 将患者分为卒中复发组(39例)、卒中稳定组(37例)、无症状颅内动脉狭窄组(46例)并设对照组(74例).收集相关临床资料,检测MMP-9和hs-CRP浓度.结果 hs-CRP水平复发组(2.34 mg/L)＞稳定组(1.45 mg/L)＞无症状狭窄组(1.31 mg/L)＞对照组(0.96 mg/L)(P=0.001);MMP-9水平复发组(121.82±72.99)μg/L＞无症状狭窄组(119.18±80.01)μg/L＞稳定组(112.76±59.66)μg/L,三组间差异无统计学意义(P=0.947),比较三组病例组MMP-9平均水平(118.08±71.06)pg/L显著高于对照组[(57.55±10.44)μg/L,P＜0.001];Spearman相关分析显示:MMP-9与hs-CRP之间呈显著正相关(r=0.337,P＜0.001).结论 hs-CRP在卒中稳定期仍维持较高水平,并与卒中复发相关;而MMP-9与动脉粥样硬化相关性强于卒中事件.     

载脂蛋白A1/载脂蛋白B比值与冠状动脉严重程度相关性研究

目的 探讨载脂蛋白A1(qpolipoproteinA1,ApoA1)/载脂蛋白B(apoplipoprotein B,ApoB)比值与冠状动脉狭窄严重程度的关系.方法 应用冠脉造影技术将120例患者分2组冠心病组与对照组.测定ApoA1和ApoB,并计算出比值,探讨其与冠脉病变记分(CSS)的关系.结果 冠心病组ApoA1/ApoB比值明显低于对照组(P＜0.01),ApoA1/ApoB比值与CSS呈负相关(P＜0.05).结论 ApoA1/ApoB比值与冠状动脉狭窄严重程度呈负相关.     

载脂蛋白A1、载脂蛋白A1与载脂蛋白B比值与下肢动脉粥样硬化闭塞症的关系

目的　探讨下肢动脉粥样硬化闭塞症 (PAD)患者血清各项血脂指标的变化 ,分析各项血脂指标与该疾病及其下肢动脉病变程度、范围的关系。方法　PAD患者 (PAD组 ) 111例 ,测定各项血脂成分 ,并以同期住院的心脏神经官能症患者 (对照组 )作比较。结果　PAD组各项血脂均有不同程度的改变 ,ApoA1、ApoA1/ApoB、LDL C与对照组比较差异有显著性或非常显著性 (P <0 .0 1或P <0 .0 5 ) ,各项血脂在不同狭窄组间比较差异无显著性 (P >0 .0 5 )。PAD与ApoA1(r =-0 .2 165 )、ApoA1/ApoB(r=-0 .2 80 1)呈负相关 ,与LDL C(r=0 .2 195 )呈正相关。结论　ApoA1、ApoA1/ApoB和LDL C可能是PAD发病的危险因素     

The relationship between high-sensitivity C-reactive protein levels and the severity of obstructive sleep apnea

Background and objective  

There is an increased risk of cardiovascular and cerebrovascular events in patients with obstructive sleep apnea (OSA). High-sensitivity C-reactive protein (hs-CRP) is a marker that predicts atherosclerotic complications. However, there are contradictory results about the correlation between serum hs-CRP levels and OSA severity. The purpose of this work was to evaluate the relationship between hs-CRP levels and the severity of OSA in newly diagnosed OSA patients.     

Association between high-sensitivity C-reactive protein and hyperuricemia

The aim of the study was to examine the cross-sectional association between high-sensitivity C-reactive protein (hsCRP) and hyperuricemia (HU). The hsCRP was measured by latex turbidity method. Uric acid was detected on Beckman Coulter AU 5800. HU was defined as uric acid ≥416 μmol/L for the male population and ≥360 μmol/L for the female population. A multivariable logistic analysis model was applied to test the association after adjusting for a number of potential confounding factors. A total of 1935 subjects were included in this study. According to the multivariable regression model, the relative odds of the prevalence of HU were increased by 0.56 times in the third quintile (OR 1.56, 95 % CI 1.03–2.38, P = 0.04), 0.55 times in the fourth quintile (OR 1.55, 95 % CI 1.01–2.36, P = 0.04) and 0.96 times in the fifth quintile (OR 1.96, 95 % CI 1.29–2.98, P < 0.01) of hsCRP comparing with the lowest quintile, and P for trend was smaller than 0.01. In the male population, a positive association existed in the highest quintile of hsCRP (OR 1.66, 95 % CI 1.04–2.66, P = 0.04), and P for trend was 0.07. In the female population, the multivariable-adjusted ORs (95 % CI) of HU in the fourth and fifth quintile of hsCRP were 3.02 (95 % CI 1.09–8.35, P = 0.03) and 3.66 (95 % CI 1.36–9.89, P = 0.01), respectively, and P for trend was smaller than 0.01. The findings of this cross-sectional study suggest that the hsCRP level is positively associated with the prevalence of HU. Level of evidence Cross-sectional study, Level III.     

血清ApoB/ApoA1、CK-MB、cTnI水平与冠心病患者冠状动脉狭窄程度的关系

目的探讨血清载脂蛋白B(ApoB)/血清载脂蛋白A1(ApoA1)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白Ⅰ(cTnⅠ)水平与冠心病(CHD)患者冠状动脉狭窄程度的关系。方法选择120例冠心病患者作为CHD组,另选择40例同期健康体检者作为正常组,比较正常组和CHD组ApoB/ApoA1、CK-MB及cTnⅠ水平差异。此外,按照Gensini评分将CHD组患者分为轻、中、重度狭窄组三组,分别为25例、52例、43例,比较不同狭窄程度CHD患者ApoB/ApoA1、CK-MB及cTnⅠ水平差异。并采用Spearman法分析ApoB/ApoA1、CK-MB及cTnⅠ水平与冠状动脉狭窄程度的相关性。结果 CHD组ApoB/ApoA1、CK-MB、cTnI水平较正常组明显升高(P0.05)。中度狭窄组ApoB/ApoA1、CK-MB、cTnⅠ水平较轻度狭窄组明显升高(P0.05),且重度狭窄组较轻、中度狭窄组明显升高(P0.05)。冠心病患者ApoB/ApoA1、CK-MB及cTnI水平与冠状动脉狭窄程度均呈正相关(r分别为0.694、0.920、0.930,P0.05)。结论冠心病患者血清ApoB/ApoA1、CK-MB及cTnⅠ水平与冠状动脉狭窄程度呈正相关。     

应用ROC曲线评价ApoB/ApoA1比值对冠脉狭窄 程度的诊断价值

【摘要】 目的 探讨血清ApoB/ApoA1比值与冠状动脉狭窄程度的关系,评价其在冠心病中的诊断价值。方法:选取我院首次行冠脉造影检查并符合入组条件的患者198例,分为冠心病组（130例）、非冠心病（68例）,再根据Gensini（GS）积分评估价病变程度,对各血脂常规指标行ROC曲线分析及相关分析。结果：①冠心病组患者较非冠心病组ApoB/ApoA水平增高（P＜0.01）。②多因素logistic回归分析ApoB/ApoA1为冠心病独立危险因素（P＜0.01）,ApoA1为冠心病保护因素（P＜0.01）。③线性相关分析显示：ApoB/ApoA1(r=0.742)与GS呈正相关（P＜0.01）,ApoA1(r=-0.773)与GS呈负相关（P＜0.01）。④ROC曲线分析ApoB/ApoA1（曲线下面积AUC 0.836;敏感性0.853;特异性0.574;P＜0.01）,最佳诊断截点（cutoff值）为0.678。结论：①ApoB/ApoA1为冠心病独立危险因素;ApoA1为冠心病保护因素。②ApoB/ApoA1能有效反应冠脉狭窄程度。     

高甘油三酯血症患者动脉僵硬度与超敏C反应蛋白的相关性研究

目的探讨高甘油三酯血症患者动脉僵硬度与超敏C反应蛋白（hsCRP）的关系。方法以脉搏波速度（PWV）水平作为动脉僵硬度的评价手段。112名高甘油三酯血症患者根据动脉硬化的程度分为低PwV组和高PWV组，分别测定肱踝脉搏波传导速度（ba—PWV）和hsCRP，并收集相关临床资料。结果高PwV组log hsCRP水平显著高于低PWV组（P〈0．05）。偏相关分析显示在校正年龄、性别、吸烟史、合并用药情况、冠心病、高血压、血脂谱、空腹血糖、胰岛素抵抗指数后ba—PWV和log hsCRP正相关（r=0．261，P=0．039）。多元回归分析显示年龄（P〈0．01）、收缩压（P〈0．05）及log hsCRP（P〈0．05）与ba—PWV相关。结论高甘油三酯血症患者中hsCRP与ba—PwV水平相关，提示动脉僵硬度可能与全身的炎症状态相关。     

The relationship between body fat and C-reactive protein in middle-aged Korean population

High-sensitivity C-reactive protein (hsCRP) has been identified as a strong independent risk factor of cardiovascular events. However, few data are available on hsCRP levels and their relationship with body fatness in Asian populations. We evaluated the relationships between hsCRP and various obesity indices: weight, body mass index (BMI), fat mass (FM), fat percent (F, %), waist circumference (WC), waist-hip ratio (WHR), and subscapular and suprailiac skinfold thicknesses in a community-based Korean cohort with hsCRP < or = 10 mg/l (n = 9773, age = 40-69 years, a rural and an urban community was selected). The median hsCRP level was 1.4 mg/l (interquartile range 0.6-2.4 mg/l). Of obesity indices examined, F, % was most strongly correlated with log-transformed hsCRP levels (r = 0.18 in men, 0.24 in women, respectively, P < 0.01). In multiple regression model including age, sex, community, blood pressure, BMI, WC, WHR, fasting glucose, insulin, lipids, smoking, alcohol and exercise, F, % was most potently associated with hsCRP (P < 0.0001). F, % accounted for 13.8% of the variability in hsCRP level, whereas other factors less than 6%. This result suggests that F, % is a strong associating factor of hsCRP levels of the various obesity indices in middle-aged Korean population.     

血清高敏感C反应蛋白和老年男性冠心病的关系

目的　探讨血清高敏感C反应蛋白 (hsCRP)与老年男性冠心病的关系及其可能机制。方法　经冠状动脉造影证实的 6 4例老年男性患者分为冠心病组 (36例 )和对照组 (2 8例 ) ,检测血浆hsCRP水平 ,以多项临床及生化指标为危险因素进行统计分析。结果　冠心病组的hsCRP水平 (4 .73± 3.16 )mg L与对照组 (1.6 7± 1.93)mg L比较 ,差异有显著性意义。单因素logistic回归分析 ,发现hsCRP是冠心病发生的一个独立危险因素 ;高hsCRP(≥ 1.5mg L)者发生冠心病的OR值为 7.4。若把hsCRP分为三等分 ,当其每升高一个等分 ,冠心病临床病情严重程度加重一个或一个以上等级的可能性增加 3.9倍。年龄、BMI、总胆固醇、HDL C以及临床病情严重程度与hsCRP显著相关 ,但校正年龄和BMI之后 ,只有临床病情严重程度与hsCRP仍保持显著相关。结论　老年男性冠心病患者的体内炎症反映水平是升高的 ,hsCRP是老年男性冠心病患者临床病情严重程度的一个敏感指标。