Correlation between the ratio of serum low-density lipoprotein cholesterol and high-density lipoprotein cholesterol with that of serum apolipoproteins B and A-I

Summary Phosphowolframate/magnesium chloride, a commonly used precipitation method for the determination of high-density lipoprotein cholesterol in human serum, yields a supernatant containing almost all of the lipoproteins apo A-I and apo A-II but no lipoprotein apo B. The correlation between high-density lipoprotein cholesterol and apo A-I was very high (r=0.94), as well as that between the precipitation method and ultracentrifugal analysis (r>0.95,P<0.001). In contrast, detergent precipitation (for the determination of low-density lipoprotein cholesterol in human serum) produced sediments which contained the major proportion of apo B and only minor amounts of apo A-I and apo A-II. The precipitation method for low-density lipoprotein cholesterol showed very good agreement with ultracentrifugal analysis (r=0.99). Yields of 80.2% were obtained for apo B with both methods. Results obtained using the precipitation methods showed excellent agreement with those obtained using the Friedewald formula (r>0.99). Results were also very similar when hypertriglyceridemic serum samples were briefly centrifuged before analysis of cholesterol, high-density lipoprotein cholesterol and triglyceride values. The present study shows highly significant correlations between cholesterol/high-density lipoprotein cholesterol or low-density lipoprotein cholesterol/high-density lipoprotein cholesterol and apo B/apo A-I ratios (P<0.001). Apo B and apo A-I levels could be used in addition to low- and high-density lipoprotein cholesterol values when assessing the risk of cardiovascular disease, if the methods for determining serum apolipoproteins have been properly standardized.     

Total cholesterol and high-density lipoprotein cholesterol in sensorineural deafness

In order to verify an assumed hypothesis of a correlation between sensorial hearing loss and arteriosclerosis type injuries, these parameters were studied: total cholesterol and cholesterol associated to high density lipoproteins in order to evaluate the risk of developing coronary heart disease in patients with cochleopathy as compared to control patients. It proved impossible to point out any significant difference between results obtained in the two groups for any of the analytical parameters considered.     

Interlaboratory proficiency survey of cholesterol and high-density lipoprotein cholesterol measurement

We conducted a proficiency survey of cholesterol and high-density lipoprotein (HDL) cholesterol analysis in local clinical laboratories to determine whether increased national emphasis on cholesterol measurement had resulted in changes in performance from previous surveys. Sets of frozen aliquots of plasma and HDL supernate pools were sent to nine laboratories for analysis; results were compared with Northwest Lipid Research Center values, and relationships were determined by linear regression. Of all the cholesterol measurements, 81% were considered acceptable (i.e., within 9% of the NWLRC value), and 61% of the HDL cholesterol measurements were considered acceptable (within 50 mg/L of NWLRC values). These data represented no improvement over previous surveys. Workload had increased significantly: 79% for cholesterol and 284% for HDL cholesterol. On a bias plot, six of the laboratories demonstrated inaccuracy greater than the +/- 3% recommendation within the critical range of 2000-2400 mg/L for total cholesterol. For HDL cholesterol, two laboratories demonstrated bias greater than 10% at the critical point of 350 mg/L, with three additional laboratories displaying strong bias outside the decision point. The survey results indicate that apparently further improvements must be made for laboratories to achieve acceptable performance in cholesterol analysis.     

Interlaboratory proficiency survey of high-density lipoprotein cholesterol measurement

Proficiency surveys of Seattle-area laboratories suggest only slight improvement in overall performance in high-density lipoprotein (HDL) measurement between 1978 and 1982, although the reported workload for HDL has increased by 15%. The mean interlaboratory SD was 64 mg/L (ranging from 34 for a pool averaging 299 mg/L to 136 for a pool averaging 886 mg of HDL cholesterol per liter) in 1982, compared with 79 mg/L (range 48-155) in 1978-79. Of the individual laboratory results in the current survey, 39% deviated by more than 50 mg/L from target values as compared with 37% in 1978-79. The discrepant values were primarily ascribable to method inaccuracy: only 30% of laboratories in 1982 reported results that averaged within 30 mg/L of target values (vs 50% in 1978). For within-run precision, 80% of laboratories in 1982 had SDs of less than 30 mg/L, vs 70% in 1978. The 1982 survey included a lyophilized serum prepared by spray freezing and bulk lyophilization (Hyland Omega), identical to the pools used in the College of American Pathologists Comprehensive Chemistry Survey, and five pools of frozen plasma. Interlaboratory variation and biases for the Omega pool were similar to those for the frozen pools.     

血清脂蛋白亚类和高密度脂蛋白胆固醇酯化速率的生物学变异

目的 研究血清HDL亚类(HDL2-C、HDL3-C)、LDL亚类(LDLa-C、LDLb-C)、FERHDL和MERHDL的个体内和个体间的生物学变异(CVI、CVG).方法 选取2010年9-10月卫生部北京医院20名健康成年志愿者,男女各10名.每隔2周采集空腹静脉血1次,共采集4次,用超速离心-高效液相色谱(HPLC)法测定各脂蛋白亚类水平及FERHDL和MERHDL,计算其CVI和CVG,并给出各项指标的分析质量要求.结果 不同血脂指标的生物学变异不同,HDL3-C和HDL2-C的平均CVI分别为5.5％和7.2％,但两者的CVG差别较大,分别为8.7％和45.5％;LDLa-C和LDLb-C平均CVI分别为11.2％和18.7％;FERHDL和MERHDL的CVI分别为11.9％和12.3％,其中FERHDL的CVG (49.5％)大于MERHDL的CVG(30.6％).CVI存在较大个体差异.结论 本研究考察了血清脂蛋白亚类和HDL胆固醇酯化速率的生物学变异,可为这些血脂类危险因素的分析质量控制及心血管病危险分析奠定基础.     

Simple high-density lipoprotein cholesterol assay based on dry chemistry

Background: Currently, high-density lipoprotein cholesterol (HDL-C), a factor which prevents progression of arteriosclerosis, is measured using laboratory-based chemistry analyzers without a pretreatment step. Because HDL-C is measured with a pretreatment step in many point-of-care testing systems, a direct assay is needed. Methods: A dry-chemistry-based assay using surfactants has recently been developed in parallel with the development of a dedicated reagent. A simple analyzer that accepts whole blood samples was also developed. Results: The assay demonstrated excellent precision, dilution linearity and intermethod comparison. In an interference test, assay values tended to be lower in the presence of high concentrations of hemoglobin, conjugated or unconjugated bilirubin. Neither ascorbic acid up to 20 mg/dl, nor formazin turbidity up to 2100, had an effect on the assay. Conclusions: This dry-chemistry assay using only surfactants for specificity in the direct HDL-C method was judged useful for point-of-care instrumentation in terms of equipment compactness, operational simplicity and rapid responsiveness.     

Polyacrylamide gel electrophoresis in quantification of high-density lipoprotein cholesterol

We evaluated a method for quantifying high-density lipoprotein cholesterol in plasma, based on electrophoretic migration of the prestained (with Sudan Black III) sample through a discontinuous polyacrylamide++ gel and densitometric integration of the stain associated with each class of lipoprotein. With this method, operations can be carried out on all types of lipoproteins over a broad range of concentrations. Overloading with very-low and low-density lipoproteins did not affect reliability within a wide range of HDL concentrations (0.45 to 16.60 mmol/L). Results for 22 individual plasma samples from normal and dyslipemic subjects correlated well with those by ultracentrifugal analysis (r=0.96; Student's t= 0.90, p > 0.30). We conclude that this method is reliable, sensitive, and accurate, It may be used for simultaneously typing dyslipoproteinemias and assaying HDL cholesterol.     

高密度脂蛋白胆固醇与特发性肺栓塞的关系

目的 探讨高密度脂蛋白胆固醇( HDL-C)与特发性肺栓塞之间的关系.方法 收集我院2005年1月至2011年3月确诊的34例特发性肺栓塞患者(PE组)临床资料,选择同时期性别、年龄、基础疾病相匹配的我院体检中心健康体检者109名为对照组.PE组和对照组均空腹10h后次日7:00抽取肘部静脉血,检测血总胆固醇(TC)、HDL-C、低密度脂蛋白胆固醇(LDL-C).结果 PE组与对照组在HDL-C比较中差异有统计学意义[分别为:(1.10±0.28)、(1.49±0.35) mmol/L,t=- 5.427、P＜D.05],而两组在TC、LDL-C差异均无统计学意义(P均＞0.05).特发性肺栓塞与HDL-C存在一定联系(r =0.284,P＜0.05).结论 TC与LDL-C与特发性肺栓塞可能无关,而HDL-C与特发性肺栓塞存在一定关系.     

弥漫大B细胞淋巴瘤的治疗进展

弥漫大B细胞淋巴瘤是非霍奇金淋巴瘤中最常见的一种类型,也是发生在成人淋巴瘤中最常见的一种类型。其在临床表现、形态学、免疫表型、细胞遗传学、分子生物学、对化疗的反应及预后上都表现出明显的异质性。随着诊断医学的发展和新的药物的开发和应用,弥漫大B细胞淋巴瘤在诊断和治疗方面取得一些进展,特别是在免疫组化的分类和嵌合抗CD20单克隆抗体利妥昔单抗联合治疗方面,使弥漫大B细胞淋巴瘤在疗效和预后得到了很大的改善。     

Correlation between total homocysteine, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol in the serum of patients with myocardial infarction

OBJECTIVES: Determine the Low-density lipoprotein cholesterol (LDL-C), High-density lipoprotein cholesterol (HDL-C) and serum total homocysteine in myocardial infarction patients and control subjects. DESIGN AND METHODS: The study group consisted of 126 patients 67 male, and 59 females, aged 29-73 (mean 48.65 +/- 3.81) years. The entry criteria for the patient group was typical or atypical chest pain, unequivocal changes in the electrocardiogram. The control group consisted of 135 normal volunteers, 71 male and 64 females, age 21-63 (mean 42.73 +/- 5.79) years. Measurement of serum total homocysteine was performed using gas chromatography. Measurement of Low-density lipoprotein cholesterol, and High-density lipoprotein cholesterol were performed using spectrophotometer. RESULTS: Patients with myocardial infarction were found to have higher serum total homocysteine levels than controls, (P < 0.05). Serum total homocysteine levels were significantly correlated with low-density lipoprotein cholesterol and high-density lipoprotein cholesterol. There was a negative correlation between total homocysteine and HDL-C levels (P < 0.05, r = -0.93). There was a positive correlation between total homocysteine and LDL-C levels (P < 0.05, r = 0.98). CONCLUSIONS: The above mentioned findings suggest the potential usefulness of LDL-C, HDL-C and serum total homocysteine as prognostic markers in myocardial infarction patients. These findings should influence future studies on the etiology and pathogenesis of myocardial infarction.     

Blood rheology and the low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio in dyslipidaemic and normolipidaemic subjects

The association between blood rheology and the ratio of low-density lipoprotein cholesterol (LDL-C) to high-density lipoprotein cholesterol (HDL-C) was investigated in 142 dyslipidaemic and 253 normolipidaemic subjects. Blood rheology was examined by the microchannel method and fasting serum concentrations of LDL-C, triglyceride and HDL-C were measured. Passage time of whole blood correlated positively with LDL-C concentration, triglyceride concentration and LDL-C/HDL-C ratio, and negatively with HDL-C concentration. Passage time of whole blood was significantly higher in dyslipidaemic and normolipidaemic subjects with LDL-C/HDL-C ratio > 2.0 than in those with ratio < 1.5. Thus, dyslipidaemic subjects had impaired blood rheology, elevated LDL-C and triglyceride concentrations and elevated LDL-C/HDL-C ratio, and reduced HDL-C concentrations. Dyslipidaemic and normolipidaemic subjects with a more elevated LDL-C/HDL-C ratio had greater blood rheology impairment than those with a less elevated ratio. These data suggest that an elevated LDL-C/HDL-C ratio may be helpful in predicting impaired blood rheology.     

总胆固醇/高密度脂蛋白胆固醇比值预测冠心病危险程度的评价

目的 评价总胆固醇/高密度脂蛋白胆固醇(TC/HDL-C)比值预测冠心病危险程度的价值.方法回顾性分析250例冠心病患者的临床资料分为:稳定型心绞痛组(SA组),不稳定型心绞痛组(UA组),并另选125例健康者为对照组,测定两组的TC/HDL-C、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和HDL-C并比较其差异性和异常率.结果SA组及UA组TC、TG、LDL-C及TC/HDL-C均高于对照组(P<0.01),HDL-C低于对照组(P<0.01),HDL-C分别为(1.08±0.36)mmol/L、(1.03±0.29)mmol/L vs(1.66±0.67)mmol/L,SA组、UA组HDL-C、LDL-C及TC/HDL-C异常率与对照组比较差异有统计学意义(P<0.05),分别为36.9%、39.1%Vs 20.0%,32.0%、32.8%Vs 16.0%,65.6%、72.7%vs 38.6%.结论TC/HDL-C作为冠心病危险因素的预测价值和灵敏度高于单项血脂指标.     

血必净注射液对脓毒症患者高密度脂蛋白胆固醇水平的影响

目的 探讨血必净注射液对脓毒症患者高密度脂蛋白胆固醇(high-density lipoprotein cholestero,HDL-C)水平的影响.方法 将38例脓毒症合并低HDL-C血症患者随机分为两组,对照组19例予常规综合治疗,治疗组19例在对照组基础上加用血必净注射液,分别监测两组治疗前及治疗后3 d、7 d、10 d血清HDL-C、载脂蛋白A_1(apoA I)及APACHEⅡ评分的动态变化,分析血必净注射液对脓毒症患者HDL-C水平预后的影响.结果 治疗组7 d、10 d后HDL-C、apoA Ⅰ较用药前明显升高,与对照组比较差异亦有统计学意义(P<0.05),APACHEⅡ评分降低,预后改善.结论 血必净注射液能提高脓毒症患者体内HDL-C水平,在一定程度改善脓毒血症预后.