脂肪肝和血脂的关系

肝脏是脂肪代谢的重要场所。脂肪肝的定义：肝脏对脂肪合成能力增加和转运人血的能力下降时,脂类物质（三酰甘油）在肝脏内蓄积过多,超过肝脏重量5％或组织学上有50％以上的肝实质脂肪化时,即为脂肪肝。由于生活不断改善,我国脂肪肝的发病率逐年升高,已占平均人口的10％,脂肪肝已作为一种常见病进入我们的生活。肥胖、嗜酒和糖尿病的人群中脂肪肝可高达50％-60％,     

Predicting smoking status in a college-age population

OBJECTIVE: The purpose of this study was to determine the factors that predict smoking group membership in a college-age population. DESIGN: A nonexperimental cross-sectional design was used to examine factors that distinguished among four groups: never established (n = 591), former (n = 41), nondaily (n = 80), and daily (n = 76) cigarette smokers. SAMPLE: A pencil and paper questionnaire was returned by 788 randomly selected college students, 18-24 years of age. RESULTS: Significant differences were found among the groups on their mothers', fathers', siblings', and peers' smoking behaviors and attitudes toward smoking. The nondaily and daily smoking groups reported a greater number of risk behaviors than the never established and former smoking groups. The two groups of current smokers also were more likely to report an increased level of depressive symptoms compared with the nonsmoking groups. The number of high school and college friends who smoke and self-reported high-risk alcohol and drug behaviors predicted smoking group membership in a polytomous logistic regression. CONCLUSIONS: Strategies to alter the social environment and decrease the exposure of nonsmoking students to others who model smoking behaviors may help decrease smoking initiation and prevent relapse on college campuses.     

瘦素、脂代谢与胆固醇结石形成的相关性

目的通过对胆固醇结石患者血清瘦素及血脂成分浓度的测定,旨在探讨瘦素(LP)在胆固醇结石形成中的作用。方法收集兰州医学院第二附属医院普外科胆结石住院患者,确定22例作为实验组(胆石组),其中男10例,女12例。术后通过肉眼观察和化学检测证实为胆固醇结石。患者术前进行各项检查排除心、肝、肾等器官病变,且无高血压、糖尿病、肝炎等慢性病变,不伴或伴胆囊炎但非急性发作者。另外,随机抽取本院经体检及生化全项检查无血脂增高及其他明显病变的健康人群16例,其中男8例,女8例,作为对照组。用生化法检测胆固醇结石组患者及对照组血清总胆汁酸(TBA)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白的含量;并测身高、体重、腰围,计算体重指数(BMI)、体表面积;用放免法测血清瘦素值。结果胆石组和对照组血脂成分差异具有显著意义。HDL:胆石组为(1.21±0.27)mmol/L,对照组为(1.5±0.3)mmol/L,结石组比对照组低,差异具有显著性意义(t=2.21,P<0.05);血清胆固醇:胆石组为(4.6±0.7)mmol/L,对照组为(4.0±1.0)mmol/L,差异具有显著性意义(t=2.40,P<0.05);载脂蛋白A1(apo-a1):胆石组为(1.28±0.28)g/L,对照组为(1.53±0.25)g/L,差异也具有显著性意义(t=2.56,P<0.05)。胆石组血清瘦素含     

Effect of serum lipids on the pharmacokinetics of atazanavir in hyperlipidemic rats

Atazanavir (ATV) has been successfully used in HIV patients with severe hyperlipidemia (HL); however, little is known about the pharmacokinetics of ATV in HL. The aim of this study was to investigate the pharmacokinetics of ATV in HL. With the increase of serum lipids, the protein binding rate in HL rats (approximately 97%) was significantly higher than that in control (approximately 87%). After intravenous (iv), oral (po) and intraportal (ip) administration of ATV at a dosage of 7 mg/kg, AUCs in HL rats were 12.41, 5.24 and 8.89 μg/mL h, respectively, and were significantly higher than those in control rats (4.09, 1.70 and 3.38 μg/mL h). Despite the decrease of distribution volume (Vd_ss), the terminal half-life (t_1/2) in HL tended to be shorter than in control, and hepatic distribution of ATV in HL rats was 4.8-fold increases. These results suggested that the uptake of ATV into liver might counteract the decrease of Vd_ss. On the other hand, there was no significant difference in bioavailability, and the lymphatic transport to AUC showed no statistical change. In conclusion, although the protein binding rate and AUC were significantly increased, the pharmacokinetics of ATV might be tolerated in HL.     

临床研究吸烟者血脂与冠状动脉病变严重程度的关系

目的 研究吸烟者血脂与冠状动脉病变程度的关系.方法 对231例按受冠状动脉造影检查且资料大致匹配的吸烟患者(n=143)与非吸烟患者(n=88)进行回顾性研究,根据冠状动脉造影显示病变所累及血管的数量分为冠状动脉造影正常亚组和1支病变亚组、2支病变亚组及3支病变亚组,分析吸烟者与非吸烟者血脂异常与冠状动脉病变程度之间的关系.结果 与吸烟者相比,非吸烟者的H DL-C水平更高(P＜0.05),冠脉病变程度更轻(P＜0.05或P＜0.01).非吸烟者的各冠脉不同程度病变亚组与吸烟者各对应亚组比较,HDL-C和LDL-C/HDL-C水平更高,差异有统计学意义(P＜0.05或P＜0.01).结论 吸烟者中有更高的血脂异常发生率和更加严重的冠状动脉狭窄性病变.     

南宁地区壮族人群甲状腺功能与血脂关系的研究

目的探讨广西南宁地区壮族人群甲状腺功能与血脂的关系。方法采用整群抽样方法对1000例广西南宁地区壮族人群的甲状腺激素(TSH、TT3、TT4、FT3、FT4)和血脂:总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白A(apoA1)、载脂蛋白B(apoB)进行测定,并将其结果与1000例当地汉族人群作比较。结果壮族人群的老年组TT4、FT3、FT4高于汉族人群(P<0.05),TSH低于汉族人群(P<0.05);而TC、TG、HDL、LDL、apoB低于汉族人群(P<0.01,P<0.05)。壮族人群的TSH、FT3、FT4与HDL呈负相关,TSH、FT3、FT4与TG呈正相关。结论广西南宁地区壮族成年人群甲状腺功能与血脂有密切关系,壮族成年人群的甲状腺激素水平和血脂与汉族人群存在着显著性差异。     

Thyroid function tests, serum lipids and gender interrelations in a middle-aged population.

OBJECTIVE: To study the value of screening for thyroid function in a screening program for hyperlipidaemia. DESIGN: A screening study in primary health care. SETTING: All individuals in a defined rural area, S?der?kra, Sweden, aged 40-59 years were invited to a screening programme at the local primary health care centre. PARTICIPANTS: 782 individuals were invited for screening. Blood samples were obtained from 88% of the invited males and from 92% of the females. MAIN OUTCOME MEASURES: Thyroid function tests (thyroid stimulating hormone (TSH) and free T4), serum lipids (total-cholesterol, HDL-cholesterol, LDL-cholesterol and s-triglycerides), b-glucose and body anthropometry (body mass index and waist to hip circumference) were measured. RESULTS: 0.57% of males and 1.13% of females showed evidence of hypothyroidism as defined by a TSH value greater than 3.75 mU/l of those with s-cholesterol concentration above 7 mmol/l. In addition, higher TSH values in females were associated with higher s-cholesterol, s-LDL-cholesterol and s-triglycerides. CONCLUSION: It seems appropriate to screen for hypothyroidism in females with s-cholesterol above 7.0 mmol/l.     

Relationship between thyroid status and renal function in a general population of unselected outpatients

ObjectiveTo investigate the relationship between thyroid and kidney function.Design and methods13,383 results of serum creatinine and thyroid stimulating hormone (TSH) were retrieved from the database of our Laboratory.ResultsWhen compared with euthyroid subjects, those with TSH < 0.2 mIU/L and > 2.5 mIU/L had increased and decreased estimated glomerular filtration rate (e-GFR), respectively. TSH levels were an independent predictor of e-GFR.ConclusionsA mutual relationship was observed between kidney and thyroid status.     

江苏省常州地区自然人群人体测量指标与血压、血脂关系的研究

目的调查常州地区自然人群的高血压和血脂紊乱的发病率,探讨并比较3种人体测量指标包括体重指数(BMI)、腰臀比(WHR)和体脂肪率(FAT%)及其与血压、血脂的关系。方法在常州市社区自然人群中采用临床横断面研究通过整群抽样抽取研究样本,采用格式化调查表收集人群信息,并检测血糖、血脂、血压、BMI、WHR、FAT%、尿酸、肝肾功能等指标。结果常州地区自然人群血脂紊乱、高血压、糖尿病的发病率分别为41.6%、28.2%和10.7%。调整年龄差异后男女的BMI、WHR和FAT%均有显著差异,其中男性的BMI、WHR高于女性,女性的FAT%显著高于男性。在自然人群中BMI和WHR在预测血脂紊乱和高血压的能力上没有显著差异,并都显著高于FAT%的预测能力,但在男女分层后无差别。3种人体测量指标的的独立影响因素包括SBP、HDL、LDL、UA。年龄是BMI和WHR的影响因素。结论常州地区自然人群高血压和血脂紊乱的发病率呈现高发趋势;BMI、WHR和FAT%不仅是肥胖的指标,对潜在的心血管疾病危险因素—血脂紊乱和高血压发生的危险性亦有预报作用。超重和肥胖的早期发现,指导人群改变生活习惯,控制BMI、WHR和FAT%的上升发展趋势的工作迫在眉睫。     

单纯性肥胖儿童血浆瘦素水平的变化及其与血脂、血糖水平变化的关系

目的 研究单纯性肥胖儿童血清瘦素水平与血糖及血脂、脂蛋白异常的关系。方法 采用放射免疫分析法、酶法对50对7-10岁肥胖及健康对照儿童进行血清瘦素水平及血糖、血脂、脂蛋白水平的测定。结果 单纯性肥胖儿童血清瘦素水平显著高于体重正常组，血清总胆固醇（TC）、甘油三酯（TG）及低密度脂蛋白胆固醇（LDL—C）水平均显著高于体重正常组，血清高密度脂蛋白胆固醇（HDL—C）水平均显著低于体重正常组，轻中度肥胖组血糖水平与对照组无显著性差异（P〉0．05），中度肥胖组血糖水平显著高于对照组儿童（P〈0．05）。血清瘦素水平与体重指数（BMI）、TC、TG、LDL—C、血糖（BS）呈显著正相关关系（P均〈0．05），与血清HDL—C呈显著负相关（P〈0．045）。结论 单纯性肥胖儿童血清瘦素水平显著增高，且与代谢综合征及心血管疾病的危险因素密切相关，可作为筛查高危肥胖儿童的有用指标。     

Relationship between lifestyle factors and hyperhomocysteinemia in general Chinese population: a cross-sectional study

Objectives: Hyperhomocysteinemia (Hhcy) is a known cardiovascular disease (CVD) risk factor. Observational studies had supported the role of lifestyle factors such as physical activity, diet and alcohol consumption in CVD prevention. Our study aimed to determine the relationship between Hhcy and lifestyle factors in general Chinese population.

Methods: In this cross-sectional study, a total of 7135 adults (3320 men and 3815 women) aged 35 years or older were recruited from the rural Northeast China. Data on lifestyle factors, such as physical activities, sleep duration, current smoking and drinking status, dietary habits and familial factors were collected in interviews and laboratory examinations were performed by well-trained personnel.

Results: Plasma total homocysteine (tHcy) level was higher in men than in women, and greater in the elderly than in other age groups. Subjects with Hhcy were more likely to be current smokers (men: OR 1.328, 95% CI 1.143–1.543, p<0.001; women: OR 1.465, 95% CI 1.214–1.767, p<0.001). Separately, men with Hhcy were more likely to have an education of primary school or below (OR 1.251, 95% CI 1.068–1.465, p=0.006) and less likely to eat more vegetables (OR 0.927, 95% CI 0.863–0.996, p=0.037) than the normal-tHcy participants. In women, participants with Hhcy were more likely to have longer sleeping time (>9h/d) (OR 1.677, 95% CI 1.292–2.177, p<0.001), low physical activity (OR 1.721, 95% CI 1.197–2.475, p=0.044) and increased diet score (OR 1.126, 95% CI 1.007–1.259, p=0.037) and less likely to be current drinkers (OR 0.488, 95% CI 0.297–0.802, p=0.005) than the normal-tHcy participants.

Conclusion: Our study revealed that physical activity and current drinking status were not significantly associated with Hhcy in males, but inversely associated in females. In both genders, current smoking status and dietary habits were significantly associated with Hhcy. Our study supports existing recommendations for Chinese to maintain a physically active behaviors and healthy lifestyle habits.     

肥胖儿童血清尿酸、血脂水平与血压的关系

目的探讨肥胖儿童血清尿酸、血脂水平与血压的关系。方法抽样调查湖南省湘潭市13702例2~18岁儿童,将71例肥胖自愿者及30例年龄、性别相匹配的非肥胖自愿者分为两组,分别测体重指数(BMI)、收缩压(SBP)、舒张压(DBP)、血清尿酸(UA)、高敏C反应蛋白(hs-CRP)和血脂水平,比较两组的差异和各指标间的相互关系。结果肥胖儿童血清UA、hs-CRP、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和载脂蛋白B(apoB)均显著高于对照组(P<0.05),而高密度脂蛋白胆固醇(HDL-C)和载脂蛋白AⅠ(apoAⅠ)则显著低于对照组(P<0.05)。血清UA与SBP、DBP的相关系数分别为0.369和0.366(P<0.0001),BMI与SBP、DBP的相关系数分别为0.587和0.560(P<0.0001)。结论儿童血清UA水平、肥胖与血压密切相关,血清UA增高可能是儿童高血压的一个危险因素。     

新疆健康人群血清尿酸与肾小球率过滤水平相关性研究

目的探讨新疆健康体检人群尿酸水平与肾小球滤过率的相关性。方法采用整群抽样方法对2008年1～12月克托玛依市社区健康体检者6532例（A组）及在新疆医科大学第一附属医院体检健康者1579例（B组）人群进行问卷调查与血生化项目检测,计算估算肾小球滤过率（estimatedglomerularfiltrationrate,eGFR）,采用多重线性回归分析eGFR的独立影响因素。结果在男性群体和年龄〈45岁女性群体中血清尿酸水平为eGFR下降的独立危险因素;A组年龄≥45岁女性群体中年龄为eGFR下降的独立危险因素;B组男性群体中腰臀比和血清尿酸水平为eGFR下降的危险因素;B组女性群体中血清尿酸水平为eGFR下降的独立危险因素,而少数民族是eGFR的保护因素。结论新疆健康人群血清尿酸水平在各年龄阶段的男性人群和年龄〈45岁女性人群中是eGFR下降的危险因素。     

血脂与肝脂酶启动子514C/T多态性的关系

目的:探讨肝脂酶(HL)启动子514C/T基因多态性与血脂水平的关系。方法:用聚合酶链反应-限制性内切酶片段长度多态性分析技术(PCR-RFLP),对112名三酰甘油(TG)正常水平者和103例高TG者的HL启动子514C/T基因多态性进行研究。结果:HL启动子514TT等位基因频率在高TG组为0.4563,比正常TG组0.3348高,但差异无显著性。在总研究组中TT型的年龄、TG浓度明显高于CC型和CT型,而载脂蛋白A1(ApoA1)则明显降低(P<0.05)。按性别分层后发现TT型女性和男性的TG、低密度脂蛋白胆固醇(LDL-C)的浓度均明显高于非TT型同性(P<0.05),而高密度脂蛋白胆固醇(HDL-C)、ApoA1浓度则分别低于非TT型的同性(P     

Relationship between apolipoproteins and the alteration of HDL subclasses in hyperlipidemic subjects

BACKGROUND: To elucidate the relationship between the apolipoproteins, especially apoA-I and the alteration of HDL subclasses in hyperlipidemic, HTC and HTG subjects. METHODS: ApoA-I contents of plasma HDL subclasses were quantitated by two-dimensional gel electrophoresis coupled with immunodetection in 233 normolipidemic subjects and 312 hyperlipidemic subjects (132 HTC and 180 HTG subjects). Making use of the mean +/-1 SD of apoA-I levels, we further subdivided normolipidemic, hyperlipidemic, HTC and HTG subjects into 3 subgroups, respectively. RESULTS: Subjects in the middle and low apoA-I subgroups had decreased HDL-C and apoA-I while increased TG, apoB100, apoCII, apoCIII and apoE concentrations. With the reduction of apoA-I concentrations, the apoA-I contents of all HDL subclasses decreased successively and significantly. The relative percentage of small-sized HDL increased significantly while those of large-sized HDL(2a), HDL(2b) decreased significantly in hyperlipidemic, especially in HTG group. Multiple liner regression result revealed that apoA-I was positively and significantly correlated with all HDL subclasses and apoA-I level influenced the distribution of HDL subclasses powerfully in hyperlipidemic subjects. CONCLUSIONS: Both the rate and efficiency of RCT might be weakened more seriously in hyperlipidemic, especially in HTG subjects with low apoA-I levels. ApoA-I level might be a powerful factor correlated with the distributions of HDL subclasses.     

Relationship between prevalence of impaired glucose tolerance and NIDDM in a population.

OBJECTIVE: To study the relationship between the prevalence of impaired glucose tolerance (IGT) and non-insulin-dependent diabetes mellitus (NIDDM) across populations of the Pacific Ocean region to assess whether variability in those two proportions followed some predictable pattern related to modernization of life-style and risk factor levels. RESEARCH DESIGN AND METHODS: Prevalence estimates from studies with 75-g oral glucose loads and World Health Organization criteria were age standardized. RESULTS: The linear correlation between IGT and NIDDM prevalence was poor (0.22 in men and 0.24 in women), although it was improved when the outlying data of Micronesian Nauruans and Australian Aborigines were excluded (r = 0.65, P less than 0.01 in men and r = 0.54, P less than 0.01 in women). However, an epidemicity index calculated as the percentage of total glucose intolerance (TGI) made up by IGT (i.e., IGT/TGI) had the strongest correlation with NIDDM prevalence (r = -0.81, P less than 0.001 in men and r = -0.77, P less than 0.001 in women) and also explained more of its variance, with no population having undue influence on the relationship. When IGT/TGI was plotted against NIDDM prevalence for the genetically homogeneous rural (relatively traditional) and urban (modernized) segments of five Pacific island populations, there was a clear tendency for IGT/TGI to decline as the prevalence of NIDDM increased in association with worsening risk factor levels. However, longitudinal data for the high prevalence population of Nauru demonstrated that at least in a stabilizing epidemic, changes in the prevalence of IGT and NIDDM may not be easily predictable. CONCLUSIONS: The epidemicity index may be useful as an indicator of the potential for higher future NIDDM prevalence in whole populations. Populations will probably equilibrate at a certain NIDDM prevalence dependent on the strength of their genetic susceptibility to the disease and their degree of exposure to adverse environmental risk factors, including modern diet, physical inactivity, and obesity.     

Effect of pectin on serum cholesterol,fecal bile acids and biliary lipids in normolipidemic and hyperlipidemic individuals

Pectin, 40–50 g/day for two weeks administered to nine normolipidemic and hyperlipidemic patients, had no effect on serum triglycerides but did cause a significant decrease in the serum total and unesterified cholesterol of hypercholesterolemic subjects in particular. This was associated with increased excretion of fecal bile acids and total steroids and increased concentration of plasma methyl sterols. Thus, the serum cholesterol reduction by pectin appears to be caused by increased cholesterol elimination into stools as bile acids which is then balanced by enhanced cholesterol synthesis. The composition of biliary bile acids and lipids was not changed and secondary bile acids and sterols decreased inconsistently in feces. The measurement of fecal dry weight suggested that the bulk of the pectin was degraded by bacteria during passage through the intestine. Consequently fecal mass and dry weight were not consistently increased, suggesting that pectin may not be an ideal fibre for increasing fecal bulk in functional colonie disorders.