吸烟对健康人血清HDL-C等7项指标水平影响的对比观察

经对生活和工作环境相似的40~69岁健康男性工人吸烟组697人和不吸烟组841人的对比观察,说明吸烟对健康人血清脂蛋白组分胆固醇水平有明显影响。吸烟组HDL-C、HDL₂-C、HDL₃-C、HDL₂-C/HDL₃-C明显低于不吸烟组,LDL-C、VLDL-C、LDL-C/HDL-C明显高于不吸烟组,且与吸烟量、时间、习惯呈剂量反应关系。吸烟是降低HDL-C、HDL₂-C、HDL₃-C、HDL₂-C/HDL₃-C和升高LDL-C、VLDL-C、LDL-C/HDL-C的危险因素。与不吸烟组相比,吸烟降低HDL-C等4项指标水平和升高LDL-C等3项指标水平的RR分别为1.09~5.77和2.37~3.59。被动吸烟者HDL-C等7项指标水平与轻度吸烟者相似,说明被动吸烟对血清脂蛋白组分胆固醇有明显影响。     

18岁及以上HIV感染者抗病毒治疗后CD4+T淋巴细胞计数水平比较

目的 观察并比较≥18岁HIV感染者（感染者）接受国家免费艾滋病抗病毒治疗（ART）36个月内,不同年龄组CD₄⁺T淋巴细胞（CD₄）计数水平,探讨年龄因素对参加ART的感染者CD₄计数水平的影响。方法 研究对象为2010年1月1日至2012年12月31日在广州市、柳州市和昆明市3家艾滋病治疗定点医院初次接受ART年龄≥18岁感染者,观察时间为初次接受ART之日（基线）起满36个月。研究对象基线和随访数据通过国家ART信息系统收集。按照基线年龄分组为18～49岁组、50～59岁组和≥60岁组。CD₄计数按照基线水平分为<200个/μl和200～350个/μl两层。以基线和治疗36个月内不同时间CD₄计数水平为因变量,应用混合效应线性模型分析基线年龄、病毒抑制情况、性别、基线CD₄/CD₈比值以及开始ART方案等因素对CD₄计数水平的影响。结果 共收集5 331例感染者数据。基线CD₄<200个/μl和200～350个/μl两层的年龄构成差异无统计学意义（χ²=0.13, P=0.938）。在基线CD₄<200个/μl层,50～59岁组和≥60岁组在ART 36个月内的CD₄计数水平均低于18～49岁组;在基线CD₄为200～350个/μl层,50～59岁组与18～49岁组的CD₄计数水平差异无统计学意义,≥60岁组的CD₄计数水平低于18～49岁组。结论 年龄是ART后CD₄计数水平的相关影响因素,针对≥50岁感染者应该更早启动ART,有助于其免疫功能恢复。     

膳食纤维不同成分对大鼠脂质代谢的影响

本文观察了3种不同膳食纤维(DF)制成品(纤维素、果胶、琼脂)对高胆固醇膳大鼠脂质代谢的影响。结果发现:果胶和纤维素组自实验2周末,琼脂组于6周末与对照组相比有明显的降低血清TC作用;3种DF均有不同程度降低肝胆固醇作用;各组血清TG、HDL-C,HDL_2-C,HDL_3-C间无显著差异;纤维素组和果胶组HDL-C/TC比值明显高于对照组。3种DF均可使大鼠排粪量增加,对大鼠摄食量及生长无影响。     

孕中期维生素D水平与脂代谢关联的研究

目的 探讨孕中期维生素D水平与脂代谢指标的关系。方法 于2015年3月至2018年2月在合肥3家医院产科门诊招募1 875名处于孕中期的孕妇作为研究对象。进行问卷调查并留取清晨空腹静脉血,检测其血清25（OH）D、脂代谢指标TC、TG、HDL-C和LDL-C。采用Cubic非线性模型和线性回归模型分析孕中期维生素D水平与脂代谢指标间的关系。结果 孕中期维生素D缺乏率为75.3%,TC、TG、HDL-C和LDL-C均值分别是（233.22±38.87）、（226.24±83.88）、（79.04±12.77）和（109.54±25.95）mg/dl。多因素线性回归结果显示,以25（OH）D五分位组（Q1～Q5）中Q5为对照组,Q1～Q4组的TC、TG均显著升高,Q1和Q2组的LDL-C显著升高,且在Q1组观察到TC、TG和LDL-C的最高差值（TC：β=16.88,95% CI：10.50～23.26;TG：β=34.92,95% CI：21.32～48.53;LDL-C：β=9.06,95% CI：4.77～13.35）。未观察到5组间HDL-C的显著差异。以维生素D是否缺乏分层后结果显示,当25（OH）D<50 nmol/L时,25（OH）D每增加10 nmol/L,TC、TG和LDL-C分别降低3.53 mg/dl（95% CI：1.30～5.75）、7.42 mg/dl（95% CI：2.41～12.44）和2.08 mg/dl（95% CI：0.60～3.57）,差异有统计学意义;而当25（OH）D≥50 nmol/L时,未发现25（OH）D与TC、TG和LDL-C间存在显著关联。无论维生素D是否缺乏,均未观察到25（OH）D与HDL-C的显著关系。结论 孕中期维生素D水平与脂代谢指标间存在非线性关系,仅在维生素D缺乏状态下,25（OH）D与脂代谢指标存在显著负相关。     

贵州省1996－2015年注射吸毒人群HIV/AIDS死亡率及其影响因素分析

目的 了解贵州省注射吸毒人群中HIV/AIDS死亡情况及其影响因素,为降低HIV/AIDS死亡率提供参考依据。方法 采用回顾性队列研究方法,以我国艾滋病防治基本信息系统中1996－2015年贵州省注射吸毒人群HIV/AIDS为研究对象,应用Cox比例风险回归模型分析其死亡的影响因素。结果 共有3 958例注射吸毒HIV/AIDS纳入分析,全死因的死亡比例为44.01%（1 742/3 958）,总死亡率为7.80/100人年,生存时间M=8.08年;抗病毒治疗（ART）组死亡率为3.57/100人年,美沙酮维持治疗（MMT）组死亡率为4.08/100人年。多因素Cox回归分析结果显示,研究对象的死亡与性别、民族、确认HIV阳性时年龄、确认HIV阳性后首次CD₄⁺T淋巴细胞计数（CD₄）、ART和MMT有关;女性的死亡风险是男性的0.82倍（95% CI：0.69～0.98）;少数民族的死亡风险是汉族的1.39倍（95% CI：1.21～1.60）;确认HIV阳性时年龄≥50岁的死亡风险是<20岁的2.44倍（95% CI：1.07～5.56）;确认HIV阳性后首次CD₄≥500个/μl组的死亡风险是CD₄<200个/μl组的0.27倍（95% CI：0.22～0.32）;未参加ART的死亡风险是参加者的2.83倍（95% CI：2.45～3.26）;未参加MMT的死亡风险是参加者的1.35倍（95% CI：1.15～1.59）。结论 1996－2015年贵州省注射吸毒人群HIV/AIDS中,男性、确认HIV阳性时年龄较大者、确认HIV阳性后首次CD₄较低、未参加ART和MMT的病例,死亡风险较高。     

中国4省份55岁及以上中老年人认知功能与帕金森病前驱期患病概率的关联研究

目的 分析我国河北省、浙江省、陕西省和湖南省（4省份）≥55岁中老年人帕金森病前驱期（pPD）患病概率，探讨总体认知功能及不同认知域功能与pPD患病概率的关联性。方法 利用神经系统疾病专病社区队列研究2020年调查数据，选择未患阿尔茨海默病和帕金森病的有完整人口统计学、疾病史、认知功能评估和帕金森病风险因素数据的≥55岁中老年人4 634人。采用蒙特利尔认知测验中文版量表评估认知功能，按照国际帕金森病及运动障碍协会诊断标准评估pPD患病概率并判定pPD，采用多因素线性回归模型分析认知功能与pPD患病概率的关联性。结果 研究对象总体认知功能评分、记忆、执行力、视空间、语言、注意力和定向指数评分的M（Q₁，Q₃）分别为25（20，30）、13（11，15）、10（7，12）、6（4，7）、5（4，6）、15（12，18）和6（6，6）分，pPD患病概率M（Q₁，Q₃）为0.42%（0.80%，1.73%），可能或极可能患pPD者比例为0.4%。总体认知功能评分四等分组pPD患病概率分布差异有统计学意义（P<0.001），可能或极可能pPD患者比例差异有统计学意义且呈下降趋势（P=0.001）。调整混杂因素后，多因素线性回归分析结果显示，总体认知功能评分Q₂、Q₃和Q₄组pPD患病概率较Q₁组分别降低23.4%、31.2%和20.1%，相应的β值（95%CI）分别为0.766（0.702~0.836）、0.688（0.631~0.751）和0.799（0.730~0.875），且趋势有统计学意义（P<0.001）。较高的执行力、视空间、语言、注意力和定向指数评分与较低的pPD患病概率有关，差异有统计学意义（均P<0.001）。结论 总体认知功能及执行力、视空间、语言、注意力和定向功能减退可能增加中老年人pPD患病概率，提示早期认知功能干预对预防pPD有重要意义。     

5μg和10μg重组乙型肝炎疫苗初次免疫正常应答和高应答新生儿5年抗体持久性比较

目的 比较5 μg和10 μg乙型肝炎疫苗（HepB）初次免疫（初免）正常应答和高应答新生儿初免后5年的抗体持久性。方法 选用5 μg（重组啤酒酵母）和10 μg（重组汉逊酵母）HepB,按照"0-1-6"程序完成3剂次初免的新生儿,并在接种第3剂次后1~6个月（T₀）和5年（T₁）后分别采集静脉血,采用化学发光微粒子免疫分析法（CMIA）定量检测抗-HBs,比较两剂量接种后正常应答和高应答（T₀时抗-HBs ≥ 100 mIU/ml）者T₁时的抗体阳性率（抗-HBs ≥ 10 mIU/ml）和平均抗体浓度（GMC）;通过多因素分析探讨接种剂量与抗体持久性的关系。结果 HepB 5 μg组和10 μg组分别共有1 883名和1 495名观察对象纳入分析,T₁时抗-HBs阳性率分别为49.92%（943/1 883）和75.92%（1 135/1 495）,差异有统计学意义（χ²=237.75,P<0.001）;GMC分别为10.23（95%CI：9.38~11.16）mIU/ml和28.91（95%CI：26.65~31.35）mIU/ml,差异有统计学意义（F=280.36,P<0.001）。10 μg组T₁时抗-HBs阴转者抗-HBs滴度分布与5 μg组的差异有统计学意义（χ²=39.75,P<0.001）。多因素分析显示,排除其他因素影响后,HepB初免剂量与T₁时抗-HBs阳性率和抗-HBs滴度均独立相关[P<0.001,OR=1.44（95%CI：1.20~1.73）;P<0.001,β=0.27（95%CI：0.14~0.40）]。结论 新生儿使用10 μg重组HepB初免后5年抗-HBs持久性优于5 μg重组HepB。     

新疆维吾尔自治区3～9岁汉、维吾尔族儿童腰围和腰围身高比分布特征及其作为肥胖筛查指标的探讨

目的 了解新疆维吾尔自治区(新疆)汉、维吾尔(维)族3～9岁儿童腰围(WC)和腰围身高比(WHtR)分布特征,探讨其作为儿童肥胖筛查指标的价值。方法 采用分层整群随机抽样方法,于2014年4月抽取新疆四地区幼儿园和小学一、二年级汉、维族儿童,测量身高、体重及WC;以WC的性别年龄别第80百分位值(P₈₀)以及WHtR≥0.48为参考值,在BMI正常儿童中筛查可能患有腹型肥胖的儿童。结果 共测量3～9岁儿童4 024名,其中汉族2 461名,维族1 563名;汉、维族儿童WC、WHtR P₅₀和P₈₀数值相近,P₉₅相差明显;BMI正常的汉、维族儿童中存在WC≥P₈₀或WHtR≥0.48的儿童:BMI正常的4～岁汉族男童中,WC≥P₈₀的比例为8.0%,4～岁维族女童中该比例为16.3%; <7岁儿童中WHtR≥0.48的比例在10%以上,随着年龄段增长该比例逐渐下降。结论 新疆汉、维族儿童WC和WHtR分布特征相似,WC和WHtR可用于从BMI正常儿童中筛查超重/肥胖儿童,建议在学龄前儿童超重/肥胖筛查时与BMI联合使用。     

我国18岁及以上成年人尿镍水平与胰岛素抵抗、胰岛功能及糖尿病的关联研究

目的 探讨中国≥18岁成年人体内尿镍暴露与胰岛素抵抗、胰岛功能及糖尿病的关联。方法 从2017-2018年国家人体生物监测项目随机选取糖尿病患者500名为病例组,并按照1∶1的比例选择对照组。采集调查对象尿液和静脉血,检测尿镍及血清中FPG、空腹胰岛素等糖代谢指标,并采用稳态模型评估法计算胰岛素抵抗指数（HOMA-IR）、β细胞功能指数（HOMA-β）和校正HOMA-β。采用多因素logistic回归模型分析尿镍与糖尿病患病风险的关联。采用多元线性回归模型计算尿镍水平与HOMA-IR、HOMA-β和校正HOMA-β的关联。结果 病例组和对照组男女性别比1∶1。多因素logistic回归模型显示,在校正文化程度、吸烟状况、饮酒状况、大米摄入频率、肉类摄入频率、糖尿病家族史、BMI、TC、高血压及尿肌酐水平后,与尿镍水平T₁组相比,T₂、T₃组糖尿病患病的OR值（95%CI）分别为1.36（0.98~1.89）和1.60（1.14~2.24）;多元线性回归模型显示,尿镍水平与HOMA-IR升高存在正向关联,与尿镍水平T₁组相比,T₃组HOMA-IR的β值为0.12（95%CI：0.01~0.25）,且尿镍水平每升高一个log转换单位（2.71 μg/L）,log转换后HOMA-IR的β值为0.06（95%CI：0.02~0.10）。尿镍水平与校正HOMA-β升高存在负向关联,与尿镍水平T₁组相比,T₃组校正HOMA-β的β值为-0.26（95%CI：-0.41~-0.11）,且尿镍水平每升高一个log转换单位（2.71 μg/L）,log转换后校正HOMA-β的β值为-0.09（95%CI：-0.14~-0.04）。结论 中国成年人尿镍暴露与胰岛素抵抗及糖尿病患病风险存在正向关联,与胰岛β细胞功能存在负向关联。     

膳食胆固醇摄入对妊娠期糖尿病的影响

目的 研究妊娠期妇女孕前1年、孕早期、孕中期膳食胆固醇摄入对妊娠期糖尿病的影响。方法 收集2012年3月至2016年9月在山西医科大学第一医院产科住院分娩孕妇的一般人口学特征、妊娠期糖尿病诊断结果及膳食胆固醇摄入情况,根据对照组孕妇不同时期胆固醇摄入的P₂₅、P₅₀、P₇₅将其分为4组。采用非条件logistic回归分析孕前1年、孕早期、孕中期膳食胆固醇摄入量与妊娠期糖尿病的关系,及不同年龄段孕妇膳食胆固醇摄入对妊娠期糖尿病发生的影响。结果 共纳入研究对象9 005人,其中妊娠期糖尿病1 388例。多因素分析结果显示,孕前1年胆固醇摄入量≥ 76.50 mg/d且孕中期摄入量为≥ 46.75 mg/d的孕妇患GDM的风险增加。按年龄分层后,年龄<35岁孕妇的孕前1年和孕中期胆固醇摄入量≥ 76.50 mg/d是妊娠期糖尿病的危险因素（分别为OR=1.336,95%CI：1.083~1.647;OR=1.341,95%CI：1.087~1.654）,孕妇年龄≥ 35岁组未发现膳食胆固醇摄入与妊娠期糖尿病发生有关。结论 妊娠期妇女孕前1年及孕中期膳食胆固醇摄入高均会增加妊娠期糖尿病的发生风险。     

Nutrient intake,body fat,and lipid profiles of competitive male and female bodybuilders.

The purpose of this research was to measure nutrient intake, body fat, [estimated from seven skinfolds: chest, axilla, triceps, subscapular, abdominal, suprailiac, and thigh (Jackson and Pollock, 1985)], total cholesterol (TC), HDL-cholesterol (HDL-C), HDL2-C, and HDL3-C of 19 male and 8 female bodybuilders competing in the National Physique Committee's USA Bodybuilding Championships (Raleigh, NC, April 1988). Casual blood samples and anthropometric data were collected 18 hours prior to competition, whereas 7-day diet records were completed 1 week prior to competition. Only 11 males and 2 females provided blood samples. Competitors were not tested for steroid use. These data are unique because the measurements were collected on site at the competition. Data are presented as means and standard deviations. Estimated body fat for males (6.0 +/? 1.8%) and females (9.8 +/? 1.5%) was quite low. Blood lipids (mg%) for males (TC = 187 +/? 11, HDL-C = 37 +/? 6, HDL2-C = 13 +/? 4, and HDL3-C = 24 +/? 4) were not indicative of increased coronary heart disease (CHD) risk. Data for the 2 females (TC = 190, 205; HDL-C = 56, 56; HDL2-C = 22, 8; and HDL3-C = 34, 48) could only be evaluated on an individual basis. Body fat was significantly correlated with HDL-C (r = 0.63; p = 0.04) and HDL3-C (r = 0.65; p = 0.03), but not TC nor HDL2-C. Of the dietary variables, only saturated fat was significantly correlated with HDL2-C (r = 0.60; p = 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)     

Nutrient intake, body fat, and lipid profiles of competitive male and female bodybuilders

The purpose of this research was to measure nutrient intake, body fat, [estimated from seven skinfolds: chest, axilla, triceps, subscapular, abdominal, suprailiac, and thigh (Jackson and Pollock, 1985)], total cholesterol (TC), HDL-cholesterol (HDL-C), HDL2-C, and HDL3-C of 19 male and 8 female bodybuilders competing in the National Physique Committee's USA Bodybuilding Championships (Raleigh, NC, April 1988). Casual blood samples and anthropometric data were collected 18 hours prior to competition, whereas 7-day diet records were completed 1 week prior to competition. Only 11 males and 2 females provided blood samples. Competitors were not tested for steroid use. These data are unique because the measurements were collected on site at the competition. Data are presented as means and standard deviations. Estimated body fat for males (6.0 +/- 1.8%) and females (9.8 +/- 1.5%) was quite low. Blood lipids (mg%) for males (TC = 187 +/- 11, HDL-C = 37 +/- 6, HDL2-C = 13 +/- 4, and HDL3-C = 24 +/- 4) were not indicative of increased coronary heart disease (CHD) risk. Data for the 2 females (TC = 190, 205; HDL-C = 56, 56; HDL2-C = 22, 8; and HDL3-C = 34, 48) could only be evaluated on an individual basis. Body fat was significantly correlated with HDL-C (r = 0.63; p = 0.04) and HDL3-C (r = 0.65; p = 0.03), but not TC nor HDL2-C. Of the dietary variables, only saturated fat was significantly correlated with HDL2-C (r = 0.60; p = 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)     

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.     

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?     

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.     

Screening for coronary heart disease risk in the elderly: total cholesterol versus high-density lipoprotein-cholesterol.

Despite recent national recommendations to use total cholesterol (TC) measures to screen patients for hyperlipidemia and coronary heart disease (CHD) risk, it is unclear how predictive this approach is for older adults, who tend to have higher high-density lipoprotein-cholesterol (HDL-C) values and therefore higher TC. We looked at lipid profiles of 190 adults with a mean age of 70.8 years (range 51 to 86 years) to determine the value of TC in predicting risk states based on HDL-C. One hundred sixty-two did not have a diagnosis of CHD; 28 had a diagnosis of CHD. Of those subjects without CHD, 13 (8.0%) with a TC under 200 mg/dL were "underscreened" since they had a low HDL-C value under 40 mg/dL. Men were three times more likely to be underscreened on the basis of TC alone. Thirty (18.5%) of the subjects were "overscreened" since they had a TC greater than or equal to 240 mg/dL and a normal HDL-C value greater than 50 mg/dL. Only women were overscreened. For those 28 subjects with CHD, TC values alone also "underscreened" 3 (10.7%) of this cohort, and "overscreened" 3 (10.7%). If a provider decides to screen for hyperlipidemia and CHD risk in older patients, a lipid profile rather than a nonfasting TC test should be ordered. Over 26% of the patients in this study would have been misclassified and inappropriately advised regarding their risk for CHD based on a TC value alone.     

High-density lipoprotein subclass and particle size in coronary heart disease patients with or without diabetes

ABSTRACT: BACKGROUND: A higher prevalence of coronary heart disease (CHD) in people with diabetes. We investigated the high-density lipoprotein (HDL) subclass profiles and alterations of particle size in CHD patients with diabetes or without diabetes. METHODS: Plasma HDL subclasses were quantified in CHD by 1-dimensional gel electrophoresis coupled with immunodetection. RESULTS: Although the particle size of HDL tend to small, the mean levels of low density lipoprotein cholesterol(LDL-C) and total cholesterol (TC) have achieved normal or desirable for CHD patients with or without diabetes who administered statins therapy. Fasting plasma glucose (FPG), triglyceride (TG), TC, LDL-C concentrations, and HDL3 (HDL3b and 3a) contents along with Gensini Score were significantly higher; but those of HDL-C, HDL2b+prebeta2, and HDL2a were significantly lower in CHD patients with diabetes versus CHD patients without diabetes; The prebeta1-HDL contents did not differ significantly between these groups. Multivariate regression analysis revealed that Gensini Score was significantly and independently predicted by HDL2a, and HDL2b+prebeta2. CONCLUSIONS: The abnormality of HDL subpopulations distribution and particle size may contribute to CHD risk in diabetes patients. The HDL subclasses distribution may help in severity of coronary artery and risk stratification, especially in CHD patients with therapeutic LDL, TG and HDL levels.     

冠心病患者餐后血脂、LDL氧化活性的变化

目的：探讨冠心病患餐后血脂代谢情况,方法：对11例冠心病患（冠心病组）和15例健康（对照组）予低脂饮食2周后进食脂肪餐。于餐后、餐后2、4、6、8h采用血,检测血TG、TC、LDL－C、HDL－C、LPO及LDL－C的氧化活性 LPO－LDL－C。结果：冠心病组餐前TG（P＜0．001）、LDL－C（P＜0．01）极显高于对照组,HDL－C（P＜0．001）极显低于对照组,LPO（P＜0．001）、LDL－LPO－C（P＜0．01）均极显高于对照组。冠心病组餐后各点TG（P＜001）极显高于对照组,HDL－C（P＜0．001）极显低于对照组,LPO（P＜0．001）、LDL－LPO－C（P＜0．001）极显高于对照组。多元回归分析表明餐后血脂（TG－AUC）与冠心病发生密切相关。冠心病组餐后8h的TG值（P＜0．005）显高于餐前,餐后各时段LDL－LPO－C（P＜0．001）极显高于餐前,对照组餐后各时段LDL－LPO－C（P＜0．001）极显高于餐前。结论冠心病患存在餐后高血脂、餐后高血脂与冠心病发生密切相关,冠病患餐后LDL－C代谢异常,对氧化剂敏感性增强,脂质过氧化物明显增加。