静脉输注长链及中/长链脂肪乳剂对脂蛋白代谢的影响

目的比较静脉输注长链(LCT)及中长链(MCT/LCT)脂肪乳剂时血浆脂蛋白代谢.方法选择12例健康志愿者进行前瞻性随机交叉对照研究, 连续输注MCT/LCT或LCT6小时(0.20g TG.Kg-1@h-1),测定研究前及输注中4h、6h、8h、12h及24h时血清TG、FFA,PL、FC、CE浓度以及血浆各脂蛋白成份.结果脂肪乳剂输注过程中,MCT/LCT组血清甘油三酯(TG)浓度明显低于LCT组,而血浆FFA浓度约为LCT组的3倍(p<0.001), MCT/LCT 的半衰期明显短于[LCT (68(12)分钟vs.(116(18)分钟,p<0.05].LCT组血浆游离胆固醇浓度明显高于MCT/LCT 组(p<0.05),而血浆胆固醇酯(CE)浓度在研究过程中两组均无明显变化.结论MCT/LCT的水解、代谢清除率要明显高于LCT,MCT/LCT输注时TG与LDL之间转换率较高,脂肪颗粒较少获取CE,其残余颗粒的清除也高于LCT.     

中链甘油三酯饮食对神经肽Y及瘦素的作用研究

目的观察中链甘油三酯(MCT)对血清和下丘脑瘦素、神经肽Y(NPY)浓度,下丘脑长型瘦素受体(Ob-Rb)、mRNA表达的影响。方法20只Wistar雄性大鼠,用含30%MCT或长链甘油三酯(LCT)的饲料喂养8周,用ELISA法测定血清和下丘脑瘦素的水平,用放射免疫法检测外周血和下丘脑NPY的浓度,用real-time RT-PCR技术测定下丘脑NPY、瘦素受体(Ob-Rb)基因表达水平的差异。结果MCT组大鼠体重增长量和体脂含量均小于LCT组(P<0.01),MCT组瘦素脑/血比明显高于LCT组,MCT组大鼠下丘脑ob-Rb mRNA表达水平明显高于LCT组(P<0.01),下丘脑及血清NPY浓度明显低于LCT组(P<0.01)。结论MCT通过促进Ob-Rb基因表达,抑制NPY合成和分泌。     

饮用牛奶和豆浆对健康男性青年血脂的影响

[目的]探讨饮用牛奶和豆浆对健康男性青年血脂的影响. [方法]36名男性健康大学生随机分入牛奶组、豆浆组和矿泉水组,每天饮用相应饮品1000 ml,连续饮用3周.测定干预前后血浆中甘油三酯、胆固醇、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平的变化. [结果]干预后牛奶组的血浆LDL-C水平从(2.27±0.34)mmol/L下降至(1.93±0.44)mmol/L(P<0.05),豆浆组从(2.24±0.29)mmoL/L下降至(1.95±0.36)mmol/L(P<0.05).与矿泉水对照组比较,牛奶组和豆浆组降LDL-C作用更为显著(P<0.01),同时豆浆组的血浆甘油三酯水平也显著降低(P<0.05). [结论]饮用牛奶或豆浆有降血脂作用,从而预防动脉粥样硬化乃至其他心血管疾病.     

孕期血脂水平对妊娠期并发症及子代的影响

目的探讨孕期血脂水平对妊娠期并发症及子代的影响。方法回顾性分析2014年2月至2016年1月于衡水市第二人民医院建档、待产至分娩的200例孕妇的临床资料,包括其孕早期(孕10～12周)、孕晚期(孕36～37周)血清总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、载脂蛋白A(Apolipoprotein A,ApoA)、载脂蛋白B(Apolipoprotein B,ApoB)水平。追踪围产期并发症发生情况,按是否发生妊娠期并发症分为并发症组与无并发症组。比较两组孕期母体血脂水平,并按血脂水平分组,比较不同血脂水平孕妇新生儿状况及母儿并发症发生率。均随访至新生儿出生3个月,测定子代出生4周、12周血糖、血脂水平。结果孕早期、孕晚期孕妇HDL-C、ApoA、ApoB水平比较,差异无统计学意义(P0.05);孕晚期,孕妇TC、TG、LDL-C均上升,与孕早期比较差异有统计学意义(P0.05);200例孕妇围产期发生并发症32例(16.00%),并发症孕妇TC、TG、LDL-C、ApoA均高于无并发症孕妇(P0.05);妊娠期并发症组血脂异常检出率(78.13%)高于无并发症组(11.31%)(P0.05);血脂异常组新生儿出生体质量、巨大儿发生率高于血脂正常组(P0.05);血脂异常组新生儿出生4周、12周TC、TG水平均高于血脂正常组新生儿(P0.05)。结论孕晚期孕妇高血脂可能增加妊娠期并发症及巨大儿发生风险,导致子代血脂代谢异常。     

联合检测血清胰岛素抵抗与脂质代谢相关指标对2型糖尿病合并高血压人群的探讨

目的观察胰岛素抵抗与脂代谢对2型糖尿病(T2DM)合并高血压人群的影响。方法取1 708例健康体检者为对照组(Ⅰ组);1 697例T2DM患者为试验组,其中单纯T2DM 674例(Ⅱ组),T2DM合并高血压1 023例(Ⅲ组),采用全自动生化分析仪测血糖(GLU)、糖化血红蛋白(Hb A1c)、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(LDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB);采用化学发光免疫分析仪测空腹胰岛素(FINS);计算稳态模型胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(HOMA-ISI)、体质量指数(BMI)、血压、DM病史等临床资料。结果与Ⅰ组比较,Ⅱ组、Ⅲ组收缩压(SBP)、舒张压(DBP)及GLU、FINS、Hb A1c、HOMAIR、BMI、TC、TG、LDL-C、LDL-C/HDL-C、TG/HDL-C、ApoB上升;HOMA-ISI、HDL-C、ApoA1、ApoA1/ApoB下降;除HOMA-ISI、HDL-C、ApoA1、ApoA1/ApoB外,其余各指标Ⅲ组与Ⅱ组比较,有上升趋势。结论高血压、胰岛素抵抗、脂代谢紊乱是T2DM合并高血压患者发病的危险因素。     

健康体检人群尿酸水平与糖脂代谢关系

目的分析健康体检人群尿酸与糖脂代谢的关系。方法收集2009年10月在新疆医科大学第一附属医院进行健康体检人员的血液样本1 236份,采用日立7060全自动生化分析仪检测血液生化指标,血尿酸浓度检测采用尿酸酶法。结果男性载脂蛋白A(ApoA)为(1.23±0.139)g/L,女性为(1.32±0.150)g/L;高密度脂蛋白(HDL-C)男性为(1.30±0.23)mmol/L,女性为(1.52±0.338)mmol/L,男性低于女性,而其他指标均高于女性(P<0.05);汉族ApoA、尿素氮(BUN)、肌酐(SCR)、甘油三酯(TG)、HDL-C高于维吾尔族,而维吾尔族载脂蛋白B(ApoB)、总胆固醇(TC)、空腹血糖(FBS)、低密度脂蛋白(LDL-C)高于汉族,统计学分析ApoA、ApoB、TC和LDL-C差异有统计学意义(P<0.05);高尿酸组除了ApoA和FBS外,其他指标均高于正常组(P<0.05);随尿酸水平增高,ApoA和HDL-C有降低的趋势外,其他脂代谢指标均增高,差异有统计学意义(P<0.05);但是尿酸对血糖影响不大;除了低高密度脂蛋白血症,其他代谢紊乱均随尿酸水平增高。结论不同民族和...     

sdLDL-C、TG、ApoA1对冠心病发生的预测价值

目的探究小而密低密度脂蛋白胆固醇(sdLDL-C)、甘油三酯(TG)、载脂蛋白A1(ApoA1)预测冠心病发生的价值。方法选取2019年1月至2020年8月本院收治的121例冠心病患者为观察组,选取同期100例无冠心病的健康体检者为对照组,检测两组sdLDL-C、TG、ApoA1、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B(ApoB)、脂蛋白a(Lpa)水平。比较两组一般资料,探讨sdLDL-C水平与其他血脂水平的相关性,分析冠心病发生的影响因素及sdLDL-C、TG、ApoA1在冠心病发生中的预测价值。结果观察组sdLDL-C、TG、LDL-C、ApoB、Lpa水平高于对照组,ApoA1、HDL-C水平低于对照组,差异均有统计学意义(均P0.05)。sdLDL-C水平与ApoA1、HDL-C呈负相关(均P0.05),与TG、LDL-C、ApoB、Lpa呈正相关(均P0.05)。多因素Logistic回归分析发现sdLDL-C、TG、LDL-C、ApoB、Lpa为发生冠心病的危险因素,ApoA1、HDL-C为保护因素(均P0.05)。经ROC曲线分析显示,sdLDL-C、TG、ApoA1预测冠心病发生的AUC分别为0.825、0.701、0.711。结论 sdLDL-C与其他血脂水平密切相关,sdLDL-C、TG、ApoA1水平可预测冠心病的发生,有临床应用价值。     

南宁市儿童ApoB基因Xba Ⅰ位点多态性分析

目的 研究南宁市126名健康体检儿童载脂蛋白B(ApoB)基因Xba Ⅰ位点各基因型的分布情况,探讨其多态性对儿童生长发育、营养状况、血脂代谢及肾功能的影响.方法 应用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术检测126例健康体检儿童ApoB基因Xba Ⅰ位点的基因型,计算体质指数(BMI),测定血清总蛋白(TP)、白蛋白(AIB)、球蛋白(GLO)、白蛋白/球蛋白(A/G)、脂蛋白a(LPa)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、非高密度脂蛋白胆固醇(non-HDL)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1、(ApoA1)、ApoB、ApoA1/B、尿素氮(BUN)、肌酐(CCr)及尿酸(UA).结果 (1)Xba Ⅰ位点各基因型的频率分别为X-/X-92.06%(116/126),X+/X-7.14%(9/126),X+/X+0.79%(1/126);等位基因X-与X+的频率分别为95.63%和4.37%;(2)等位基因X+组血清TP、AIB、A/G和ApoA1/B显著低于X-组,而BMI、LPa、TC、TG、non-HDL、LDL-C、ApoB、BUN和CCr明显高于X-组.结论 ApoB基因Xba Ⅰ位点多态性对儿童生长发育、营养状况、血脂代谢及肾功能有影响.     

新生儿肝功能障碍时不同脂肪乳剂对血脂和肝功能影响的比较研究

目的 :比较中 /长链和长链脂肪乳剂对肝功能障碍新生儿血脂和肝功能的影响。　方法 :将 40例血清胆红素水平≥ 5 1.3μmol/L(3mg % )的新生儿随机分成两组 ,分别应用中 /长链脂肪乳剂 (MCT/LCT组 ,2 0 %Lipo fundin)和长链脂肪乳剂 (LCT组 ,2 0 %Intralipid) ,剂量均为 2 g/ (kg·d) ,持续 1周。在实验前、后分别抽血测定血脂和肝功能。　结果 :两组总胆固醇无显著变化 ,甘油三酯在LCT组升高 ,在MCT/LCT组下降 ,与实验前相比均无显著差异 ,组间比较MCT/LCT非常显著地低于LCT组。胆红素在两组均显著下降 ,但MCT/LCT组下降比LCT组更加显著。γ GT和ALP在LCT组无明显改变 ,但在MCT/LCT组却有显著降低 ,并显著低于LCT组。　结论 :在危重新生儿合并有肝功能障碍时 ,应用中 /长链脂肪乳剂显著优于长链脂肪乳剂。     

妊娠期肝内胆汁淤积症患者糖脂代谢特点及其围产结局的观察

目的:探讨妊娠期肝内胆汁淤积症(ICP)的糖脂代谢特点及其围产结局。方法:回顾性收集广东省妇幼保健院产检并分娩的ICP患者资料86例,根据ICP发病孕周不同,分为早发型组30例(发病孕周28周),晚发型组56例(发病孕周≥28周),选择同期正常妊娠孕妇60例作为对照组。比较3组的糖脂代谢生化指标及围产结局。结果:ICP组孕妇血清空腹血糖(FPG)、空腹胰岛素(FINS)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、载脂蛋白B(ApoB)水平均明显高于对照组,而高密度脂蛋白(HDL-C)、载脂蛋白A(ApoA)和ApoA/ApoB均低于对照组,差异均有统计学意义(P0.05)。ICP组剖宫产率、早产率、羊水污染发生率、产后出血量、新生儿窒息率等均高于对照组,分娩孕周及新生儿出生体重均低于对照组(P0.05)。在ICP早发型组的FPG、FINS、TG、TC、LDL-C和ApoB水平均高于晚发型组(P0.05),而HDL-C和ApoA/ApoB均低于晚发型组(P0.05)。早发型组早产率、羊水污染率、新生儿窒息率明显高于晚发型组,新生儿出生体重则低于晚发型组,差异均有统计学意义(P0.05)。结论:早发型ICP更易出现糖脂代谢异常及不良围产结局,需引起重视。     

中长链脂肪酸食用油对高甘油三酯血症患者脂代谢的影响——性别反应差异

目的中长链脂肪酸(MLCT)食用油对不同性别的高甘油三酯(TG)血症患者脂代谢的影响。方法101名高TG血症患者随机分为MLCT食用油组(50例)和长链脂肪酸(LCT)食用油组(51例),两组间在性别分配上无显著性差异。控制每日膳食摄入量及食用油摄入量(25～30g/person·d),规定运动方式,实验期8w。分别于研究开始前和8w后进行人体成份测量(身高、体重、体脂肪量等)、腹部CT扫描及血生化指标检测。结果研究结束后,男性MLCT食用油组BMI、TG、ApoB、ApoAⅡ、ApoC2及ApoC3浓度均明显降低,且体重、BMI、腰围、体脂肪重、体脂肪百分比、腹部脂肪总面积、腹部皮下脂肪面积及TG、ApoB、LDL-C、ApoAⅡ、ApoC2、ApoC3和ApoE指标降低的程度明显优于LCT组。女性只有腰臀比指标的降低程度明显优于LCT组,其余各项指标在两组之间均无显著差异。结论在合理膳食条件下,男性高TG血症患者使用MLCT食用油可减轻体重,降低血TG浓度,改善脂蛋白水平,调整脂代谢,而女性效果不明显。     

中长链脂肪酸食用油对高甘油三酯血症患者血脂及脂蛋白水平的影响

目的研究中长链脂肪酸食用油对高甘油三酯血症患者血脂及脂蛋白水平的影响。方法采用临床随机对照法,按随机原则将112例高甘油三酯血症患者分为中长链脂肪酸食用油组和长链脂肪酸食用油组,控制每13膳食摄人量及食用油摄入量（25～30g／d）,推荐每日运动量,分别在研究开始前和8周后,检测两组研究对象的身高、体重、空腹血糖,血清丙氨酰氨基转移酶（ALT）、天冬氨酰氨基转移酶（AST）、总胆固醇、甘油三酯、高密度脂蛋白胆固醇,低密度脂蛋白胆固醇,载脂蛋白A1（ApoA1）、载脂蛋白B（ApoB）、载脂蛋白AⅡ（ApoAⅡ）、载脂蛋白C2（ApoC2）、载脂蛋白C3（ApoC3）及载脂蛋白E（ApoE）。结果进入结果分析者101例,其中长链脂肪酸食用油组50例。中长链脂肪酸食用油组51例。研究开始时两组的体重、血清ALT、AST、总胆固醇、甘油三酯等生化指标的差异均无统计学意义（P〉0．05）。食用中长链脂肪酸食用油8周后,患者的体重及血清甘油三酯、ApoC2、ApoC3水平均显著低于研究开始时（P〈0．05）,而ApoA1显著高于研究开始时（P〈0．05）。研究结束时,中长链脂肪酸食用油组的体重、血清甘油三酯、ApoB、ApoAⅡ、ApoC2及ApoC3水平均显著低于长链脂肪酸食用油组（P〈0．05）。结论合理膳食条件下,中长链脂肪酸食用油可降低高甘油三酯血症患者血脂浓度,改善脂蛋白水平。     

载脂蛋白E基因多态性对肥胖儿童体质指数与血脂的影响

目的 研究载脂蛋白E（ApoE)基因多态性对单纯肥胖儿童体质指数（BMI）与血脂的影响。方法 检测324名8～12岁单纯肥胖儿童的血脂,测量体重和身高,计算BMI,同时使用多聚酶链反应检测他们的ApoE基因型。结果 E3/3是最常见的基因型,ApoE基因型分布为:E3/3 198人（61.1%),E3/4 36人（11.1%),E2/3 54人(16.7%）,E4/4 36人（11.1%）,未检测到E2/2和E2/4两种基因型。在ApoE 3组中,BMI与所有血脂指标呈明显相关。除低密度脂蛋白-胆固醇（LDL-C）、TC、载脂蛋白B(ApoB）外,其他血脂指标与BMI的相关性在其他ApoE组中则不尽相同。在ApoE2组中,BMI与TG呈明显相关,与高密度脂蛋白-胆固醇（HDL-C）、ApoA I无明显相关;在ApoE 4组中,BMI与HDL-C,ApoA I明显相关,而与TG无明显相关。结论 ApoE基因多态性可能对单纯肥胖儿童BMI与血脂的关系有一定影响。     

中长链脂肪酸食用油对高甘油三酯血症患者脂代谢的影响

目的探讨中长链脂肪酸食用油对高甘油三酯血症患者血脂的影响。方法将112名高甘油三酯血症患者分为2组,分别食用中长链脂肪酸食用油和长链脂肪酸食用油,指导每日运动量、热能和食用油摄入量(25～30g/d)。研究开始前和8w后对两组研究对象进行人体测量、血生化检测。结果有11人退出研究,中长链脂肪酸食用油和长链脂肪酸食用油组分别有51人和50人,两组间性别分布没有差别。研究前、第2、4、6、8w,两组间热能、蛋白质、脂肪、碳水化合物和体力活动时间也无差别。与研究前相比,食用中长链脂肪酸食用油8w后体重、BMI、腰围、臀围、腰臀比、体脂肪量、体脂肪百分比等人体测量指标明显降低,而且体重、BMI、腰围、体脂肪、体脂肪百分比降低的程度明显优于长链脂肪酸食用油组。中长链脂肪酸食用油组8w后TG、ApoB、ApoAII、ApoC2、ApoC3水平明显下降,且降低的程度均明显优于长链脂肪酸食用油组。结论合理膳食条件下,中长链脂肪酸食用油可减轻高甘油三酯血症患者体重,降低血甘油三酯水平,改善脂蛋白代谢。     

单纯肥胖儿童载脂蛋白E遗传多态性研究

〖目的〗 探讨单纯肥胖症儿童的载脂蛋白Ｅ（ＡｐｏＥ）遗传多态性对血脂水平和肥胖水平和肥胖程度的影响。〖方法〗 ３９例肥胖儿童禁食１２小时,采静脉血。采用等电聚焦电泳测定ＡｐｏＥ遗传表型、酶法和比浊法测定血脂指标。〖结果〗 单纯肥胶儿童血清ＴＧ、ＴＣ、ＬＤＬ－Ｃ、ＨＤＬ－Ｃ及ＡｐｏＡ１水平明显升高。与ＡｐｏＥ３／３表型相比,ＡｐｏＥ４／３表型血ＴＣ、ＬＤＬ、Ｃ、ＡｐｏＡ１显著增高,ＡｐｏＥ２／３表型     

The influence of dietary medium and long chain triglycerides on growth performances and fat deposition in growing rats.

The present study was undertaken to investigate the effects of dietary medium and long chain triglycerides (MCT and LCT) on fat deposition and fatty acid composition of adipose tissues of rats. Twenty-seven Wistar strain male rats were divided into three groups and fed semisynthetic experimental diets: Basal (AIN 76), MCT (basal+C8:0 10%), LCT (basal+corn oil 10%). Feed intake was measured every day and body weight was measured once a week. At the beginning, 4th and 8th week of experimental feeding, 3, 12, 12 rats were slaughtered, respectively. Liver, perirenal and epididymal adipose tissue pads were weighted and their fatty acid composition was determined. Chemical composition of wholebody carcass was measured. Body weight gain was greater in rats fed the LCT diet than in rats fed the basal and MCT diets. Feed intakes were decreased in rats fed the MCT and LCT diets compared to that of the basal group. Subsequently, when compared to the basal group rats, feed efficiencies in rats fed the MCT and LCT diets were improved at the level of 6 and 14% for 4 weeks, and then 17 and 24% for 8 weeks, respectively. The weight of perirenal and epididymal adipose tissue pads tended to be larger in rats fed the MCT and LCT diets than in the basal group, although not significant. There were not significant differences in wholebody composition among the three groups. But it appeared that in rats fed the MCT diet, moisture content tended to be decreased and crude protein content increased compared to the LCT group rats. Fatty acid composition of the rats fed the LCT diet showed a good reflection of dietary fatty acid composition. Unlike LCT, little of medium chain fatty acid (MCFA) itself were incorporated into liver or adipose tissues. However, it seems that fat deposition of the MCT group was accomplished not by incorporation of dietary fatty acids but by de novo fatty acids synthesis.     

Abstracts of Articles on Energy Metabolism and Obesity

The present study investigates fat deposition, variances of fatty acid (FA) composition, and lipogenic enzyme activities through dietary medium- and long-chain triglyceride (MCT and LCT) supplementation in growing rats. Eighteen male Wistar rats were divided into three groups and fed isocalorically for 4 weeks with control (based on AIN 76), MCT (C8:0 26%), or LCT (corn oil 25%) diets. Compared to the control group with 0.28 +/? 0.01, feed efficiency was lower in the MCT rats and greater in the LCT rats (0.24 +/? 0.01 and 0.33 +/? 0.01, respectively). Weights of perirenal and epididymal adipose tissue pads of the MCT rats were similar to those of the control group, but were significantly lower than those of the LCT group. Whole-body carcass components data of MCT rats showed the decrease in moisture and protein contents compared to those of control and LCT rats. Fat content of LCT rats was 25-30% higher than those of the MCT and control group. Glucose-6-phosphate dehydrogenase, citrate cleavage enzyme, and malic enzyme activities of liver and epididymal adipose tissue were markedly low in LCT rats. In the MCT group, however, lipogenic enzyme activities were not suppressed, and malic enzyme activity was drastically increased. FA composition of whole-body triglycerides and epididymal adipose tissue in MCT rats showed that C16:0 and C16:1 levels were higher than those of the LCT rats. In contrast, FA composition of the LCT group presented high C18:2 content.(ABSTRACT TRUNCATED AT 250 WORDS)     

Dietary medium-chain triacylglycerols suppress accumulation of body fat in a double-blind, controlled trial in healthy men and women.

We investigated the effect of long-term ingestion of dietary medium-chain triacylglycerols (MCT) on body weight and fat in humans. Using a double-blind, controlled protocol, we assessed the potential health benefits of MCT compared with long-chain triacylglycerols (LCT) in 78 healthy men and women [body mass index (BMI) > or = 23 kg/m(2): n = 26 (MCT), n = 30 (LCT); BMI < 23 kg/m(2): n = 15 (MCT), n = 7 (LCT)]. Changes in anthropometric variables, body weight and body fat during the 12-wk MCT treatment period were compared with those in subjects consuming the LCT diet. The subjects were asked to consume 9218 kJ/d and 60 g/d of total fat. The energy, fat, protein and carbohydrate intakes did not differ significantly between the groups. Body weight and body fat in both groups had decreased by wk 4, 8 and 12 of the study. However, in the subjects with BMI > or = 23 kg/m(2), the extent of the decrease in body weight was significantly greater in the MCT group than in the LCT group. In subjects with BMI > or = 23 kg/m(2), the loss of body fat in the MCT group (-3.86 +/- 0.3 kg) was significantly greater than that in the LCT group (-2.75 +/- 0.2 kg) at 8 wk. In addition, in subjects with BMI > or = 23 kg/m(2), the decrease in the area of subcutaneous fat in the MCT group was significantly greater than that in the LCT group at wk 4, 8 and 12. These results suggest that the MCT diet may reduce body weight and fat in individuals (BMI > or = 23 kg/m(2)) more than the LCT diet.     

Randomized Clinical Trial of New Intravenous Lipid (SMOFlipid 20%) Versus Medium‐Chain Triglycerides/Long‐Chain Triglycerides in Adult Patients Undergoing Gastrointestinal Surgery

Background: SMOFlipid 20% is intravenous lipid emulsion (ILE) containing long‐chain triglycerides (LCT), medium‐chain triglycerides (MCT), olive oil, and fish oil as a mixed emulsion containing α‐tocopherol. The aim was to assess the efficacy of this new ILE in gastrointestinal surgery compared with MCT/LCT. Methods: In this prospective study, 40 patients were randomized to SMOFlipid 20% or MCT/LCT (Lipovenoes 20%) group. Clinical and biochemistry data were collected. Inflammatory markers (CRP, IL‐6, IL‐10, TNF‐α, TGF‐β1) and oxidative stress (ROS and superoxide) were measured. Results: Thirty‐five patients (17 males and 18 females) with a mean age of 57 years completed the study. The patients’ demographic characteristics (age, gender, height, body weight, and BMI) were similar without significant differences between groups. The increment of triglyceride on day 6 from baseline was significantly lower in SMOFlipid group than in Lipovenoes MCT/LCT group. Inflammatory markers, as well as superoxide radical and total oxygen radical were not different between groups. Conclusions: Despite the comparable effect on inflammatory response, because of its well‐balanced fatty acid pattern, relatively low n‐6:n‐3 ratio, and high vitamin E content, SMOFlipid had a better triglyceride‐lowering effect as compared with MCT/LCT in adult patients undergoing gastrointestinal surgery.     

载脂蛋白A1、B检测在肝硬化并发肝性脑病预后判断中的意义

目的探讨载脂蛋白A1、B(Apo A1、Apo B)在肝硬化并发肝性脑病时的变化及其动态检测的意义。方法检测128例肝硬化组患者,健康体检组96例的Apo A1、Apo B。比较肝硬化组与健康体检组、肝硬化并发肝性脑病组与未并发肝性脑病组Apo A1、Apo B的变化。对27例并发肝性脑病的肝硬化患者治疗2周后行治疗前后Apo A1、Apo B的配对分析。结果肝硬化患者与健康体检组、肝硬化并发肝性脑病与未并发肝性脑病组比较,Apo A1、Apo B均下降,其差别有统计学意义(P<0.01及P<0.01,P<0.01及P<0.05)。27例并发肝性脑病的肝硬化患者治疗2周后好转者Ap0 A1上升(P<0.01),恶化者下降(P<0.05);Apo B治疗前后差异无统计学意义。结论(1)Apo A1、Apo B的降低同肝硬化肝功能受损相关。(2)并发肝性脑病(HE)时肝功能损害加重Apo A1、Apo B进一步下降。测定Apo A1、Apo B能初步反映HE时肝功能受损的情况。(3)Apo A1和Apo B动态检测有助于判断肝性脑病患者预后,以Apo A1更为敏感,与临床相结合有助于对肝性脑病的诊断及治疗。