ApoB100／ApoA1比值对老年冠心病患者经皮冠状动脉介入治疗后的预测作用

目的探讨ApoB100／ApoAl比值对于老年冠状动脉粥样硬化性心脏病（冠心病）患者在经皮冠状动脉介入（percutaneouscoronaryintervention,PCI）治疗后心血管事件的预测价值。方法人选2009年9月至2012年5月在广东省人民医院住院首次确诊为冠心病并行支架植入的年龄大于或等于65岁的患者271例为研究对象。根据载脂蛋白（apoprotein,Apo）B100／ApoAl比值的平均值（0．76）分为高比值组（n=127）和低比值组（n=144）;根据低密度脂蛋白胆固醇（10wdensitylipoproteincholesterol,LDL—C）浓度（2．06mmol／L）是否达标,分为达标组（n=213）和非达标组（n=58）;根据血运是否完全重建分为完全重建组（n=158）和不完全重建组（n=113）。术后均按要求进行冠心病二级预防．阿司匹林及氯吡格雷双联抗血小板药物服用一年,常规服用他汀类降脂药物,进行一年的电话随访。分析患者心血管事件（死亡、卒中、再血管化、再住院）的发生情况,根据年龄、脂蛋白（a）、高密度脂蛋白胆固醇（highdensitylipoproteincholesterol,HDL—C）、LDL．C、ApoB100、ApoAl、ApoB100／ApoAl、LDL—C／HDL—C、总胆固醇／HDL．C、non—HDL—C的水平分为高低两组,作为自变量,心血管事件的总体发生情况以及各个亚组为因变量,进行Logistic回归分析。结果在再血管化方面,ApoB100／ApoAl高比值组的发生率高于低比值组,两者问比较差异有统计学意义（11．02％VS．2．78％,P〈O．01）。在不完全血运重建患者中,ApoBl00／ApoAl高比值组再血管化发生率高于低比值组,差异有统计学意义（16．39％口53．85％,P=0．036）。Logistic回归分析结果显示,总体心血管事件的发生和各单个事件的发生与年龄、脂蛋白（a）、HDL．C、LDL—C、ApoB100、ApoAl、ApoB100／ApoAl、LDL—C／HDL—C、总胆固醇／HDL—C、non—HDL—C无统计学的相关性。结论Ap08100／ApoAl作为一个脂蛋白相关的指标,在预测老年人PCI治疗后心血管事件的发生有一定的价值,尤其是在不完全血运重建患者再血管化方面。     

载脂蛋白B/载脂蛋白A1及相关血脂指标对冠心病经皮冠状动脉介入治疗术预后的预测价值

目的探讨冠心病经皮冠状动脉介入治疗（percutaneous transluminal coronary, PCI）术后载脂蛋白B/载脂蛋白A1（ApoB/A1）比值及相关血脂指标的变化,及其对术后心脏事件的预测价值。 方法收集2013年5月至2014年8月在晋中市第一人民医院行PCI的老年患者117例,根据服用降脂药物的种类分为阿托伐他汀组（71例）、辛伐他汀组（46例）。观察比较两组患者术前及术后1、6、12个月的总胆固醇（TC）、LDL-C、HDL-C水平及ApoB/ApoA1、TC/HDL比值的变化情况,并分析其与12个月内发生心脏事件（再发心绞痛、心肌梗死、心源性猝死、再次血管重建术、死亡）的相关性。组间不同时点的比较以及趋势性和交互作用均采用重复测量方差分析,预后分析采用受试者工作特征曲线下面积（AUC）。 结果出院后1个月内不良事件发生率为4.3%（5/117）,出院后1～6个月不良事件发生率为6.0%（7/117）,出院后6～12个月不良事件发生率为12.0%（14/117）。两组患者LDL-C、HDL-C、TC水平及ApoB/ApoA1比值、TC/HDL-C比值的变化均为线性趋势（F=53.878、134、10.364、52.852、64.523,P<0.05或0.01）,而且随访期间两组患者LDL-C、HDL-C、TC水平均处于正常范围。术后1个月,各项血脂指标对于判断PCI术后预后的意义不大,但ApoB/ApoA1比值较其他血脂指标对术后预后判断价值更大（AUC=0.43,最接近0.05）;术后6、12个月ApoB/ApoA1比值较其他血脂指标对术后预后判断价值也更大（AUC=0.709、0.010,均P<0.05）。 结论PCI术后ApoB /ApoA1比值与心脏事件的发生相关,相对于其他血脂指标预测价值更大,而且随着时间的延长其预测性越来越准确。     

首诊老年高血压患者血脂水平分析

目的:探讨老年高血压患者的血脂水平特点。方法:首诊老年高血压患者常规化验总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB),以健康体检老年人为对照组,两组进行比较。结果:高血压组TC、TG、LDL-C、ApoB水平较对照组显著升高(P<0.05~<0.001),ApoA1、HDL-C较对照组显著降低(P<0.05~<0.001)。高血压组的血脂水平不受年龄、性别和高血压分级的影响。结论:老年高血压患者血脂水平存在明显异常,但血脂水平与年龄、性别、血压无关。     

Apolipoprotein A1 is a stronger prognostic marker than are HDL and LDL cholesterol for cardiovascular disease and mortality in elderly men

The aim of this study was to compare apolipoprotein A1 (ApoA1) and B (ApoB) with high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) as markers for cardiovascular mortality and morbidity in elderly men. We analyzed serum ApoA1, ApoB, total cholesterol, HDL-C, and LDL-C in a group of 77-year-old men (n = 785). The results were correlated with data from the Swedish cause of death registry. Receiver-operating characteristic curves showed that, of the studied serum markers, ApoA1 was the best predictor for ischemic heart disease mortality (area under the curve = 0.724, 95% confidence interval, 0.691-0.755). There were also significant correlations between the apolipoproteins and other known risk markers for cardiovascular disease such as triglycerides, high-sensitivity C-reactive protein (hsCRP), and cystatin C. Serum ApoA1 is a better risk marker than are ApoB, ApoB/ApoA1 ratio, HDL-C, and LDL-C for cardiovascular disease and mortality in elderly men.     

Interactions of the apolipoprotein A5 gene polymorphisms and alcohol consumption on serum lipid levels

Objectives Apolipoprotein(Apo) A5 gene poly-morphisms and alcohol consumption have been associated with increased serum triglyceride(TG) levels,but little is known about their interactions on serum lipid levels.The present study was undertaken polymorphismsand alcohol consumption on serum lipid levels.Methods A total of 516 unrelated nondrinkers and 514 drinkers aged 15 -89 were randomly selected from our previous stratified randomized cluster samples.Genotyping of the ApoA5was performed by polymerase chain reaction and restriction fragment length polymorphism,and then confirmed by direct sequencing.Interactions of the ApoA5alcohol consumption were assessed by using a cross-product term between genotypes and the aforementioned factor.Results The levels of total cholesterol (TC),TG,high-density lipoprotein cholesterol(HDL-C), ApoA1 and ApoB were higher in drinkers than in nondrinkers (P<0.05-0.001).The genotypic and allelic frequencies of the three single nucleotide polymorphisms(SNPs) were not different between the two groups.The levels of TG in non-drinkers, and TC,TG,low-density lipoprotein cholesterol (LDL-C)and ApoB in drinkers were different among the three -1131T>C genotypes(P<0.05-0.001).The -1131C allele carriers had higher serum TC,TG,LDL-C and ApoB levels than the allele noncarriers.The levels of TG,HDL-C and ApoB in nondrinkers,and TG and HDL-C in drinkers were different between the two c.553G>T genotypes(P<0.05-0.01).The C.553T allele carriers had higher serum TG and ApoB levels,and lower HDL-C levels than the allele noncarriers.Serum lipid levels in nondrinkers were not different among the three c.457G>A genotypes(P<0.05 for all), but the levels of HDL-C,LDL-C,ApoA1 and ApoB in drinkers were different between the GG and GA/AA geno-types (P<0.05-0.001).The C.457A allele carriers had lower serum HDL-C,LDL-C,ApoAl and ApoB levels than the allele noncarriers.We also observed four haplotypes:G-G-T, G-G-C,G-A-T,and T-G-C with frequencies ranging from 0.06 to 0.87,representing 100%o     

冠心病合并代谢综合征患者血脂特点及其与冠脉病变程度的关系

目的：探讨冠心病合并代谢综合征（MS）患者血脂特点及MS对冠脉病变程度的影响。方法：冠状动脉造影确诊为冠心病的患者258例,分为MS以及非MS组,计算其gensini评分并测定血清脂质谱以及其他相关危险因素,评价冠心病合并MS患者血脂特点及其与冠脉病变严重程度的关系。结果：冠心病合并MS组与不合并MS组患者比较,冠脉病变的程度和范围均明显加重（P〈0．01）．MS组血浆甘油三酯（TG）、总胆固醇（TC）、载脂蛋白B（ApoB）以及ApoB／A1比值较未合并MS组的明显增高（P〈0．05～〈0．01）．高密度脂蛋白-胆固醇（HDL-C）显著低于对照组（P〈0．01）,而ApoA1以及低密度脂蛋白-胆固醇（LDL-C）并无显著差异,操作特征曲线（ROC）的曲线下面积（AUC）最大者为TG（0．732）,其次为ApoB、LDL-C／HDL-C、HDL-C以及ApoB／ApoA1。结论：冠心病合并MS患者存在多种脂质参数异常,与冠状动脉损伤范围以及狭窄密切相关．TG、TC、HDL-C以及ApoB是评价MS较好的脂质参数。     

雌激素替代疗法对绝经后冠心病患者及正常妇女的影响

目的观察雌激素治疗绝经后冠心病患及正常妇女体内血脂、血小板聚集率、氧自由基及纤溶活性变化。方法选５３例绝经后妇女冠心病患为冠心病组,４２例绝经后健康妇女为正常对照组,每组病例再单盲随机分为治疗组和安慰剂组,治疗组予尼尔雌醇（每月４ｍｇ／次）治疗６个月,安慰剂组予安慰剂治疗,观察治疗前后患雌激素水平及血脂各项指标、血小板聚集率、氧自由基和纤溶活性变化。结果冠心病组雌激素水平低于正常对照组（Ｐ＜     

高脂血症与血清载脂蛋白含量关系的研究

目的　探讨高脂血症与载脂蛋白的关系。方法　对杭州市 6 6 9名高脂血症患者和 2 6 2名健康人 ,用全自动生化分析仪测定TC、TG、HDL -C、LDL -C、ApoAⅠ、AⅡ、B、CⅡ、CⅢ、E。结果　与健康对照组比较 (1)高胆固醇血症组 ,HDL -C、LDL -C明显升高 (P <0 0 1) ,各类载脂蛋白均升高 ,尤以ApoAⅠ升高最明显。 (2 )高甘油三酯血症组 ,HDL-C低于正常对照组 (P <0 0 1) ,LDL -C无显著性差异 (P >0 0 5 ) ,ApoAⅠ降低 (P <0 0 1) ,ApoB、ApoCⅡ、ApoCⅢ、ApoE均有明显升高 (P <0 0 1)。 (3)混合型高脂血症组 ,LDL -C升高 (P <0 0 1) ,ApoAⅡ、ApoB、ApoCⅡ、ApoCⅢ、ApoE升高最明显 (P <0 0 1)。结论　高脂血症ApoAⅡ、B、CⅡ、CⅢ、E水平均升高 ;高胆固醇血症ApoAⅠ、B和HDL -C、LDL -C可同时升高 ;ApoCⅢ是高甘油三酯的重要影响因素 ;混合型高脂血症高甘油三酯伴LDL -C/HDL -C比值升高 ,可视为CHD的高危人群     

瑞舒伐他汀对冠心病患者LDL-C/HDL-C、ApoA1/ApoB100和hs-CRP的影响

目的 研究瑞舒伐他汀对冠心病患者LDL-C/HDL-C、ApoA1/ApoB100和hs-CRP的影响及其安全性.方法 入选100例冠心病患者,随机分为辛伐他汀组（40 mg/d）48例和瑞舒伐他汀组（10 mg/d）52例,用药前和用药后8周末分别监测血清中的血脂参数、LDL-C/HDL-C、ApoA1/ApoB100和hs-CRP的浓度及肝肾功能,比较两组治疗前、后及两组治疗后各指标的差异.结果 ①两组治疗前后比较,血脂水平、LDL-C/HDL-C、ApoA1/ApoB100和hs-CRP均有明显变化（P＜0.05）,差异有统计学意义.②瑞舒伐他汀组治疗后的LDL-C、HDL-C、ApoBl00、LDL-C/HDL-C、ApoA1/ApoB100差异较辛伐他汀组明显（P＜0.05）,且有统计学意义.③两组不良反应少,安全性好.结论 对于冠心病患者,瑞舒伐他汀有更好的调脂疗效,且安全性与辛伐他汀相似.     

通心络胶囊对冠心病患者血脂及内皮素的影响

目的观察通心络胶囊对冠心病伴高脂血症患者血脂、内皮素的影响。方法将60例冠心病伴高脂血症患者随机分为治疗组(30例)和对照组(30例),两组基础治疗相同,治疗组在对照组基础治疗上加服通心络胶囊,治疗四周后观察两组患者血脂、内皮素及临床症状的变化。结果与对照组比较,治疗组在降低总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、内皮素(endothelin,ET)、载脂蛋白B(ApoB)、脂蛋白(a)[Lp(a)]和升高载脂蛋白A(ApoA)/ApoB比值方面疗效更为显著,两组升高高密度脂蛋白胆固醇(HDL-C)的疗效相似。结论通心络胶囊可有效调节冠心病伴高脂血症患者血脂水平,改善内皮功能。     

长期血液透析和腹膜透析患者血脂水平及其相关因素分析

目的：观察血液透析和腹膜透析对终末期肾衰竭患者血脂的影响及相关因素。方法：血透患者36例，腹透(CAPD)患者25例，对照组35例，分别检测开始透析时及透析后12个月时的血脂、血浆白蛋白、血清肌酐(Scr)水平。结果：腹透组患者12个月后血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、极低密度脂蛋白胆固醇(VLDL-C)、载脂蛋白B(ApoB)及脂蛋白(a)[Lp(a)]较透析前明显增高，HDL-C、ApoA1较透析前明显降低；血透组患者12个月后HDL-C明显降低；二组患者透析前ApoA1明显低于对照组，ApoB、Lp(a)明显高于对照组，二组患者透析前均有明显的低蛋白血症，透析后血浆白蛋白明显降低，腹透患者尤其显著。血浆白蛋白水平与血脂呈显著相关。结论：尿毒症患者透析前即存在血脂异常，透析治疗并不能消除高脂血症，甚至加重高脂血症，以腹透患者明显。营养不良、低蛋白血症是透析患者高脂血症的主要致病因素。     

外周血血脂水平与老年性白内障相关性研究

目的 探讨外周血血脂水平与年龄相关性白内障(age-related cataract,ARC)的相关性.方法 采用回顾性病例对照设计,选取2018年1月-2019年12月于复旦大学附属眼耳鼻喉科医院就诊并确诊为ARC的患者280例作为观察组,其中男性140例,女性140例.同时选取同期217例正常健康体检者作为对照组,...     

老年冠心病患者血清脂质和脂质过氧化物测定的临床意义

本文观测了４４例老年冠心病患者血清脂质，丙二醛和超氧化物歧化酶，并与健康老年人对照比较，结果显示除胆固醇外其余各项指标２组间均有显著差异，老年ＣＨＤ组ＭＤＡ明显高于对照组，而ＳＯＤ则与之相反。多元回归分析表明，血清低密度脂蛋白胆固醇，而血清高密度脂蛋白胆固醇与ＳＯＤ呈显著正相关。提示老年ＣＨＤ患者高脂血症与脂质过氧化间有一定关系，它对判断老年ＣＨＤ的病情及预后有重要参考意义。     

老年男性ApoA／ApoB与代谢综合征及其各组分相关性研究

目的探讨老年男性中载脂蛋白A／载脂蛋白B（ApoA／ApoB）与代谢综合征（metabolic syndrome，MS）及其相关组分的关系。方法采用横断面调查方法，选取2006年6月至2006年12月在我科进行体检的具有完整资料的老年男性共1729人，平均年龄（73．94±6．77）岁。测量身高、体质量、腰围、血压、血糖、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、ApoA、ApoB、ApoA／ApoB。根据ApoA／ApoB四分位值将人群分为4组，以Logistic回归分析ApoA／ApoB与MS及其组分的关系。结果（1）中心性肥胖、高TG、低水平HDL-C、高血糖、MS患病率随着ApoA／ApoB降低而逐渐升高（P〈0．01）。（2）有代谢异常患者ApoA／ApoB水平较无代谢异常者低（P〈0．01）。（3）ApoA／ApoB水平随代谢异常组分增多而降低（P〈0．01）。（4）ApoA／ApoB下四分位组发生MS是ApoA／ApoB上四分位组的4．126倍（P〈0．01）。去除高血脂影响后，ApoA／ApoB下四分位组发生MS是ApoA／ApoB上四分位组的2．651倍（P〈0．01）。结论ApoA／ApoB与MS及其相关组分有密切的关系，MS、代谢异常者ApoA／ApoB较低。而低ApoA／ApoB也较易出现MS。ApoA／ApoB对MS的影响是独立于TC、TG、HDL-C、LDL-C之外的。     

冠状动脉病变与血脂代谢异常的相关性

目的　探讨冠状动脉病变与血脂代谢紊乱的关系。方法　将2 6 7例疑似冠心病的患者依据冠状动脉造影结果分为对照组(非冠心病组) 1 0 1例,冠心病组1 6 6例,其中单支病变组54例,双支病变组6 8例,三支病变组4 4例,同时测定并统计分析血脂各成分及其比值与冠状动脉病变之间的关系。结果　冠心病(CHD)组总胆固醇(TC)、低密度脂蛋白胆固醇(LDL- C)、甘油三脂(TG)水平明显高于对照组,高密度脂蛋白胆固醇(HDL C)水平明显低于对照组,差异有统计学意义。随着冠状动脉病变范围的增加,TC、LDL C、载脂蛋白B(ApoB)、TC HDL- C、LDL- C HDL- C升高,HDL- C降低,与对照组比较,差异有统计学意义。冠心病组血脂各组分和其比值与冠状动脉积分的相关分析表明,TC HDL- C、LDL -C HDL -C与冠状动脉病变的相关性最强。结论　血脂代谢紊乱的严重程度与冠状动脉病变的严重程度是一致的,通过异常的血脂代谢有可能初步预测冠状动脉病变,其中LDL- C HDL- C、TC- HDL C比值优于其他血脂指标。     

Association of the ApoB/ApoA-I ratio with stroke risk: Findings from the China Health and Nutrition Survey (CHNS)

Background and aimsStudies on associations of apolipoprotein B (ApoB), apolipoprotein A-I (ApoA-I) and the ApoB/ApoA-I ratio with stroke risk are scarce. We aimed to prospectively examine the associations of the ApoB/ApoA-I ratio and other lipid profiles with the risk of stroke using data from the China Health and Nutrition Survey (CHNS).Methods and resultsA total of 7318 participants without stroke at baseline in 2009 were included in the final analysis and followed for a median of 6.1 years. The serum lipid profiles including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), ApoA-I, and ApoB were measured at baseline. Multivariable Cox proportional hazards models were used to evaluate the associations between these parameters and stroke risk. The ApoB/ApoA-I ratio was positively associated with incident stroke, yielding adjusted hazard ratio (HR) of 1.32 (95% CI: 1.09–1.59, P = 0.004). In comparison, ratio of ApoB and ApoA-I containing lipoproteins, the non-HDL-C/HDL-C ratio, possessed relatively weaker association with incident stroke (HR: 1.24, 95% CI: 1.01–1.52, P = 0.036). Furthermore, the risk associations for the ApoB/ApoA-I and non-HDL-C/HDL-C ratios were prominent among those participants aged >51, body mass index ≤23, or female. There were no significant associations of other lipids and their ratios with the stroke risk.ConclusionsHigher ApoB/ApoA-I ratio was associated with an increased risk of stroke. Our findings suggest that the ApoB/ApoA-I ratio may serve as a better risk indicator of stroke than other lipid profiles and their ratios.     

不同糖耐量人群血清载脂蛋白A5的变化及其与糖脂代谢异常的相关性

目的 探讨不同糖耐量人群HbA1c与载脂蛋白A5 （ApoA5）及血脂的关系. 方法 将研究对象分为T2DM组98例、IGR组87例及糖耐量正常组（NGT） 100名.比较各组HbA1c、ApoA5、TC、TG、LDL-C和HDL-C水平. 结果 T2DM、IGR组HbA1 c,TC,TG,LDL-C高于NGT组,ApoA5、HDL-C低于NGT组（P＜0.05）;T2DM组HbA1 c,TC,TG,LDL-C高于IGR组,ApoA5、HDL-C低于IGR组（P＜0.05）.糖耐量异常程度与血浆ApoA5呈负相关,ApoA5与TC,TG,LDL-C,HbA1c,HOMA-IR,BMI和WHR呈负相关,与HDL-C及HOMA-β呈正相关. 结论 ApoA5可能是HbA1c与脂代谢异常的预测指标.     

血脂指标动态变化与冠心病患者择期经皮冠状动脉介入术后非靶血管病变进展的关系研究

背景冠心病(CHD)患者采用经皮冠状动脉介入治疗(PCI)具有确切效果,但存在靶血管支架再狭窄和非靶血管病变进展问题。目的探讨血脂指标动态变化与CHD患者择期PCI后非靶血管病变进展的关系。方法选取2017年1月-2019年5月空军军医大学第一附属医院心内科择期PCI后二次入院的CHD患者150例,根据非靶血管病变进展情况分为进展组45例和无进展组105例。比较两组患者性别、年龄、民族(包括回族、汉族)、吸烟情况、既往史(高血压、糖尿病)、CHD家族史、体质指数(BMI)、随访时间及syntax积分及第1次入院、第2次入院血脂指标〔包括总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、非高密度脂蛋白胆固醇(non-HDL-C)、TG/HDL-C及non-HDL-C/HDL-C〕;CHD患者择期PCI后非靶血管病变进展的影响因素分析采用多因素Logistic回归分析;绘制受试者工作特征(ROC)曲线以评价non-HDL-C对CHD患者择期PCI后非靶血管病变进展的预测价值。结果进展组患者女性比例、糖尿病发生率、syntax积分高于无进展组,第1次入院TC、TG、non-HDL-C低于无进展组,两次入院TC、TG、LDL-C、non-HDL-C、TG/HDL-C、non-HDL-C/HDL-C差值高于无进展组(P<0.05)。多因素Logistic回归分析结果显示,性别〔OR=0.302,95%CI(0.122,0.751)〕、糖尿病〔OR=2.946,95%CI(1.222,7.102)〕、non-HDL-C动态变化〔OR=1.900,95%CI(1.131,3.192)〕、TG/HDL-C动态变化〔OR=1.506,95%CI(1.024,2.215)〕是CHD患者择期PCI后非靶血管病变进展的独立影响因素(P<0.05)。ROC曲线分析结果显示,non-HDL-C动态变化与TG/HDL-C动态变化预测CHD患者择期PCI后非靶血管病变进展的曲线下面积(AUC)比较,差异无统计学意义(P>0.05)。结论 non-HDL-C动态变化、TG/HDL-C动态变化是CHD患者择期PCI后非靶血管病变进展的独立影响因素,且其对CHD患者择期PCI后非靶血管病变进展有一定的预测价值。     

The relationship between high-sensitivity C-reactive protein and ApoB, ApoB/ApoA1 ratio in general population of China

Inflammatory biomarker high-sensitivity C-reactive protein (hsCRP) is considered as a major predictor of cardiovascular events. Apolipoprotein B (ApoB) directly reflects the number of plasma atherogenic lipoproteins, and may play a major role in vascular inflammation. We aimed to assess whether an association between ApoB and hsCRP exists and, furthermore, to examine whether ApoB is more predictive of the inflammatory status than other cardiovascular risk factors. This was a cross-sectional study, with 511 apparently healthy adult subjects enrolled. Waist circumference (WC), body mass index (BMI), and blood pressure (BP) were measured. Plasma glucose levels, hsCRP, lipid profile, and insulin were collected after 10-14 h fasting. From the lowest to the highest quartile of hsCRP, the values for BMI, WC, BP, HOMA-IR, insulin, glucose level, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), ApoB and the ApoB/apolipoprotein A1 (ApoA1) ratio were increased as the hsCRP level increased (P < 0.01), and high-density lipoprotein cholesterol (HDL-C) and ApoA1 levels declined as hsCRP level increased (P < 0.0001). Pearson's correlation analysis demonstrated that hsCRP correlated with all variables (P < 0.01), except for total cholesterol (TC) (P = 0.154) and LDL-C (P = 0.087). According to forward stepwise regression analysis with hsCRP as the dependent variable, WC was the only variable entered the regression model. ApoB level correlated with hsCRP level but was not the major determinant of hsCRP. WC was stronger than other cardiovascular risk factors in the associations with hsCRP. Abdominal obesity rather than atherogenic dyslipidemia was the primary cause of chronic inflammatory status.     

The role of lipid profile in determining the risk of ischemic stroke in the elderly: a case-control study

In this study, we investigated the association of lipids with ischemic stroke and its different subtypes in elderly patients. In particular, lipid parameters not extensively investigated so far in previous case-control studies specifically focused in the old population, such as lipoprotein Lp (a) and Apoproteins AI (ApoAI) and B (ApoB), have been taken into account. Seventy nine patients (mean age 83 +/- 7.4, range 67-99), consecutively admitted to a Geriatric Ward between January 1998 and June 2000 with acute stroke (first event) were studied. A complete clinical and laboratory assessment, including neurological evaluation, head CT scan, carotid ultrasonography and ECG, was employed to define the clinical and etiologic stroke subtype, according to standardized criteria. Fasting blood samples were collected within 48 h from admission, for determination of total cholesterol (TC), triglycerides (TG), High Density Lipoprotein-cholesterol (HDL-C), Lp(a), ApoAI and ApoB; Low Density Lipoprotein-Cholesterol (LDL-C) was estimated by Friedwald formula. Eighty eight age and sex-matched outpatients, referred to the hospital for non-inflammatory disorders of joints and musculoskeletal system, served as controls. Patients showed HDL-C and HDL-C/ApoAI ratio significantly lower than controls, with higher LDL-C/HDL-C ratio. Analysis on quartiles of lipoprotein concentrations showed also a significant increase in odds of stroke for LDL-C concentrations over 100 mg/dl, in absence of a linear relationship between LDL-C levels and risk. Multiple logistic regression, adjusting for non-lipid risk factors for stroke, confirmed the independent association of low HDL-C and HDL-C/ApoAI with all strokes, as well as with each subtype. In conclusion, these data suggest that lipids give some contribution to stroke risk even in the elderly, with a more prevalent role for HDL than LDL, and that lipid profile assessment must be taken into account in estimating the individual risk of stroke.