464例体检者体质量、血脂、血糖、尿酸结果分析

目的调查研究464例体检者体质量、血脂、血尿酸、血糖的水平及其关系,为制定合理的预防心脑血管疾病和糖尿病的措施提供参考依据。方法对464例体检者资料进行整理分析,按性别、年龄分组比较体质量指数（BMI）和血脂、血尿酸、血糖的水平及相关关系;按BMI分为肥胖组和非肥胖组,比较两组之间血脂、血尿酸、血糖的水平;进一步按性别、BMI比较两组之间血脂、血尿酸、血糖的水平。结果在464例体检者中男性血清尿酸显著高于女性,差异有统计学意义（P〈0.01）。血脂、血糖不同性别,不同年龄之间也有差异。肥胖组的血脂、血尿酸、血糖的水平显著高于非肥胖组,差异有统计学意义（P〈0.01）,BMI与血脂、血糖、血尿酸、年龄之间呈正相关,差异有统计学意义（P〈0.01）。男性肥胖者比例高于女性,差异有统计学意义（P〈0.01）。结论肥胖影响血脂、血尿酸、血糖代谢,降低体质量对预防心脑血管疾病和糖尿病有重要意义。     

血清非高密度脂蛋白胆固醇水平对冠心病的临床诊断价值

目的：探讨血清非高密度脂蛋白胆固醇以及载脂蛋白B水平对冠心病的临床应用价值。方法检测118例冠心病（CHD）患者血清三酰甘油（TG）、总胆固醇（TC）、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（apoAl）和载脂蛋白B（apoB）水平,并计算出非高密度脂蛋白胆固醇（non-HDL-C）及apoB/apoA1比值,分析各血脂指标与冠心病的关系。结果 CHD患者血清TG、non-HDL-C和apoB/apoA1比值均高于对照组（P〈0.01）,HDL-C和apo Al水平均低于对照组（P〈0.01）,差异有统计学意义。 HDL-C和apoA1的诊断灵敏度明显高于TC和LDL-C,而non-HDL-C、apoB以及apoB/apoA1的特异度均较高。结论血清non-HDL-C及apoB/apoA1比值的升高与心血管事件发生危险性明显正相关,其预警价值高于传统指标LDL-C和TC,与冠状动脉粥样硬化病变关系密切,尤其对于LDL-C和TC已经达标者控制其non-HDL-C和apoB水平在冠心病的防治中有重要意义。     

糖尿病合并脑梗死与血脂异常相关性的临床观察

目的观察糖尿病合并脑梗死与血脂异常的相关性。方法分析66例糖尿病患者和30例正常对照的血糖和血脂。结果糖尿病无血管并发症组与对照组的血脂比较,仅有甘油三酯(TG)、载脂蛋白B(apoB)升高,载脂蛋白A-Ⅰ(apoA-Ⅰ)、apoA-Ⅰ/apoB下降有显著性差异(P<0.05),其他血脂改变无显著性差异;糖尿病合并脑梗死组与对照组比较,血脂及脂蛋白改变均有非常显著性差异(P<0.01);糖尿病合并脑梗死组与无血管并发症组比较,空腹血糖(FBG)、糖化血红蛋白(HbA1c)、TG、低密度脂蛋白胆固醇(LDL-ch)、apoB、apoA-Ⅰ/apoB、脂蛋白a(LPα)等有显著性差异(P<0.05),其中LPα升高、病程延长更显著(P<0.01)。结论糖尿病患者脑梗死的发生与血脂异常具有一定的相关性。     

血清AngⅡ、apoB/apoA-1联合endocan对高血压患者并发冠心病的预测价值

目的 探讨血清血管紧张素Ⅱ(AngⅡ)、载脂蛋白B与载脂蛋白A-1比值(apoB/apoA-1联合人血管内皮细胞特异性分子(endocan)对高血压患者并发冠心病的预测价值。方法 选择2019年4月至2021年12月期间新疆维吾尔自治区人民医院收治的50例高血压合并冠心病的住院患者,设为高血压合并冠心病组;另选取同期本院收治的48例单纯高血压的住院患者,设为单纯高血压组。收集所有患者的基线资料(年龄、性别、吸烟等)和实验室检测指标[收缩压(SBP)、舒张压(DBP)、甘油三酯(TG)、血清AngⅡ、apoB/apoA-1、endocan等]。采用单因素和多因素Logistic回归分析血清AngⅡ、apoB/apoA-1联合endocan与高血压患者并发冠心病的关系,并进一步绘制ROC曲线分析血清AngⅡ、apoB/apoA-1、endocan单独及联合检测对高血压患者并发冠心病的预测价值。结果 两组高血压病程、LDL-C、血清AngⅡ、apoB、apoA-1、apoB/apoA-1、endocan比较,差异有统计学意义(χ²/t=4.044、4.093、2.908...     

糖尿病患者血清糖化低密度脂蛋白水平研究

目的分析糖尿病患者血糖、血脂及糖化低密度脂蛋白（G-LDL）水平,探讨糖尿病患者G-LDL与冠心病的关系。方法检测80例糖尿病患者及80名健康人群的血清G-LDL、血糖及常规血脂[包括三酰甘油（TG）、胆固醇（Chol）、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A-Ⅰ（apoA-Ⅰ）和载脂蛋白B100（apoB100）],糖尿病组同时测定糖化血红蛋白（HbA1c）。结果糖尿病组LDL-C和apoB100与对照组比较无差异（P〉0.05）;G-LDL、血糖、TG和Chol水平明显高于对照组（P〈0.05）;HDL-C和apoA-Ⅰ水平低于对照组（P〈0.05）。糖尿病组G-LDL与血糖浓度呈正相关关系（r=0.636,P〈0.05）,与LDL-C及HbA1c不相关（r=0.331,r=0.327,P〉0.05）。结论糖尿病患者G-LDL明显升高,脂质糖化是糖尿病患者发生冠心病的危险因素,G-LDL有望成为评价糖尿病患者并发冠心病的生化指标。     

维持性血液透析患者血清脂联素水平分析

目的探讨维持性血液透析（MHD）患者血清脂联素（Adiponectin,ADPN）水平和影响因素,及其ADPN与合并症的相关性。方法测定79例维持性血液透析患者和16例健康对照者的血清ADPN（ELISA法）、肝肾功能、血脂、C反应蛋白（CRP）、胰岛素（Fins）,计算体重指数（BMI）、稳态模型胰岛素抵抗指数（HOMA-IR）,及透析患者的尿素清除指数（Kt/V）、标准化蛋白分解代谢率（nPCR）,分组观察合并糖尿病、高血压及心脑血管疾病的MHD患者的血清ADPN,分析血清ADPN与这些参数、合并症的相关性。结果MHD组的血清ADPN显著高于对照组[（13.73±8.64）mg/L比（6.27±3.57）mg/L,P〈0.01]。MHD组血清ADPN与BMI、Fins、HOMA-IR、CRP、三酰甘油（TG）呈明显负相关,与胆固醇（TC）、高密度脂蛋白（HDL）呈明显正相关,Kt/V对血清ADPN水平有一定影响。在合并糖尿病和心脑血管疾病的MHD患者中血清ADPN水平较低。结论血清ADPN在MHD患者中明显升高,与糖脂代谢、动脉硬化关系密切,是一个心脑血管保护因子。     

原发性高血压并发心脑血管疾病患者的临床表现分析

目的 研究高血压伴冠心病和／或脑血管病患者的临床特征，并探讨其临床意义。方法 对55例高血压伴冠心病和／或脑血管病患者，进行动脉硬化指数（AST）测定，并检测患者的血尿酸、血糖．血脂、肌酐、尿素氖等血液生化指标及一般情况。另选不伴有冠心病．脑血管病的高血压患者63例作为对照。结果 与高血压对照组比较，高血压件冠心病和／或脑血管病患者的年龄大、病史时间长，ASI、脉压、血尿素氮明显增高（均P〈0．01）；收缩压、血尿酸、总胆固醇、肌酐也增高（均P〈0．05）；而舒张压（P〈0.01），心率却较低（P〈0．05）。多因素logistic回归分析显示：高血压患者并发心脑血管疾病的独立相关因素有脉压、血肌酐、年龄（0R=1．204，1.120，1．099；P=0028，0．045，0．039）。结论 年龄大、病史时间长、高尿酸、高血脂、高脉压、动脉硬化、肾功能下降与高血压患者并发心脑血管疾病相关联。脉压、血肌酐水平和年龄是高血压患者并发心脑血管疾病的独立相关因素。     

血脂指标的比值对冠心病诊断价值的临床探讨

目的探讨血脂、脂蛋白与载脂蛋白水平变化及其相关指标的比值对冠心病（CHD）的临床诊断价值。方法检测65例CHD患者（CHD组）及40例健康人（健康对照组）血脂、脂蛋白与载脂蛋白，计算相关指标的比值，并进行统计学处理与分析。结果CHD组患者血清TG、LDL-C、apoB水平显著增高（P〈O．01），apoAl、HDL-C水平显著降低（P〈O．01），TC水平无统计学差异（P〉0．05）；TG／HDL-C、LDL-C／HDL-C、apoAl／apoB、HDL-C／TC比值水平与对照组比较差异有统计学意义（P〈O．001或P〈O．01）。结论与单项TG、TC、HDL-C、LDL-C、apoAl、apoB检测指标相比，TG／HDL-C、LDL-C／HDL-C、apoAl／apoB、HDL-C／TC等相关指标的比值对冠心病的诊断、临床评估，更有临床使用价值。     

血脂及血脂蛋白检测与动脉硬化性心脑血管疾病的相关性分析

目的：探讨血脂及血脂蛋白检测与动脉硬化性脑血管疾病发生间的关系及其早期预测价值。方法选取2011年10月~2012年11月1558例体检人群进行人口学资料、心血管疾病危险因素调查,同时检测血脂、脂蛋白、脉搏波传导速度等指标,应用Pearson相关分析血脂、脂蛋白与动脉硬化的关系。结果颈-股动脉脉搏波传导速度与TC、LDL-C、Lpa 呈正相关（r＝0.19,r＝0.17,r＝0.15,P＜0.001）,与 HDL-C 呈负相关（r＝-0.28,P＜0.001）,与 TG 无相关性（r＝0.11,P＞0.05）;颈-桡动脉脉搏波传导速度与Lpa呈正相关（r＝0.24,P＜0.001）,与HDL-C呈负相关（r＝-0.27,P＜0.001）,与TC、LDL-C、TG无相关性（r＝0.01,r＝0.09,r＝0.01,P＞0.05）。结论血脂及脂蛋白与动脉硬化性心脑血管疾病相关,TC是中央大动脉硬化,Lpa、HDL-C是中央大动脉硬化及外周中动脉硬化独立的危险因素。     

非酒精性脂肪肝与胰岛素抵抗的关系

目的：探讨非酒精性脂肪肝（NAFLD）的发病与空腹血糖（FBG）、胰岛素抵抗指数（IR）、体重指数（BMI）及脂紊乱的关系。方法：对112例NAFLD患者,以及年龄、性别相匹配的112例正常对照者,检测空腹胰岛素水平及血脂,采用稳态模式评估法计算胰岛素抵抗指数,测量身高、体重,计算BMI以及腰臀比。结果：NAFLD组与对照组之间空腹胰岛素、IR、BMI及血脂紊乱比较差异有显著性（P〈0.05,或〈0.01）。IR、腰臀比是影响肝脏脂肪含量的主要危险因素。结论：IR、腰臀比是影响NAFLD的主要危险因素。     

Lipoprotein predictors of cardiovascular events in statin-treated patients with coronary heart disease. Insights from the Incremental Decrease in End-points through Aggressive Lipid-lowering Trial (IDEAL)

Background. Few studies have looked into the ability of measurements of apolipoprotein B (apoB) and apolipoprotein A-1 (apoA-1) or apoB/apoA-1 to predict new coronary heart disease (CHD) events in patients with CHD on statin treatment.

Aims. In the IDEAL trial, to compare lipoprotein components to predict CHD events and to what degree differences in those parameters could explain the observed outcome.

Methods. We compared the ability of treatment with atorvastatin 80 mg/day to that of simvastatin 20–40 mg/day to prevent CHD events in patients with CHD and used Cox regression models to study the relationships between on-treatment levels of lipoprotein components to subsequent major coronary events (MCE).

Findings. Variables related to low-density lipoprotein cholesterol (LDL-C) carried more predictive information than those related to high-density lipoprotein cholesterol (HDL-C), but LDL-C was less predictive than both non-HDL-C and apoB. The ratio of apoB to apoA-1 was most strongly related to MCE. However, for estimating differences in relative risk reduction between the treatment groups, apoB and non-HDL-C were the strongest predictors.

Interpretation. The on-treatment level of apoB/apoA-1 was the strongest predictor of MCE in the pooled patient population, whereas apoB and non-HDL-C were best able to explain the difference in outcome between treatment groups. Measurements of apoB and apoA-1 should be more widely available for routine clinical assessments.     

Effect of moxonidine on lipid subfractions in patients with hypertension

Moxonidine is centrally acting imidazoline type-1 receptor agonist that significantly lowers blood pressure and has some insulin-sensitising actions. Its effects on plasma lipid profiles are uncertain. This study examined the effects of moxonidine on detailed lipid and lipoprotein profiles in 12 patients with hypertension and type 2b Fredricksen hyperlipidaemia. Treatment with moxonidine in six patients who completed the study resulted in a 10/5 mmHg reduction in 24-h ambulatory blood pressure (p = 0.01). A significant reduction in total and low-density-lipoprotein cholesterol (LDL-C) of 10% (p = 0.04) and 18% (p = 0.03), respectively, was seen. Triglycerides were reduced non-significantly by 23%, and high-density-lipoprotein cholesterol (HDL-C) was increased by 16%. There were no significant changes in apolipoprotein (apo) A-1 and B concentrations. No significant shifts were seen in HDL-C, LDL-C, very-low-density-lipoprotein cholesterol (VLDL-C) or apolipoprotein peak positions with therapy. Analysis of area under curve for each subfraction showed that moxonidine therapy resulted in a redistribution within the apoB profile. A slight non-significant reduction in VLDL apoB was seen. There was a reduction in the dense LDL apoB peak (p = 0.02) but less in the buoyant LDL apoB peak (p = 0.17) with a countervailing increase in LDL-C in the buoyant fraction (p = 0.01). The HDL-C and apoA-1 profile showed a shift from dense HDL apoA-1 (p = 0.01) to a buoyant HDL apoA-1sub-species (p = 0.01). These changes are consistent with a tendency for moxonidine to improve atherogenic lipid and lipoprotein profiles by actions on insulin-sensitisation and possibly through a direct cholesterol-reducing effect as seen with other imidazoles.     

Dyslipidemia is a strong predictor of myocardial infarction in subjects with chronic kidney disease

Abstract

Aim. To evaluate dyslipidemia as predictor of myocardial infarction (MI) in subjects with or without chronic kidney disease (CKD). Methods. In 142,394 middle-aged Swedes referred for laboratory evaluation, glomerular filtration rates (GFR) were estimated using the Modification of Diet in Renal Disease study equation. CKD was defined as GFR 15–60 mL/min/1.73 m². Subjects were stratified into presence or absence of CKD, and lipid measures were related to MI using Cox's proportional hazards regression. Results. During 12 years of follow-up there were 5,466 MIs. The adjusted hazard ratio for MI for the highest versus the lowest quartile of the apolipoprotein (apo) B/apoA-1 ratio among individuals without CKD was 2.88 (95% confidence interval 2.54–3.26) and for those with CKD 3.35 (2.25–4.91). The corresponding estimates for the total cholesterol/high-density lipoprotein (HDL) cholesterol ratio were 3.13 (2.78–3.52) and 3.54 (2.43–5.17), respectively. Receiver operator characteristics analyses showed an advantage in the prediction of MI for the apoB/apoA-1 ratio as compared to conventional lipids (P < 0.0001). Conclusions. The ratio of apoB/apoA-1, the ratio of total cholesterol/HDL cholesterol, and non-HDL cholesterol were all strong predictors of myocardial infarction, both among subjects with and without renal dysfunction, with a possible advantage for the apoB/apoA-1 ratio.     

Combined use of high-sensitivity C-reactive protein and apolipoprotein B/apolipoprotein A-1 ratio prior to elective coronary angiography and oral glucose tolerance tests

Objectives

The study aimed to investigate the predictive value of the combination of high-sensitivity C-reactive protein (hs-CRP) and apolipoprotein B (apoB)/apoA-1 ratio for the outcomes of coronary angiography (CAG), echocardiography and oral glucose tolerance tests (OGTTs).

Design and methods

Hs-CRP, apoB, apoA-1, and the profiles of CAG, echocardiography and OGTTs as well as traditional risk factors were measured in 1757 cardiology patients.

Results

Hs-CRP or apoB/apoA-1 ratio was significantly correlated with the presence and severity of angiographic profiles, the levels of left ventricular (LV) ejection fraction, LV mass and LV mass index, and the presence of abnormal glucose metabolism. The combination of hs-CRP and apoB/apoA-1 ratio had greater correlation with abnormal glucose metabolism than its individual components in patients with normal fasting glucose, and was an independent predictor for coronary artery disease.

Conclusions

The combination of hs-CRP and apoB/apoA-1 ratio may be a strong predictor for coronary artery disease and abnormal glucose metabolism.     

血脂正常的冠心病患者血清载脂蛋白AⅠ、B_（100）检测的临床意义

目的探讨血脂正常的冠心病患者血清载脂蛋白水平及其检测的临床意义。方法检测３９例血清总胆固醇（ＴＣ）及甘油三酯（ＴＧ）均正常的冠心病患者血脂、脂蛋白及载脂蛋白（ａｐｏ）ＡＩ、Ｂ１００水平，并与４１例健康人作了比较。组内差别用ｔ检验，相关性比较用直线回归分析。结果ＨＤＬ－Ｃ、ａｐｏＡｌ含量及ａｐｏＡＩ／ａｐｏＢ１００比值显著低于健康人，差异显著至极显著（Ｐ＜０．０５～ｐ＜０．００１），ａｐｏＢ１００显著高于健康人，差异显著（Ｐ＜０．０５）。冠心病患者ＴＣ、ＴＧ及ＬＤＬ－Ｃ与ａｐｏＢ１００存在密切正相关。结论血清３ｐｏＢ１００含量升高、ａｐｏＡＩ含量及ａｐｏＡＩ／ａｐｏＢ１００比值降低是预测冠心病危险的最敏感、最准确的指标之一，特别是对血脂正常、无动脉硬化体征的冠心病患者。     

Hyperinsulinemia and insulin resistance in pathogenesis of atherosclerosis and ischemic heart disease

AIM: To confirm the pathogenetic relationship of hyperinsulinemia, insulin resistance, and coronary disease. MATERIAL AND METHODS: Thirty-nine coronary patients (male) were examined using lipid loading test, bicycle ergometry, coronarography, and measurements of insulin, cholesterol (CS), triglycerides (TG), very low density lipoproteins (VLDL), low density lipoproteins (LDL), high density lipoprotein (HDL) CS, apoA-1, and apoB. RESULTS: Blood levels of CS, TG, VLDL, LDL, HDL CS, apoA-1, apoB, and insulin were measured before and 3, 6, and 9 h after lipid loading in 39 coronary patients and 20 normal subjects. Coronarography showed initially high levels of insulin in coronary patients with pronounced changes. Insulin level drastically increased after insulin loading; increases in TG and apoB levels were the most pronounced, while the concentrations of HDL CS and apoA-1 decreased and did not normalize 6 h after lipid loading. CONCLUSION: The results confirmed the relationship between hyperinsulinemia, insulin resistance, and coronary disease.     

男性冠心病患者血清性激素和血脂水平的临床研究

目的探讨男性冠心病（CHD）患者血清性激素与血脂水平的临床意义。方法采用电化学发光免疫分析和生物化学分析测定106例男性CHD患者和41名正常对照组血清雌二醇（E2）、睾酮（T）、总胆固醇（TC）、甘油三脂（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）和载脂蛋白B（apoB）。结果与正常对照组比较,CHD组E2增高、T降低（P〈0．05）,CHD组E2／T比值为42．39±7．33,较正常对照组（21．04±6．73）增高（P〈0．01）。CHD组血清TC和apoB水平增高、HDL-C和LDL-C水平降低（P〈0．05）;TG和apoA1差异无统计学意义（P〉0．05）。结论男性CHD患者E2增高、T降低,TC和apoB增高,HDL—C和LDL—C降低,代谢紊乱是CHD患者的典型特征。     

2型糖尿病患者血浆致动脉硬化指数与其他几种动脉硬化指数的应用价值比较

目的比较2型糖尿病（DM）血浆致动脉硬化指数（AIP）、低密度脂蛋白胆固醇（LDL-C）／高密度脂蛋白胆固醇（HDL—C）比值及动脉硬化指数（AI）和血脂综合指数（LCI）的应用价值。方法测定124例2型DM患者和111名正常对照者三酰甘油（TG）、总胆固醇（TC）、HDL—C等,计算LDL-C、AIP、LDL—C／HDL—C比值、AI和LCI。将2型DM患者分为HDL—C〈0．91mmol／L及HDL—C≥0．91mmol／L2组进行分析。结果2型DM组的AIP、AI和LCI均高于正常对照组（P〈0．001）,其中AIP值最高,A1次之。2型DM患者HDL-C〈0．91mmol／L组的AIP、AI、LDL—C／HDL—C比值均高于HDL-C≥0．91mmol／L组（P〈0．001）,AIP的升高较明显。2型DM血脂升高组调脂前后AIP差异明显（P〈0．001）。结论比较AIP和其他3种指数,以AIP差异最明显。AIP是反映2型DM患者发生动脉粥样硬化危险性最有判断价值的指标。     

探讨同型半胱氨酸血脂及血液流变学在糖尿病视网膜病变中的意义

目的：探讨同型半胱氨酸（HCY）、血脂及血液流变学在糖尿病视网膜病变患者中的变化及临床意义。方法121例糖尿病患者,其中有视网膜病变组52例,无视网膜病变组69例,另设健康对照组50例,进行HCY、空腹血糖（FBG）、糖化血红蛋白（HbA1c）、胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）及血液流变学各项指标检测。结果（1）与健康对照组比较,糖尿病两组患者HCY、FBG、HbA1c、TC、TG、LDL-C和血液流变学各项指标均明显升高（P＜0．01）;（2）糖尿病视网膜病变组HCY、HbA1c、TC、TG、LDL-C和血液流变学各项指标明显高于无视网膜病变组（P＜0．01）;（3）各组HDL-C比较,差异无统计学意义（P＞0．05）。结论糖尿病视网膜病变患者存在高HCY血症、脂代谢紊乱和血液流变学异常,检测糖尿病患者HCY、血脂及血液流变学指标的变化有助于早期发现糖尿病患者视网膜病变。