中国不同地区膳食脂质摄入量的分析

１９９２年中国总膳食研究在１９９０年的基础上做了适当的改进,将城市和农村的样品分别进行分析。本文报道了该项研究中膳食脂质部分的结果（包括总脂肪、胆固醇、脂肪酸）。除南方二区外,同一地区的城市和农村居民在脂肪、胆固醇的摄入量上有较大的差异。北方二区农村居民的脂肪摄入量明显不足,而北方一区城市居民脂质的摄入量较高,胆固醇摄入量已超过每人每日３００ｍ ｇ 的水平。南方居民膳食脂肪中多不饱和脂肪酸所占比例低而单不饱和脂肪酸所占比例高。基于以上分析,作者认为我国居民膳食脂质摄入情况基本合理,但由于地域差异较大,在进行膳食指导时（如关于补充ＥＰＡ,ＤＨＡ 的问题）应对不同地区的情况进行具体分析,有针对性地提出建议     

The effects of clofibrate on plasma glucose,lipoproteins, fibrinogen,and other biochemical and haematological variables in patients with mature onset diabetes mellitus

Summary We have studied the effects of clofibrate treatment on glucose tolerance and plasma insulin, plasma triglyceride, cholesterol and non-esterified fatty acid (NEFA) levels, and on various haematological variables (including plasma fibrinogen level, red cell flexibility, whole blood viscosity, and plasma -thromboglobulin level) in patients with mature-onset diabetes. Twenty-two patients (11 men and 11 women) were randomly allotted to treatment with clofibrate, 1 g twice daily, or a corn-oil placebo for 12 weeks, and then changed to the alternate medication for another 12 weeks. Half the patients took clofibrate in the first 12 weeks of the study, and half took the placebo. The patients stayed on their usual diet, and 13 also took tolbutamide before and during the trial. The trial was double-blind. At the beginning, middle and end of the trial fasting measurements were made, and plasma glucose, insulin, triglyceride, and NEFA concentrations were then measured repeatedly during the next 8 h (from 8.00 a. m. to 4 p. m.), to allow calculation of the mean 8-h concentration of these substances. In general, plasma concentrations of glucose, triglyceride, cholesterol, NEFA and fibrinogen were lower when the patients were taking clofibrate then when they were taking the corn-oil placebo, but higher when taking the placebo than at entry to the trial. We favour the explanation that clofibrate has lowered these concentrations, when compared with the placebo. The alternative interpretation, that 2 g per day of the placebo increases plasma concentrations of glucose, triglyceride, cholesterol, NEFA and fibrinogen, and that clofibrate has little effect, seems unlikely. The first interpretation, that clofibrate has a positive effect when compared with an inert placebo, has been adopted when interpreting the results. Clofibrate treatment led to a 15% lower fasting blood glucose level, and 11% lower mean 8-h glucose concentration than did placebo (p<0.01) but it did not significantly change plasma insulin concentration. The fasting and mean 8-hour concentrations of plasma triglyceride and fasting plasma cholesterol concentrations were reduced by clofibrate (by 44%, 33% and 10% respectively, p<0.05). Clofibrate decreased the fasting plasma NEFA level by 27% (p<0.01), and the mean 8-h plasma NEFA concentration by 23% (p<0.05). A weak relationship between the mean 8-h levels of plasma NEFA and plasma glucose (r=0.49, p<0.05) was consistent with the suggestion that the change in plasma glucose could, in part, be due to a change in NEFA concentration. The mean plasma fibrinogen concentration was decreased 23% by clofibrate (p<0.01). There was a positive correlation between the observed decrease during treatment and the baseline fibrinogen concentration (r=0.80, p<0.001), i. e. the greatest decrease occurred in those subjects with the highest plasma fibrinogen concentrations. Whole blood viscosity fell slightly, but erythrocyte flexibility was not significantly changed by clofibrate. The mean haemoglobin concentration and leucocyte count fell slightly during clofibrate treatment and the platelet count rose. -thromboglobulin was not affected. Clofibrate treatment was associated with rises in plasma albumin, urea, creatine kinase and aspartate aminotransferase, and falls in plasma bilirubin, -glutamyl-transpeptidase and alkaline phosphatase. Most of these changes occurred within the reference range.     

The Effect of Parenterally Administered Cyclodextrins on Cholesterol Levels in the Rat

The inclusion complex formation of intravenously administered hydroxypropyl--cyclodextrin and -cyclodextrin with endogenous lipids was studied. We tested the hypothesis that complex formation of endogenous cholesterol with cyclodextrins in the bloodstream leads to extraction of cholesterol from the large lipoprotein particles. The relatively small cholesterol–cyclodextrin complexes then leave the bloodstream via capillary pores, and dissociation of the complex in the extravascular compartment finally causes redistribution of cholesterol from blood to tissue. This hypothesis is supported by the following experimental findings. Intravenous administration of cyclodextrins led to a transient decrease in plasma cholesterol levels in a dose-dependent manner, and in vitro cholesterol-cyclodextrin complexes passed dialysis membranes with a molecular weight cutoff of 6000–8000. Further, cyclodextrins increased protein binding of the steroidal drug spironolactone, probably through removal of cholesterol from plasma protein binding sites. Finally, extravascular redistribution was directly demonstrated in histological studies of the kidneys. Glomerular filtration of the cholesterol–cyclodextrin complex is followed by dissociation of the complex in the ultrafiltrate, resulting in cholesterol accumulation in the proximal tubule cells. The cholesterol--cyclodextrin complex has a limited aqueous solubility. Crystallization of this complex in renal tissue might explain the nephrotoxicity of parenterally administered -cyclodextrin. The absence of such crystallization might explain the lower nephrotoxicity of hydroxypropyl--cyclodextrin after intravenous administration.     

Effect of oxidized derivatives of cholesterol on uptake and degradation of very low-density β-lipoproteins by human and rabbit hepatocytes

Research Institute of Cardiology, Tomsk Scientific Center, Academy of Medical Sciences of the USSR. Research Institute of Experimental Cardiology, All-Union Cardiologic Scientific Center, Academy of Medical Sciences of the USSR, Moscow. Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 111, No. 3, pp. 254–256, March, 1991.     

A contribution to a new test method for dandruff-inhibiting and “keratolytic” action of drugs

Summary Free cholesterol in lipids from the scalp and hair is predominantly a constituent of epidermal lipids. Therefore, a reduction in cholesterol content induced by a drug indicates a reduction in cell turnover in the epidermis. As, according to the literature, increased cell turnover in the epidermis results in formation of dandruff, a reduction in the proportion of cholesterol should indicate inhibition of the formation of dandruff. Conversely, an increase in free cholesterol should generally indicate a keratolytic effect. So unequivocal an interpretation has not so far been possible in persons with dandruff, as it was not known whether free cholesterol was increased or decreased. In addition, this interpretation was not possible after use of antimicrobial substances, as in vitro investigations had failed to exclude microbial esterification of cholesterol on the scalp. The present investigation has shown that correlation of free cholesterol level with cell turnover is permissible in patients with dandruff, even if antimicrobial drugs are being tested.     

国产与进口阿托伐他汀治疗高脂血症的比较

目的:比较国产与进口阿托代他汀治疗高脂血症的疗效。方法:选择原发性高脂血症患者76例,随机分为国产阿托伐他汀(10mg·d~(-1))组和进口阿托伐他汀(10mg·d~(-1))组各38例,均治疗8周。结果:2组治疗4周时总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)均开始显著下降(P<0.01),治疗8周高密度脂蛋白胆固醇(HDL-C)开始显著上升(P<0.05),但2组间比较差异无显著意义(P>0.05);不良反应发生率国产组10.5％,进口组7.9％,2组差别无显著意义(P>0.05)。结论:国产阿托伐他汀与进口阿托伐他汀均有明显的调脂效果,两者使用均较安全。     

新型调脂药ezetimibe--胆固醇吸收的选择性抑制剂

传统的树脂类、贝特类等药物因为不良反应大，降低胆固醇效果差而不易被病人接受。他汀类药物降低胆固醇效果好，但某些病人单用他汀类药物不能有效降低体内胆固醇水平。因此本文介绍了新近在美国上市的ezetimibe，一种新型胆固醇吸收的选择性抑制剂，在单用或与他汀类药物联用时，都能稳定降低血浆低密度脂蛋白胆固醇(LDL-C)水平，为临床治疗高脂血症提供了新的选择。     

Effects of Red Palm Oil on Serum Lipids and Plasma Carotenoids Level in Chinese Male Adults

Objective Effects of red palm oil on major plasma carotenoids, tocopherol, retinol and serum lipids were evaluated when used in Chinese diet. Methods Red palm oil group (RPO) composedof 20 male subjects(aged 18-32) and soybean oil group (SBO) composed of 22 male subjects     

Effect of tamoxifen on serum cholesterol in Japanese women with breast cancer

Background To investigate whether tamoxifen therapy has a favorable effect on plasma lipids, serum cholesterol levels were measured in 228 Japanese women with breast cancer (116 premenopausal women and 112 postmenopausal women). Methods These women were treated with tamoxifen or tamoxifen+chemotherapy (tamoxifen-treated group) or were given no therapy or chemotherapy alone (control group). Results There was no difference between cholesterol levels before treatment and after a 2-year follow-up period in these groups, except for the postmenopausal tamoxifen-treated group. In this particular group, the mean levels of serum cholesterol after 1 and 2 years of follow-up (197 and 188 mg/dL, respectively) were 8% and 12% lower than those before treatment (215 mg/dL,P<0.0001). In addition, the mean level of serum cholesterol after a 2-year follow-up period was significantly higher in the postmenopausal tamoxifen-treated group than in the postmenopausal control group (218 and 188 mg/dL, respectively,P=0.0066). Conclusions In multiple regression models that included age, body mass index, and chemohormonal therapy, only tamoxifen treatment appeared to predict the change between cholesterol levels before treatment and after 2-year follow-up in postmenopausal women. These results suggest that tamoxifen has the potential benefit of reducing the serum cholesterol level, which may be closely related to cardiovascular risk, in Japanese postmenopausal women.     

磺脲类降糖药格列齐特剂量与血脂学相关性研究

目的：探讨2型糖尿病（T2DM）磺脲类口服降糖药剂量与血脂学指标异常之间的关系。方法：选择76例T2DM患者，均口服格列齐特共计57d，药物剂量逐渐增大至血糖达标或格列齐特达240mg／d，所有观察对象的最大用药量（DI）经体质量校正后排序，以50百分位数分为小剂量A组、大剂量B组，比较2组一般情况及血脂情况。结果：（1）2组除体质量指数（BMI）外，其余基线指标差异无统计学意义。（2）2组除TC外，DI、TG、HDL-C、LDL-C、TG／HDL-C及AIP差异均有统计学意义。（3）单因素直线相关分析DI与动脉硬化指数（AIP）、TG／HDL呈正相关（P〈0．01）；DI与BMI呈负相关（P〈0．01）。（4）DI（Y）与血脂指标及其他各因素（X）作多元逐步回归分析，AIP（X1）、体质量（X2）、胆固醇（X3）、TG／HDL-C（X4）。回归方程：Y=6．011X1-0．0346X2-0．0217X3-0．66X4＋4．022。结论：血脂异常与T2DM患者格列齐特用量具有良好的相关性，T2DM患者磺脲口服降糖药剂量大小与脂毒性有关。