Postprandial lipemia as a risk factor for cardiovascular disease in patients with hypothyroidism

Postprandial lipoprotein metabolism is suggested to play a role in the pathogenesis of atherosclerosis. In this study, we investigated postprandial lipemia and its relationship to cardiovascular risk factors in patients with overt and subclinical hypothyroidism. Twentynine female patients with TSH levels greater than 5 μIU/mL and 12 euthyroid control female subjects were included in the study. Fifteen patients had subclinical hypothyroidism and 14 had overt hypothyroidism. All subjects underwent an oral lipid tolerance test. If triglyceride levels increased by 80% or more, subjects were considered postprandial lipemia positive. Control, overt hypothyroid, and subclinical hypothyroid groups were not statistically different with respect to anthropometric measurements, fasting blood C-reactive protein, uric acid, homocysteine, glucose, insulin, lipoprotein (a), apolipoprotein B levels, and homeostasis model assessment index. Fasting triglyceride levels correlated positively with TSH levels. Postprandial lipemia frequency was higher in overt hypothyroid subjects than in the control group. The subclinical hypothyroid group did not differ from the hypothyroid group with respect to postprandial lipemia frequency. In subjects with TSH levels higher than 5 μIU/mL, PPL risk was increased sevenfold. The results of this study show that postprandial triglyceride metabolism is affected in hypothyroidism.     

复方蘑芋片对降血脂、体重的作用观察

目的:探索复方蘑芋片对降血脂、体重的作用.方法:用蘑芋葡甘聚糖,佐以黄芪浸膏制成0.5 g/片和对照用淀粉片剂(0.5g/片),选200例志愿者认为肥胖和高血脂者,以双盲法分组各100例受试,试前后检测血脂、体重,服药1个月为一个疗程,共观察1～3个疗程.结果:复方蘑芋组在降低血脂方面对胆固醇(TC)及β-脂蛋白(β-LP)降低十分显著,对甘油三酯(TG)也有显著降低;在降低体重方面,有效率93%,对于习惯性便秘也有较好的疗效.结论:复方蘑芋片是一种理想的降血脂、减肥、通便的药品.     

蝮蛇抗栓酶对糖尿病人血脂及纤维蛋白原的影响

本文用蝮蛇抗栓酶治疗NIDDM30例,与低分子右旋糖酐葡萄糖注射液（以下简称低右）加复方丹参注射液（以下简称丹参液）治疗NIDDM20例作为对照。对比观察了用药前后血脂的变化及纤维蛋白原的变化。结果显示：（1）对照组在治疗后仅纤维蛋白原明显下降（P＜0．01）;（2）治疗组在治疗后纤维蛋白原和甘油三酯均明显下降（P＜0．01和P＜0．05）。治疗组和对照组都使纤维蛋白原下降,二者间无显著差异（P＞0．05）,由于蝮蛇抗栓酶既使纤维蛋白原下降,又使甘油三酯下降,故是治疗糖尿病的一种近期疗效较显著的辅助治疗药物。     

Canadian Laboratory Initiative on Pediatric Reference Interval Database (CALIPER): Pediatric reference intervals for an integrated clinical chemistry and immunoassay analyzer, Abbott ARCHITECT ci8200

Objectives

A comprehensive set of age- and gender-specific pediatric reference intervals is essential for accurate interpretation of laboratory tests in a pediatric setting.

Design and methods

1459 serum/plasma from children attending select outpatient clinics and deemed to be metabolically stable, were collected from five age groups; 0-12 months, 1-5 years, 6-10 years, 11-14 years and 15-20 years. Samples were analyzed for 24 chemistries and 15 immunoassays on ARCHITECT ci8200.

Results

Reference intervals were established according to CLSI/IFCC C28-P3 guidelines by the Robust statistical method. The ranges reflect the central 95% confidence intervals for the population tested. Age and gender were partitioned using the Harris-Boyd method.

Conclusions

While these intervals are ci8200 method specific, they not only provide robust intervals for users of this system but are also useful for any laboratory requiring pediatric intervals if they can be shown to be transferable and if validated for the local patient population.     

Fenofibrate improves postprandial chylomicron clearance in II B hyperlipoproteinemia

In 11 patients with 1113 hyperlipoproteinemia we studied fasting lipids, lipoproteins, lipoprotein-modifying enzymes, and postprandial lipid metabolism after a standardized oral fat load supplemented with vitamin A before and 12 weeks after treatment with fenofibrate, a third-generation fibric acid derivative. Fasting plasma cholesterol, triglycerides, low-density lipoprotein cholesterol decreased significantly (P < 0.05, P < 0.01, P < 0.01), high-density lipoprotein subfraction 3 cholesterol increased significantly (P < 0.05), and high-density lipoprotein subfraction 2 cholesterol remained unchanged. Postprandial lipemia, i.e., the integrated postprandial triglyceride concentrations corrected for the fasting triglyceride level, and postprandial chylomicron concentrations, as assessed by biosynthetic labeling of chylomicrons with retinyl palmitate, decreased by 40.6% and 60.1% (P < 0.05; P < 0.05), respectively. The activity of lipoprotein lipase (LPL) increased by 33.6% (P < 0.05); the increase in LPL during fenofibrate treatment was positively correlated with the increase in high-density lipoprotein cholesterol (r = 0.84; P < 0.005). Hepatic lipase and cholesteryl ester transfer protein mass and activity remained unchanged. We conclude that lipid-lowering therapy with fenofibrate ameliorates fasting and, more profoundly, postprandial lipoprotein transport in hypertriglyceridemia by curbing postprandial triglyceride and chylomicron accumulation, at least in part, through an increase in LPL activity.Abbreviations LDL low-density lipoproteins - HDL high-density lipoproteins - LPL lipoprotein lipase - HL hepatic lipase - CETP cholesteryl ester transfer protein - CHD coronary heart disease - VLDL very low density lipoproteins - TG triglycerides - apo apolipoprotein Correspondence to: J.R. Patsch     

中老年冠心病患者胰岛素抵抗与血脂水平相关性研究

本文观察６８例住院非糖尿病的冠心病患者的血脂、血糖、胰岛素、Ｃ肽等水平。通过对胰岛素抵抗的敏感性测定（胰岛素抵抗敏感指数），发现其与血脂水平有明显的相关。其与ＨＤＬ－Ｃ，Ａｐｏ－Ａ，Ａｐｏ－Ｂ，ＴＧ，Ｃｈｏｌ等的相关系数分为：０．１７，０２４，－０．２８，－０．２２（Ｐ值分为：０．０２２，０．２３，０．２５，０．０１，０．０００１）。说明胰岛素抵抗与冠心病的血脂改变相关。另外，以年龄区别，６０岁上、下两组胰岛素抵抗差异显著（Ｐ＜０．０５）。     

Fatty emaciation: a case report of suspected fat overload syndrome in oral refeeding

Refeeding syndrome has been observed in patients receiving nutrition after a prolonged period of malnourishment and is characterized by multiple metabolic derangements. Besides hypophosphatemia and hypoglycemia, lipemia has been described in association with parenteral nutrition administration to the malnourished. The authors describe one anorexic patient who developed lipemia during oral refeeding, followed by a precipitous drop in hematocrit suggestive of fat overload syndrome.