高密度脂蛋白胆固醇和冠心病的相关性研究

目的:探讨高密度脂蛋白胆固醇水平与冠心病的相关性.方法:选择427例经冠状动脉造影证实的冠心病患者作为病例组,并选择同期住院的冠脉造影结果阴性的306例非冠心病患者作为对照组,测定两组患者的血清总胆固醇(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)、游离脂肪酸(FFA)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)、脂蛋白LP(a)等指标进行比较分析.结果:冠心病组与对照组比较,HDL-C水平显著降低(P＜0.05);在冠心病组中随着冠状动脉病变支数的增加,HDL-C逐渐下降(P＜0.05).多元Logistic回归分析,低HDL-C水平为冠心病的独立危险因素.结论:HDL-C与冠心病发生发展及冠脉病变程度呈显著负相关.TC/HDL-C可能对冠心病的诊断具有更好的预测价值.     

Use of the plasma triglyceride/high-density lipoprotein cholesterol ratio to identify cardiovascular disease in hypertensive subjects

This analysis evaluated the hypothesis that the plasma triglyceride (TG)/high–density lipoprotein cholesterol (HDL-C) concentration ratio can help identify patients with essential hypertension who are insulin–resistant, with the cardiovascular disease (CVD) risk profile associated with that defect. Data from a community–based study developed between 2003 and 2012 were used to compare CVD risk factors and outcome. Plasma TG/HDL-C cut–points of 2.5 (women) and 3.5 (men) subdivided normotensive (n = 574) and hypertensive (n = 373) subjects into “high” and “low” risk groups. Metabolic syndrome criteria (MetS) were also used to identify “high” and “low” risk groups. The baseline cardio–metabolic profile was significantly more adverse in 2003 in “high” risk subgroups, irrespective of BP classification or definition of risk (TG/HDL-C ratio vs. MetS criteria). Crude incidence of combined CVD events increased across risk groups, ranging from 1.9 in normotensive–low TG/HDL-C subjects to 19.9 in hypertensive–high TG/HDL-C ratio individuals (P for trends <.001). Adjusted hazard ratios for CVD events also increased with both hypertension and TG/HDL-C. Comparable findings were seen when CVD outcome was predicted by MetS criteria. The TG/HDL-C concentration ratio and the MetS criteria identify to a comparable degree hypertensive subjects who are at greatest cardio–metabolic risk and develop significantly more CVD.     

Dehydroepiandrosterone sulfate/free androgen index ratio predicts a favorable metabolic profile in patients with polycystic ovary syndrome

Potential effect of hyperandrogenemia on metabolic disturbances in polycystic ovary syndrome (PCOS) has always been a matter of interest. We analyzed the records of 125 patients with PCOS and 54 age-matched healthy women. All participants underwent biochemical and hormonal assessment and a 75?g oral glucose tolerance test was performed. PCOS and control groups were comparable in terms of age. Dehydroepiandrosterone sulfate/free androgen index (DHEAS/FAI) ratio was negatively correlated with body mass index (BMI) (p?<?.001), fasting glucose (p?=?.02), area under the curve (AUC) of glucose (p?=?.03), AUC of insulin (p?=?.001), homeostasis model assessment-estimated insulin resistance (HOMA-IR) (p?<?.001), and triglycerides (TG) (p?=?.009), and positively correlated with insulin sensitivity index (ISI) (p?<?.001) and high-density lipoprotein cholesterol (HDL-C) (p?<?.001) among PCOS patients. In logistic regression analysis, higher DHEAS/FAI ratio levels were associated with lower risk of low HDL-C [RR(95%CI); 0.97(0.95–0.98); p?<?.001] as well as atherogenic dyslipidemia (TG/HDL-C) [RR(95%CI); 0.97(0.94–0.99); p?=?.035] even after adjustment for BMI in the PCOS group. Androgens, DHEAS and FAI act differently on metabolic parameters. Our results demonstrate that high DHEA-S/FAI ratio levels are associated with a more favorable metabolic profile.     

Metabolic syndrome and its components in postmenopausal women living in southern Italy,Apulia region

Objectives

The goal of our study was to determine the prevalence of metabolic syndrome (MetS) and all its components, in a population of postmenopausal women aged over 45 years, consecutively accessed to our Heart Station, during 2014, for their first cardiac examination,furthermore to estimate their cardiovascular risk and the achievement of target blood values of main risk factors, according to current Guidelines.

Decreased small dense LDL levels in Gilbert's syndrome

Objective

To investigate the role of small dense low density lipoprotein cholesterol (sd-LDL-C) in the mechanism of decreased incidence of cardiovascular disease in Gilbert's syndrome (GS).

Design and methods

sd-LDL-C, ox-LDL, and high sensitive C reactive protein (hs-CRP) levels were investigated in subjects with GS (n = 42) and compared to healthy controls (n = 52).

Results

Age, gender and body mass index (BMI) distributions were similar between the two groups. sd-LDL-C, ox-LDL and hs-CRP levels were lower in GS than the healthy controls (p < 0.001, p < 0.001 and p = 0.001, respectively). Unconjugated bilirubin was negatively correlated with sd-LDL-C, ox-LDL and hs-CRP (r = −0.594, p < 0.001; r = −0.249, p = 0.016 and r = − 0.373, p < 0.001 respectively). In addition, sd-LDL-C was positively correlated with ox-LDL (r = 0.307, p = 0.003).

Conclusions

The findings of this preliminary study suggest that reduced sd-LDL-C, ox-LDL and hs-CRP levels may have a role in preventing atherosclerosis in subjects with GS.     

缺血性卒中患者急性期血清血脂水平与其短期预后的关系

目的 探讨缺血性卒中患者急性期血清血脂水平与其短期预后之间的关系。方法 收集急性缺血性卒中患者459例,经病因学分型后分为动脉粥样硬化型卒中组（n=310）和非动脉粥样硬化型卒中组（n=149）,随访患者发病后3个月的死亡、残疾情况。分析不同病因分型缺血性卒中患者预后影响因素。统计方法采用单因素分析及多元逐步Logistic回归分析。结果 与非动脉粥样硬化卒中患者相比,动脉粥样硬化型卒中患者年龄较大,既往有高血压病、糖尿病比率高,甘油三酯、总胆固醇水平较高,差异有统计学意义（P值分别为0.000,0.000,0.001,0.018,0.015）。非动脉粥样硬化患者中,高密度脂蛋白胆固醇（high density lipoprotein Cholesterol,HDL-C）水平与预后不良呈负相关,优势比（odds ratio,OR）为0.068,95%可信区间（confidence interval,CI）为（0.005～0.897）。结论 较高的HDL-C水平是非动脉粥样硬化型卒中预后良好的保护因素。     

透穴埋线对肥胖大鼠总胆固醇、三酰甘油、低密度脂蛋白、高密度脂蛋白的影响

目的：探讨透穴埋线法对肥胖大鼠总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDL-C）、高密度脂蛋白（HDL-C）的影响,为临床运用透穴埋线法治疗肥胖及其相关疾病提供客观的实验依据。方法：将60只健康雄性SD大鼠随机分成两组,一组12只,喂以普通饲料;另外一组48只,喂以高脂饲料。6周后,选出造模成功的20只符合要求的高脂大鼠随机分成模型组10只、透穴埋线组（简称埋线组）10只;空白对照组选取普食组的10只大鼠,共3组大鼠。实验期间,各组实验大鼠均普通饲料喂养,空白对照组不做任何处理,模型对照组陪同固定,透穴埋线治疗组予透穴埋线治疗。治疗后观察并分别比较大鼠TC、TG、LDL-C、HDL-C水平的变化。结果：造模6周后,高脂组大鼠的TC、TG、LDL-C水平均明显高于空白对照组,HDL-C水平低于正常组（P〈0.05）;实验结束后,埋线组大鼠的TC、TG、LDL-C水平较模型组明显下降,HDL-C水平明显上升（P〈0.05）。结论：经高脂饲料喂养可有效、快速的建立营养性肥胖大鼠模型,成功率达65%。透穴埋线法能降低肥胖大鼠的血清TC、TG、LDL-C水平及其他肥胖相关指标,促进脂肪代谢,提高LEP受体、INS受体的敏感性和表达,有效调控肥胖大鼠的摄食行为和脂肪代谢。     

深海鱼油对高脂模型大鼠降血脂作用的实验研究

目的探讨深海鱼油对高血脂模型大鼠血脂的调节作用。方法采用高脂饲料喂养建立高血脂大鼠模型,以低、中、高三个剂量的深海鱼油灌胃,试验结束时测血清总胆固醇、甘油三酯和高密度胆固醇脂蛋白胆固醇。结果中、高剂量组的深海鱼油能使大鼠血清中总胆固醇明显降低;低、中、高剂量组的深海鱼油均能使大鼠血清中甘油三酯降低;对血清高密度胆固醇脂蛋白胆固醇无明显影响。结论深海鱼油具有调节血脂作用。     

脂质/高密度脂蛋白胆固醇比值对急性脑梗死患者脑动脉狭窄的诊断价值

目的：探讨急性脑梗死患者脑动脉狭窄与脂质/高密度脂蛋白胆固醇（HDL-C）比值的相关性。方法：对263例住院急性脑梗死患者行头颅MRA检查,根据MRA所提示脑动脉狭窄的检查结果分为狭窄组（n=141）和对照组（n=122）。用全自动血生化分析仪测量患者的血生化指标。结果：狭窄组和对照组血清总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）水平及TG/HDL-C比值无显著性差异（P〉0.05）;血清TC/HDL-C及LDL-C/HDL-C比值有显著性差异（P〈0.05）,HDL-C水平狭窄组低于对照组（P〈0.05）。Logistic多元回归分析年龄和HDL-C降低是脑动脉狭窄的独立危险因素。结论：在急性脑梗死患者脑动脉狭窄评估中,TC/HDL-C和LDL-C/HDL-C比值是敏感性指标。