冠心病病人血清超敏C反应蛋白、尿酸和三酰甘油水平检测

目的探讨冠心病病人空腹血清超敏c反应蛋白（hsCRP）、尿酸（UA）和三酰甘油（TG）水平改变及其相关关系。方法抽取49例冠心病病人空腹肘静脉血5mL，分离血清后用全自动生化分析仪分别测定血清hsCRP、UA及TG水平，并随机选择30例正常体检者作为对照。结果冠心病病人血清hsCRP、UA和TG与对照组相比均显著升高，差异有显著性（t=2．294～2．926，P＜0．05）。49例冠心病病人中hsCRP、UA和TG水平超出正常参考范围的人数分别为21、15和18例，三者间差异无显著性（X^2=1．581，P＞0．05）。Person相关分析表明，冠心病病人3项指标间无明显相关性（r=-0．18～0．60，P＞0．05）。结论血清hsCRP、UA和TG升高分别县冠心病的独立危险因素，三者联合检测将有助于冠心病的诊断、治疗和预后判定。     

Blood Lipids and Diet in Swedish Adolescents Living in Norsjö, an Area with High Incidence of Cardiovascular Diseases and Diabetes

ABSTRACT. In Norsjö in Northern Sweden a cardiovascular intervention programme, for adults is presently tested. The aim of the present study was to investigate the presence of factors related to cardiovascular disease in all 15-year-old adolescents living in Norsjö in 1987 and 1988. The total cholesterol concentration in serum, as an average for the test period, was 4.2 mmol/l and 4.7 mmol/l for boys and girls, respectively. Fourteen per cent of the boys and 32% of the girls had a total cholesterol concentration exceeding 5 mmol/l. Twenty-seven per cent of the adolescents had high values for two or more variables related to risk of developing cardiovascular disease. The evaluation of the dietary registrations showed unsatisfactory values for fibre, P/S ratio and total fat. The dietary habits were better in the 15-year-olds in 1988 than in 1987 as judged by significantly higher average daily intake of fibre as well as a higher content of fibre per megajoule in the food.     

Blood sugar,free fatty acids and triglycerides in infants of diabetic mothers

Blood sugar (BS), free fatty acids (FFA) and triglycerides (TG) were estimated in eighteen neonates of diabetic mothers (IDM) and 36 appropriate for gestational age (AGA) term newborns of non-diabetic mothers, delivered normally and having normal blood sugar levels (30 mg/dl and above) were taken as controls. Even though blood sugar levels in the cord blood were higher in IDM group, mean levels were much lower than controls in first few hours of birth and nearly 45 per cent them developed hypoglycemia. A rise in FFA from cord levels in first few hours of birth was seen in all the cases, but levels were lower in IDM as compared to controls. TG levels showed a steady and mild rise from birth onwards. Changes in BS and FFA in IDM can be explained on the basis of hyperinsulinemic state in them in utero and in immediate postnatal period.     

Effects of simvastatin,an HMG-CoA reductase inhibitor,in patients with hypertriglyceridemia

BACKGROUND: Patients with elevated levels of serum triglycerides (TG) often have other associated lipid abnormalities (e.g., low levels of high-density lipoprotein cholesterol [HDL-C]) and are at increased risk of developing coronary heart disease. Although the therapeutic benefits of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) in hypercholesterolemic patients have been well established, less is known about the effects of statins in patient populations with hypertriglyceridemia. HYPOTHESIS: The purpose of this study was to evaluate the lipoprotein-altering efficacy of simvastatin in hypertriglyceridemic patients. METHODS: This was a multicenter, randomized, double-blind, placebo-controlled study. In all, 195 patients with fasting serum triglyceride levels between 300 and 900 mg/dl received once daily doses of placebo or simvastatin 20, 40, or 80 mg for 6 weeks. RESULTS: Compared with placebo, simvastatin treatment across all doses resulted in significant reductions (p < 0.05 - < 0.001) in serum levels of triglycerides (-20 to -31% decrease) and TG-rich lipoprotein particles. Significant (p < 0.001) reductions were also seen in low-density lipoprotein cholesterol (-25 to -35%) and non-HDL-C (-26 to -40%). Levels of HDL-C were increased (7-11%) in the simvastatin groups compared with placebo (p < 0.05 - < 0.001). CONCLUSION: The results of this study demonstrate the beneficial effects of simvastatin in patients with hypertriglyceridemia.     

Role of the liver in the degradation of very low density lipoproteins: a study of lipolysis by heparin releasable liver lipase and uptake during isolated rat liver perfusion

Abstract . The role of the liver and of a heparin-releas-able liver lipase in the metabolism of very low density lipoprotein (VLDL) was investigated in vitro and during recycling rat liver perfusion. Rat plasma VLDL and nascent hepatic VLDL were labelled biosyntheti-cally in their lipid moieties. Incubation in vitro of VLDL with the lipase caused hydrolysis of VLDL-tri-glycerides (>80%) and VLDL-phosphatidylcholine (> 30%). Nascent VLDL was a better substrate for the enzyme. The hydrolytic activities were inhibited by 70–90% when rat plasma (10–30 vol%) was added to the incubation mixture.
VLDL-triglycerides and cholesterol esters were taken up by the liver during 180 min recycling perfusion. The rate of disappearance of nascent VLDL was faster than that of plasma VLDL (half-life times of 56.2 ±13.9 and 125.0±24.8 min respectively). Injection of heparin into the perfusion medium caused accelerated uptake of the hydrolysed VLDL-triglycer-ide by the liver. Addition of plasma ( d > 1.006 g/ml) to the perfusion at a concentration of 10 vol% delayed the rate of disappearance of VLDL from the perfusate by about 50–75%.
These studies have established the capacity of the hepatic lipase to hydrolyse VLDL-lipids and the ability of the liver to degrade nascent and plasma VLDL particles. These two activities, however, are depressed by plasma and therefore previous studies of VLDL metabolism may have to be re-examined when based on incubations or perfusions in the absence of plasma.     

Effect of long-term starvation on acetate and ketone body metabolism in obese patients

Abstract. The turnover of ketone bodies and acetate was evaluated as well from the disappearance rate of (3-¹⁴C)acetoacetate or (1-¹⁴C)acetate respectively as from the conversion of FFA into these metabolites in normal weight and obese overnight-fasted and in obese long-term starved patients. The disappearance rate of (1-¹⁴C)oleate was the same in all three groups.
Long-term starvation enhanced ketone body turnover almost 10-fold, whereas the disappearance rate for ketone bodies decreased from 0·035 to 0·015 min^-1. Under the same circumstances the turnover of acetate was about 1 μmol g^-1 min^-1 accounting for about 5% of FFA turnover.
Long-term starvation decreased the conversion of (1-¹⁴C)oleate into triglycerides by almost 50% and increased the (2-C)-(4-C)/(1-C) ratio of radioactivity in ketone bodies. The reincorporation of radioactivity from the (1-C)position of (1-¹⁴C)oleate into the ((2-C)-( n -C)) position of FFA, which is a measure of the reutilization of acetyl-CoA for FFA synthesis decreased significantly during long-term starvation.     

BLOOD LIPIDS AND CORONARY HEART DISEASE

Considerable evidence confirms the fact that low levels of high-density lipoproteins (HDL) are associated with an increased risk of coronary heart disease (CHD).     

Dietary fructose: implications for dysregulation of energy homeostasis and lipid/carbohydrate metabolism

Fructose intake and the prevalence of obesity have both increased over the past two to three decades. Compared with glucose, the hepatic metabolism of fructose favors lipogenesis, which may contribute to hyperlipidemia and obesity. Fructose does not increase insulin and leptin or suppress ghrelin, which suggests an endocrine mechanism by which it induces a positive energy balance. This review examines the available data on the effects of dietary fructose on energy homeostasis and lipid/carbohydrate metabolism. Recent publications, studies in human subjects, and areas in which additional research is needed are emphasized.     

Autoimmune lymphoproliferative syndrome: a cause of chronic splenomegaly, lymphadenopathy, and cytopenias in children-report on diagnosis and management of five patients

Autoimmune lymphoproliferative syndrome (ALPS) usually manifests in early childhood with splenomegaly, lymphadenopathy, and cytopenias. In most patients, it results from mutations in genes that regulate lymphocyte apoptosis via the Fas pathway. Here, we report five children with ALPS. All five children had splenomegaly, cytopenias, and hypertriglyceridemia at presentation; four had lymphadenopathy. Mutations in the Fas receptor gene were demonstrated in three children. Clinical picture is variable: in only one child manifestations are severe enough to require immunosuppressive therapy. Diagnosis of ALPS can be challenging and increased awareness of the disease can result in more directed diagnostic approaches as well as earlier initiation of treatment.     

Diurnal triglyceridaemia and insulin resistance in mildly obese subjects with normal fasting plasma lipids

OBJECTIVE: A novel method has been developed to study diurnal triglyceride (TG) profiles using repeated capillary self-measurements in an 'out-of-hospital' situation. We assessed the diurnal capillary TG (TGc) profile in males with mild obesity and evaluated the use of plasma and capillary TG as markers of insulin resistance. DESIGN: Cross-sectional study. SETTING AND SUBJECTS: Fifty-four lean (body mass index, BMI < 25 kg m-2) and 27 mildly obese (25 < BMI < 30 kg m-2), normolipidaemic males measured capillary TG concentrations on six fixed time-points over a 3-day period in an 'out-of-hospital' situation. MAIN OUTCOME MEASURES: The total area under the TGc curve (TGc-AUC) and incremental area under the TGc curve (TGc-IAUC) were used as estimation of diurnal triglyceridaemia. Fasting blood samples were obtained once. Food intake was recorded by all participants. RESULTS: Obese and lean subjects had comparable fasting capillary TG concentrations (1.37 +/- 0.40 mmol L-1 and 1.32 +/- 0.53 mmol L-1, respectively). However, during the day, obese subjects showed a greater TG increase, resulting in significantly higher TGc-AUC (27.1 +/- 8.4 and 23.0 +/- 6.3 mmol h-1 l-1, respectively; P < 0.05) and TGc-IAUC (7.9 +/- 5.8 and 4.6 +/- 6.6 mmolh-1 L-1, respectively; P < 0.05). The total group of 81 males was divided into quartiles based on fasting plasma TG, fasting capillary TG, TGc-AUC and TGc-IAUC. Amongst these variables, TGc-AUC was the only significant discriminator of subjects with high homeostasis model assessment (HOMA) (insulin resistance) compared with low HOMA (insulin sensitive). Overall, BMI was the strongest determinant of HOMA. CONCLUSIONS: Diurnal TG profiles can be used to investigate postprandial lipaemia in both lean and mildly obese subjects and may help to detect subjects with an underlying disposition for hypertriglyceridaemia related to insulin resistance, i.e. the metabolic syndrome.