Overweight and obese youth with type 1 or type 2 diabetes share similar elevation in triglycerides during middle and late adolescence

BackgroundOverweight and obesity have been observed in children with type 1 diabetes (T1D). This further increases their future risk of Cardiovascular Disease (CVD) as well as the development of other risk factors, such as dyslipidemia.AimsTo compare lipid profiles in children and adolescents with Type 1 diabetes and lean mass (T1L), Type 1 diabetes and overweight or obese (T1OW/OB), and type 2 diabetes (T2D).MethodsThis was a cross-sectional study of 669 patients with T1D or T2D aged 2–19 years using retrospective data collected from 2003 to 2014. Included patients were categorized into lean (BMI < 85th ile and overweight or Obese (BMI ≥ 85th ile). Patients were subcategorized into three age groups: < 10 years, 10–14 years, and 15–19 years.Results7.6% of patients had T2D. Of the patients with T1D, 58.9% were lean, 26.4% were overweight, and 14.7% were obese. Total Cholesterol (TC), Low-density lipoprotein cholesterol (LDL-C) and Non-HDL-C levels were similar across groups. In the 15–19 years group, Triglycerides (TG) levels were significantly higher in T1OW/OB and similar to T2D. High-density lipoprotein Cholesterol (HDL-C) was significantly lower in T2D. Weight status significantly correlated with TG and HDL-C levels in T1D and T2D groups.ConclusionsT1OW/OB constitutes a significant proportion of the T1D population. Patients with obesity and T1D, especially if in their late adolescence, have an adverse lipid profile pattern that is comparable to adolescents with T2D. Based on these findings, risk for future CVD in T1OW/OB and T2D may be equivalent.     

基于贝叶斯多变量联合模型的体检人群脑卒中发病风险因素的纵向研究

背景 脑卒中是目前影响人类健康的主要公共卫生问题之一;健康体检纵向数据累积了大量的健康信息,由于缺失数据多、样本量小等诸多问题,导致其利用率低、重要信息未能得到充分挖掘,进而对常见慢性病的有效防控等工作带来一定困难。目的 基于贝叶斯多变量联合模型,探讨体检人群脑卒中发病风险因素,为慢性病风险因素分析提供新的方法。方法 本研究使用空军军医大学西京医院健康医学中心2008—2015年的体检资料。随访情况：以首次发生脑卒中为结局事件,发生结局事件立即停止随访;若未发生,到2015年体检信息收集完成后结束随访;体检间隔时间为1年。依据随访过程中是否发生脑卒中分为脑卒中组和非脑卒中组。纵向观察变量包括总胆固醇（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）、体质指数（BMI）和收缩压（SBP）。采用多因素Cox回归模型分析基线情况对脑卒中结局事件的影响;采用贝叶斯多变量联合模型,分析随访过程中TC、TG、LDL-C、HDL-C、BMI和SBP的纵向变化轨迹对脑卒中发病的影响。结果 本研究共纳入234例研究对象,1 581条纵向随访记录,平均随访时间为...     

脂质比值与代谢综合征的关联及预测价值评价：基于多阶段横断面研究

背景 随着代谢性疾病发病率的上升,代谢综合征(MS)的预防与控制引起广泛的关注。而脂质比值是重要的筛查指标之一,与MS之间的关系成为热点研究话题。目的 基于贵州省多阶段横断面研究人群分析三酰甘油/高密度脂蛋白胆固醇(TG/HDL-C)、总胆固醇/HDL-C(TC/HDL-C)、低密度脂蛋白胆固醇/HDL-C(LDL-C/HDL-C)及非高密度脂蛋白胆固醇(non-HDL-C)与MS发病风险的关联及预测价值评价。方法 回顾性选取贵州省参与2010年全国疾病监测地区慢性病及危险因素调查、2013年中国慢性病及其危险因素监测、2015年中国成人慢性病与营养监测和2018年中国成人慢性病与营养监测的21 727例自然人群为研究对象,收集研究对象的基线资料,根据是否患有MS将研究对象分为MS组(n=4 981)和非MS组(n=16 746)。绘制受试者工作特征曲线(ROC曲线)分别评价男性和女性TG/HDL-C、TC/HDL-C、LDL-C/HDL-C和non-HDL-C对MS的预测价值。通过Delong检验比较脂质比值预测MS发生的ROC曲线下面积(AUC)的差异。采用多因素Logistic回...     

Perfil lipídico em pacientes adultos com artrite idiopática juvenil

The inflammatory processes in the joints of a child with juvenile idiopathic arthritis (JIA) can persist into adulthood. Inflammation has been linked to distortions of the lipid profile and accelerated atherogenesis. In the present study, we examined the lipid profiles of adults with JIA compared with those of healthy people. A lipid profile of a sample of 54 adults with JIA (57.3% with polyarticular JIA, 37.0% with oligoarticular JIA, 1.9% with enthesitis-related JIA and 3.7% with systemic onset JIA) and 54 healthy subjects were compared. In the adults with JIA, data on gender, age, age at disease onset, the presence of rheumatoid factor (RF) and antinuclear antibodies (ANA), a Health Assessment Questionnaire (HAQ) and the disease duration were collected. We found that hypercholesterolaemia, increased low-density lipoprotein (LDL) and decreased high-density lipoprotein (HDL) were more common in patients with JIA than the controls (P = 0.016, P < 0.0001 and P = 0.0008, respectively). Changes in the levels of total cholesterol (TC) and LDL were more common in the individuals who had a later onset of disease (P = 0.0017 for TC and P = 0.023 for LDL). In the entire JIA group, no other variable, such as RF, ANA, disease duration or responses to the HAQ, could be linked to dyslipidaemia (P = non-significant). We concluded that the adult patients with JIA have a lipid profile with increased TC and LDL levels and decreased levels of HDL compared to the controls. No clinical feature could be correlated with this change except for the age at disease onset.     

慢性胆囊炎患者血清瘦素及可溶性瘦素受体与血脂水平的变化及关系

目的:探讨慢性胆囊炎患者血清瘦素(Lep)、可溶性瘦素受体(s LR)与血脂水平的变化及其相互关系。方法:选择103例慢性胆囊炎患者,以91例健康体检者为对照,测定所有受试者空腹血清Lep、s LR、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL),分析慢性胆囊炎患者血清Lep、s LR水平与血脂水平的关系。结果:与对照组比较,慢性胆囊炎组患者血清TC、LDL和Lep水平均明显升高,而s LR水平明显降低(均P0.05)。单因素分析显示,Lep水平与TC、TG和HDL水平呈明显正相关(均P0.05),而s LR水平与各血脂指标无明显相关性(均P0.05);多元回归分析显示,Lep水平与TC水平呈明显正相关(P0.05)。结论:慢性胆囊炎患者血清Lep明显升高、s LR水平降低以及血脂代谢紊乱,其中,Lep升高所致胆固醇代谢障碍可能是主要原因。     

绝经后女性内源性性激素及血脂水平与乳腺癌的关系

目的:探讨绝经后女性内源性性激素及血脂水平与乳腺癌的关系以及作为预测指标的可行性。方法:收集2011年7月—2014年6月期间手术治疗的绝经后女性乳腺癌患者274例(乳腺癌组)与同期因其他疾病收治的非乳腺疾病的绝经后患者279例(对照组);比较两组间性激素与血脂水平的差异,分析可能的乳腺癌预测指标。结果:乳腺癌组的雌二醇(E2)与睾酮(T)水平明显高于对照组(均P0.05),其他性激素与血脂指标两组间差异均无统计学意义(均P0.05)。分层分析显示,随E2与T水平升高,乳腺癌发病率增加,其中E2水平对乳腺癌的预测有较好的敏感性和特异性,受试者操作特征(ROC)曲线下面积(AUC)为0.730(95%CI=0.649~0.811),但T水平的预测作用不明显。结论:E2与T水平与绝经后女性乳腺癌有关,其中E2水平可作为预测因子之一,但尚未达到良好或者优秀标准。     

非传统脂质指标与缺血性卒中

缺血性卒中预防和治疗的个性化管理依然是神经病学领域的重中之重。文章旨在阐述非传统脂质谱与传统脂质在急性缺血性卒中发病以及复发中的作用,以期为卒中预防、风险分级和高危人群筛查提供全新指标,并试图探讨非传统脂质指标的潜在预测价值。     

老年冠心病患者血脂与肌酐清除率的相关性研究

目的 探讨老年冠心病患者血脂与肌酐清除率的相关性. 方法 选择784例年龄65岁及以上患者,根据冠状动脉造影结果和肌酐清除率水平进行分组,比较各项血脂水平. 结果肌酐清除率水平随冠状动脉病变的逐渐加重明显下降(F=5.35,P＜0.01).肾功能中重度损伤组(肌酐清除率小于0.83 ml· s-1·1.73 m-2)载脂蛋白A1(ApoA1)水平降低,载脂蛋白B(ApoB)水平升高(F=5.31,F=4.91,均P＜0.01).男性中肾功能中重度损伤组ApoA1水平降低(F=3.52,P＜0.05),ApoB水平升高(F=5.65,P＜0.01),冠心病患者中肾功能中重度损伤组ApoA1水平降低(F=5.79,P＜0.01),ApoB水平升高(F=4.56,P＜0.05),高密度脂蛋白胆固醇水平降低(F=3.39,P＜0.05).多元Logistic回归分析结果表明,肌酐清除率、高密度脂蛋白胆固醇、ApoA1和ApoB是冠心病的影响因素. 结论 血脂异常和肾功能减退均是冠心病发病的危险因素,血脂异常同时引起肾脏损害.对于老年冠心病患者需积极控制血脂,同时关注其他重要脏器功能.     

高血压患者血压变异性与血脂异常的关系

目的 选择原发性高血压患者为研究对象,探讨血脂代谢异常对其血压变异性(BPV)的影响.方法 入选231例40～65岁的中老年原发性高血压患者(均为初次确诊原发性高血压或经询问病史已停用所有降压药物＞2周).其中单纯高血压组119例(A组),其中男69例,女50例;高血压合并脂代谢异常组112例(B组,3个月内均未服用任何调脂药物),其中男66例,女46例.两组均询问饮酒史、吸烟史,记录年龄、性别、身高、体质量、病程、诊所血压(CBP),并计算体质量指数.测量空腹血糖(FPG)、总胆固醇(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).对入选的患者进行24h动态血压监测.收集BPV长时变异指标,将两组进行对比分析,了解血脂异常对高血压患者BPV的影响.结果 与单纯高血压组比较,高血压合并血脂异常组BPV增大,差异有统计学意义(P＜0.01).结论 高血压合并血脂异常组较单纯高血压组BPV增大.提示高血压和血脂异常均是心脑血管疾病的重要危险因素,两者之间存在密切的关系,两者联合干预治疗对减少脑血管疾病的发生、发展、预后具有重要的意义.