广西汉族人群 NPC1L1基因1735 C>G 多态性分布特征及与血脂、肥胖的关系?

目的：分析 NPC1L1基因1735 C>G 多态性分布特征及其与血脂、肥胖的关系。方法采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法,对409例汉族人群进行 NPC1L1基因多态性分型,比较不同基因型间血脂水平、BMI 的差异。结果CC,CG,GG 基因型的分布频率分别为39.40%、46.00%、14.60%;等位基因 C 和 G 频率分别为62.35%和37.65%。3种基因型组间的 LDL-C、ApoB 水平和 BMI 的差异有统计学意义(P <0.05),G 等位基因携带者(GC/GG 基因型)较 CC 型有更高的 LDL-C、ApoB 水平(P <0.05)。血脂谱和 BMI 与多种环境因素相关。结论NPC1L1基因1735 C>G 多态性与血脂水平和 BMI 相关,G 等位基因可能是高 LDL-C 水平和肥胖的一个危险因素。     

Serum lipid profiles: novel biomarkers predicting advanced prostate cancer in patients receiving radical prostatectomy

This study aimed to evaluate the role of serum lipid profiles as novel biomarkers in predicting pathological characteristics of prostate cancer (PCa). We retrospectively analyzed 322 consecutive patients with clinically localized PCa receiving radical prostatectomy (RP) and extended pelvic lymphadenectomy. Unconditional logistic regression was used to estimate the prostatectomy Gleason score (pGS), pathological stage and lymph node involvement (LNI) in RP specimens. Preoperative prostate-specific antigen (PSA) levels, biopsy GS (bGS), and preoperative tumor, node, metastasis staging were used as basic variables to predict postoperative pathological characteristics. Preoperative serum lipid profiles were introduced as potential predictors. A receiver operating characteristic (ROC) curve was used to determine predictive efficacy. Significant differences in pathological characteristics were observed among patients with normal and abnormal total cholesterol (TC), triglyceride (TG), and low-density lipoprotein (LDL) levels, with the exception of pGS in the TG group. Multivariable regression analysis revealed that the odds ratio for high levels of TC for LNI compared with normal TC levels was 6.386 (95% confidence interval [CI] 1.510–27.010), 3.270 (95% CI: 1.470–7.278) for high levels of TG for pT3–4 disease, and 2.670 (95% CI: 1.134–6.287) for high levels of LDL for pGS. The area under the ROC curve of the models with dyslipidemia was larger than that in models without dyslipidemia, in predicting pathological characteristics. Abnormal TC, TG, and LDL levels are significantly associated with postoperative pathological status in PCa patients. Together with preoperative PSA levels, bGS, and clinical stage, dyslipidemia is more accurate in predicting pathological characteristics.     

单中心老年心血管病危险因素控制现状分析

目的了解老年患者心血管病危险因素控制现状。方法选择我院老年内科住院治疗的疑诊冠心病的老年患者256例,测定血糖、血脂水平,进行24h动态血压监测,根据相关指南推荐的血压、血糖及血脂达标值判断达标情况。根据冠状动脉造影结果将入选者分为冠心病组208例与非冠心病组48例,比较2组上述危险因素控制情况。结果 256例患者中,209例(81.6%)合并高血压,24h、昼间及夜间平均血压达标率分别为75.1%、82.8%和59.3%;99例(38.7%)合并糖尿病,血糖达标率70.7%;154例(60.2%)合并血脂异常,LDL-C达标率41.4%。冠心病组与非冠心病组血压、血糖达标率比较,差异无统计学意义(P>0.05),冠心病组LDL-C达标率低于非冠心病组,差异有统计学意义(38.5%vs 54.2%,P<0.05)。结论老年心血管病高危患者中,血压、血糖达标率高,LDL-C达标率较低,尤其心血管病极高危的冠心病患者LDL-C达标率更低,应重视老年患者心血管病风险评估,并进一步加强对血脂的干预力度。     

宁夏回族脑梗死患者三磷酸腺苷结合盒转运子基因R219K多态性与血脂的关系

目的探讨宁夏回族脑梗死患者ATP结合盒转运子(ABCA1)基因R219K多态性与血脂的关系。方法连续入选住院的回族脑梗死患者105例为脑梗死组,同期入选我院门诊回族健康体验者257例为对照组。检测血脂等生化指标,用PCR-RFLP方法测基因R219K多态性,分析其与血脂的关系。结果脑梗死组和对照组RR、RK基因型及R和K等位基因频率比较,差异无统计学意义(P>0.05)。脑梗死组KK基因型较对照组明显降低,差异有统计学意义(11.4%vs 26.8%,P<0.01)。各基因型血脂水平比较,差异无统计学意义(P>0.05)。结论 KK基因型可能是回族脑梗死患者的保护因素,其保护因素可能与血脂水平无关。     

Effects of Fish Oil Supplementation on Oxidative Stress Biomarkers and Liver Damage in Hypercholesterolemic Rats

Metabolic syndrome, especially its component related to dyslipidemia, is related to the development of nonalcoholic fatty liver disease (NAFLD), which is a disease with a significant global prevalence. Supplementation with omega-3 polyunsaturated fatty acids emerged as a complementary therapeutic possibility for dyslipidemia, but its benefits are questioned. This paper aims at evaluating the effects of fish oil supplementation in rats with hypercholesterolemia induced by hypercholesterolemic diet (HD). The study design is based on an experimental model in which the animals were randomly divided into 3 groups: G1 (standard commercial feed + saline solution); G2 (hypercholesterolemic diet + saline solution) and G3 (hypercholesterolemic diet + fish oil) over a period of 16 weeks. Metabolic control parameters and oxidative stress biomarkers were evaluated according to standardized methodologies. The G3 group showed significantly lower values of plasma concentrations of TG, and hepatic myeloperoxidase as well as higher erythrocyte superoxide dismutase activity (p < 0.05). Regarding histopathological analysis, there was lipid accumulation in the liver of animals from group G2; meanwhile, hepatocytes reorganization and expressive reduction of lipid vacuoles and hepatic TG content was observed in group G3. This study demonstrated how fish oil supplementation reduced the plasma concentration and hepatic content of triglycerides, as well as liver tissue damage in histopathological analysis.     

急性脑梗死患者糖脂代谢紊乱的临床研究

目的调查急性脑梗死患者血糖及血脂代谢异常情况,以制定合理的干预策略,改善预后。方法选择急性脑梗死患者398例,按牛津郡社区脑卒中项目分型,检测空腹血糖(FPG)、糖化血红蛋白(HbAlc)、血脂,对无糖尿病史的患者在病情稳定后,进行口服葡萄糖耐量试验(OGTT),根据FPG水平,将患者分为糖代谢正常组196例,糖调节受损组78例和糖尿病组124例,对各组糖脂水平进行对比分析。结果 398例患者总的糖代谢异常率为50.8%,其中入院后新确诊糖尿病59例(14.8%)、糖调节受损78例(19.6%),在新确诊的糖代谢异常中,40.7%的糖尿病及59.0%的糖调节受损通过OGTT确诊。与糖代谢正常组比较,糖调节受损组和糖尿病组患者血脂、FPG及HbAlc水平明显升高(P<0.05);在脑梗死各亚型中,患者FPG、血脂水平无差异,但腔隙性脑梗死患者糖代谢异常比例最高。结论脑梗死患者糖代谢异常比例高,OGTT可发现大量合并糖代谢异常患者,糖脂代谢异常在动脉粥样硬化性脑梗死的病理机制中起重要作用。     

血脂与纤维蛋白原Bβ链基因多态性的关系及对其功能表达的影响

目的研究血脂对血浆纤维蛋白原(fibrinogen,Fib)含量及其聚合功能表达的影响以及与Fib Bβ链-854G/A、-455G/A、249C/T、-148C/T、448G/A和Bcl-1G/A位点基因多态性的关系。方法选取开滦集团离退休职工1 386人进行体检和问卷调查,根据血清TC、TG水平将人群分别分为无高TC组(11 38例)、高TC组(248例)和无高TG组(1131例)、高TG组(255例)。同时测定血浆Fib浓度和纤维蛋白单体聚合反应速率(FMPV)、最大吸光度(A_(max))、FMPV/A_(max)等指标,并应用PCR-RFLP技术检测Fib Bβ链6个多态性位点的基因型。结果高TC组-854变异基因型人群的Fib浓度明显高于野生基因型人群;高TG组-854变异基因型人群的Fib、FMPV、A_(max)、FMPV/A_(max)明显高于野生基因型人群(P<0.05);以TC为因变量筛选出性别、C反应蛋白、-854基因型、吸烟,以TG为因变量则筛选出C反应蛋白、体重指数、血糖、性别等指标(P<0.05)。结论不同类型血脂异常对不同Fib Bβ链多态性位点基因型人群影响不同,并通过与其他多种因素相互作用成为脑梗死发病危险因素。     

内源分泌型高级糖基化终末产物受体与冠心病危险因素对动脉弹性的影响

目的探讨冠心病患者内源分泌型高级糖基化终末产物受体(esRAGE)与冠心病危险因素对动脉弹性的影响。方法选择180例冠心病患者,检测颈-股动脉脉搏波传导速度(cf-PWV)、肱-踝动脉脉搏波传导速度(ba-PWV)和血esRAGE,分析与冠心病相关的危险因素。结果与未合并高血压、糖尿病、腰围正常和≤3个异常代谢组分患者比较,合并高血压、糖尿病、腰围异常和3个异常代谢组分患者的cf-PWV、ba-PWV明显增高,血esRAGE降低(P0.05)。log cf-PWV与年龄、收缩压、舒张压、稳态模式评估法胰岛素抵抗指数呈正相关,与esRAGE呈负相关(P0.05)。ba-PWV与年龄、收缩压、舒张压呈正相关,与esRAGE呈负相关(P0.05)。log cf-PWV与年龄、收缩压、esRAGE独立相关;ba-PWV与年龄、收缩压独立相关。结论合并危险因素的冠心病患者的动脉弹性功能明显减低,冠心病患者esRAGE水平下降在动脉弹性减低方面起着重要作用。     

小肠型脂肪酸结合蛋白基因多态性与老年冠心病人群发病风险的研究

目的研究老年人群小肠型脂肪酸结合蛋白(I-FABP)基因编码区外显子2中第54位密码子多态性与冠心病患者血脂水平和冠心病发病风险的关系。方法随机选取老年冠心病患者56例作为病例组,同时选取我院体检中心的健康老年人49例作为对照组,记录一般临床资料,检测TC、TG、LDL-C、HDL-C水平,同时采用聚合酶链反应技术、DNA限制性内切酶酶切技术检测该人群的I-FABP基因HhaⅠ酶切位点的多态性。结果所有受试者I-FABP基因编码区外显子第54位密码子存在HhaⅠ酶切位点,产生多态性片段为野生型A/A、杂合突变型A/T、纯合突变型T/T。病例组A/T、T/T基因携带者TC、TG、LDL-C水平明显高于A/A携带者,差异有统计学意义(P<0.05)。对照组A/A基因携带者与A/T、T/T基因携带者TC、TG、LDL-C、HDL-C差异无统计学意义(P>0.05)。体质量指数、饮食习惯、I-FABP等位基因是冠心病主要的独立危险因素。结论样本人群中存在I-FABP基因多态性;I-FABP基因多态性影响老年冠心病患者的脂质代谢水平,与老年人冠心病发病风险有关,可能是冠心病发生的遗传易感因素。     

汉族妇女多囊卵巢综合征胰岛素抵抗及相关代谢特征分析

目的探讨汉族妇女多囊卵巢综合征（PCOS）患者胰岛素抵抗（IR）发生情况、糖耐量受损和血脂代谢特征。方法采集118例PCOS患者临床资料，采用口服葡萄糖耐量试验（OGTT）和胰岛素释放试验评估糖代谢和IR，并进行血脂代谢检查。比较IR（Ⅰ组）和非IR（Ⅱ组）两组年龄、体重指数（BMI）、腰臀比（WHR）、血脂及其相关蛋白水平的差异性。结果PCOS患者肥胖发生率为34．75％，男型肥胖48.31％；IR发生率为55，08％；糖耐量受损15.25％；共筛出4例（3.39％）糖尿病。56，78％患者存在血脂异常，以三酰甘油、载脂蛋白B及低密度脂蛋白异常为主。Ⅰ组BMI和WHR均显著高于Ⅱ组；Ⅰ组和Ⅱ组间三酰甘油、载脂蛋白A和高密度脂蛋白水平差异有显著性。结论汉族PCOS患者中亦存在较高的肥胖、胰岛素抵抗和糖、脂代谢异常发生率，应高度重视汉族妇女PCOS患者IR和代谢紊乱所致远期并发症的防治。