血清总胆固醇、甘油三酯与高密度脂蛋白胆固醇比值同高密度脂蛋白亚类组成关系的研究

目的：探讨血清总胆固醇/高密度脂蛋白胆固醇(TC/HDL-C)、甘油三酯/高密度脂蛋白胆固醇（TG/HDL-C）比值与高密度脂蛋白（HDL）亚类组成及含量关系。 方法： 采用双向电泳-免疫印迹检测法分析了292例受试者血清HDL亚类的组成及含量。 结果： 随血清TC/HDL-C比值增大，preβ1-HDL、HDL3a含量升高，HDL2b、HDL2a含量降低。preβ1-HDL（P＜0.01，高比值组及中间组）、HDL3a（P＜0.05，高比值组）含量显著高于低比值组，而HDL2b（P＜0.01，高比值组及中间组）、HDL2a（P＜0.01，高比值组）含量显著低于低比值组；此外，高比值组preβ1-HDL、HDL3a含量显著高于中间组（P＜0.01，P＜0.05），而HDL2a、HDL2b含量显著低于中间组（P＜0.01，P＜0.01）。随血清TG/HDL-C比值增大，preβ1-HDL、HDL3a含量升高，HDL2b、HDL2a含量降低。preβ1-HDL、HDL3a（P＜0.01，P＜0.05，高比值组）含量显著高于低比值组，而HDL2b、HDL2a（P＜0.01，P＜0.01，高比值组及中间组）含量显著低于低比值组；此外，高比值组preβ1-HDL、HDL3a含量显著高于中间组（P＜0.01，P＜0.05），而HDL2a、HDL2b含量显著低于中间组（P＜0.01，P＜0.01）。相关分析发现，血清TC、TG、TC/HDL-C、TG/HDL-C与小颗粒preβ1-HDL含量呈显著正相关（P＜0.01，P＜0.01，P＜0.01，P＜0.01），与大颗粒HDL2b含量呈显著负相关（P＜0.05，P＜0.01，P＜0.01，P＜0.01）；HDL-C与小颗粒preβ1-HDL含量呈显著负相关（P＜0.05），与大颗粒HDL2b含量呈显著正相关（P＜0.01）。 结论： 血清TC/HDL-C＞5或TG/HDL-C＞2.2时，小颗粒HDL含量明显增加而大颗粒HDL含量明显减少，表明HDL成熟代谢过程受阻，胆固醇逆向转运作用减弱。

Relationship between HDL subclasses and TC/HDL-C, TG/HDL-C ratio

AIM: To study the relationship between HDL subclasses and TC/HDL-C, TG/HDL-C ratio in serum. METHODS: Apolipoprotein (apo) A-Ⅰ contents of serum HDL subclasses in 292 subjects were determined by two-dimensional gel electrophoresis associated with immunodection method. RESULTS: Compared with low TC/HDL-C ratio subgroup, apoA-Ⅰcontents of preβ1-HDL (P<0.01, in middle or high subgroup) and HDL3a (P<0.05, in high subgroup) were significantly higher, but those of HDL2b (P<0.01, in middle or high subgroup) and HDL2a (P<0.01, in high subgroup) were significantly lower. Compared with middle TC/HDL-C ratio subgroup, apoA-Ⅰ contents of preβ1-HDL, HDL3a were significantly higher (P<0.01, P<0.05), but those of HDL2a and HDL2b were significantly lower (P<0.01, P<0.01) in high subgroup. Compared with low TG/HDL-C ratio subgroup, apoA-Ⅰ contents of preβ1-HDL, HDL3a were significantly higher (P<0.01, P<0.05, in high subgroup), but those of HDL2a and HDL2b were significantly lower (P<0.01, in middle or high subgroup). Compared with middle TG/HDL-C ratio subgroup, apoA-Ⅰ contents of preβ1-HDL, HDL3a were significantly higher (P<0.01, P<0.05), but those of HDL2a and HDL2b were significantly lower (P<0.01). In addition, TC, TG, TC/HDL-C ratio and TG/HDL-C ratio showed a positive correlation with apoA-Ⅰ contents of small-sized preβ1-HDL and a negative correlation with those of large-sized HDL2b, but it was reversed for HDL-C. CONCLUSION: When TC/HDL-C>5 or TG/HDL-C>2.2 in serum, the particle size of HDL shifted towards smaller sizes, which indicates that reverse cholesterol transport might be weakened and HDL maturation might be abnormal.