餐后高甘油三酯血症与冠心病的关系

为探讨餐后高甘油三酯血症与冠心病的关系 ,6 1例研究对象被分为冠心病组 (n =30 )和对照组 (n =31)两组 ,均口服标准脂肪餐 (含脂肪 5 3.4g/m2 体表面积 ) ,分别测定其空腹及餐后 2、4、6、8及 10h的甘油三酯浓度及高密度脂蛋白胆固醇浓度。发现两组病人餐后甘油三酯浓度达高峰时间均为 6h ,冠心病组的高峰浓度 (6 .15±3.0 0mmol/L)及餐后甘油三酯代谢的曲线下面积 [2 5 .96± 14.33mmol/ (h·L) ]明显高于对照组 [4 .5 9± 2 .0 9mmol/L及 14.6 9± 6 .5 8mmol/ (h·L) ,P <0 .0 0 5 ]。Logistic多元回归分析提示 ,餐后甘油三酯代谢的曲线下面积是冠心病的独立危险因素。相关分析表明餐后甘油三酯代谢的曲线下面积与两组餐后 6h及 8h甘油三酯浓度存在明显的正相关关系。以上提示冠心病病人存在异常的餐后高甘油三酯血症 ,该异常是冠心病的独立危险因素。测定餐后 6h及 8h甘油三酯浓度可以代替餐后甘油三酯代谢的曲线下面积 ,从而简化脂肪餐负荷试验。

Relation of Postprandial Hypertriglyceridemia and Coronary Heart Disease

Aim To evaluate the effects of postprandial hypertriglyceride on CHD in Chinese. Methods Fat tolerance test (fat: 53.4 g/m 2 body surface area)was performed in 61 subjects who were divided into two groups: CHD(n=30)and control(n=30). Concentration of triglyceride(TG) and high density lipoprotein cholesterol(HDLC) were determined before and 2,4,6,8 and 10 h after a standardized fat test meal. Both the peak concentration of postprandial TG (6.15±3.00 mmol/L) and the Area Under Curve [AUC, 25.96±14.33 mmol/(h·L)] of postprandial triglyceride concentration were higher in CHD than those [4.59±2.09 mmol/L and 14.69±6.58 mmol/(h·L),P<0.005] in control. The AUC is an independent risk factor of CHD by multivariate logistic-regression analysis. There is a positive correlation between AUC and the concentration of 6 and 8 h postprandial triglyceride(TG 6 or TG 8). Conclusions Our study indicated that there be abnormal postprandial hypertriglyceridemia in CHD. The abnormal postprandial hypertriglceridemia is an independent risk factor of CHD. The concentration of TG 6 or TG 8 may replaced AUC and simplify the fat load test.