冠心病患者低密度脂蛋白亚型分布特点

Distribution characteristics of low-density lipoprotein subtypes in patients with coronary heart disease

目的探讨冠心病(CHD)患者低密度脂蛋白(LDL)亚型分布情况及其与CHD的关系。方法纳入CHD患者162例(CHD组),选取既往无心血管疾病病史的同期于我院健康体检并行冠状动脉造影排除CHD者207例(对照组)。收集所有受试者的一般临床资料、实验室检查结果、LDL各亚型水平、LDL平均颗粒大小及LDL A型、LDL B型占比,并分组进行比较。各变量与CHD发生风险的相关分析采用Pearson相关性分析或logistic回归分析。结果CHD组总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平及高血压病、糖尿病患者比例均高于对照组,高密度脂蛋白胆固醇(HDL-C)水平低于对照组;CHD组LDL1水平、LDL平均颗粒大小及LDL A型占比均低于对照组,LDL3、LDL4、LDL5水平、LDL B型占比均高于对照组(P<0.05)。Pearson相关性分析结果显示,LDL1及LDL平均颗粒大小与CHD的发生风险呈负相关,LDL3、LDL4、LDL5及LDL B型与CHD的发生风险呈正相关(P<0.001)。Logistic回归分析结果显示,LDL B型、甘油三酯(TG)、TC、LDL-C、高血压病、糖尿病均与CHD的发生风险呈正相关,HDL-C与CHD的发生风险呈负相关(P<0.05)。结论LDL3、LDL4、LDL5、LDL B型与CHD发生风险呈正相关,LDL1、LDL平均颗粒大小分与CHD发生风险呈负相关。LDL3~LDL5水平升高、LDL平均颗粒大小降低和LDL B型均可作为CHD的重要危险因素。

Objective To investigate the distribution of low-density lipoprotein(LDL)subtypes in patients with coronary heart disease(CHD)and the relationship between low-density lipoprotein subtypes and CHD.Methods A total of 162 patients with CHD(CHD group)were included,and 207 patients without history of cardiovascular disease who underwent physical examination and coronary angiography in our hospital during the same period were selected as the control group.The general clinical data,laboratory results,levels of LDL subtypes,average LDL particle size and the proportion of LDL type A and LDL type B were collected and compared.Analysis of correlation between each variables and risk of CHD by using Pearson correlation analysis and logistic regression analysis.Results The levels of total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C)and proportion of hypertension and diabetes patients in CHD group were higher than those in control group,high-density lipoprotein cholesterol(HDL-C)level was lower than that in control group;the levels of LDL1,average LDL particle size and the proportion of LDL type A in CHD group were lower than those in control group,and the levels of LDL3,LDL4,LDL5 and the proportion of LDL type B were higher than those in control group(P<0.05).Pearson correlation analysis showed that LDL1 and LDL mean particle size were negatively correlated with the risk of CHD,while LDL3,LDL4,LDL5 and LDL type B were positively correlated with the risk of CHD(P<0.001).Logistic regression analysis showed that LDL type B,triglyceride(TG),TC,LDL-C,hypertension and diabetes were positively correlated with the risk of CHD,HDL-C was negatively correlated with the risk of CHD(P<0.05).Conclusion LDL3,LDL4,LDL5 and LDL type B are positively correlated with risk CHD,while LDL1 and LDL mean particle size are negatively correlated with risk CHD.The increase of LDL3-LDL5 levels,the decrease of LDL mean particle size and LDL type B may be important risk factors for CHD.