高密度脂蛋白及高密度脂蛋白胆固醇酯化速率与冠心病的相关性研究

Correlative study of High density lipoprotein cholesterol, Fractional rate of cholesterol esterification and Coronary heart disease

目的探讨高密度脂蛋白胆固醇（highdensitylipoproteincholesterol，HDL—C）、高密度脂蛋白胆固醇酯化速率（Fractionalrateofcholesterolesterification，FERHDL）与冠心病（coronaryarterydis-ease，CAD）的相关性。方法纳入本研究病例共116例，均未服用过他汀类药物，分为CAD组（n=79）和对照组（n=37），收集研究对象的一般临床资料并进行FERHDL、脂蛋白亚类的测定。应用t检验检测FERHDL在CAD及其常见危险因素中有无差异。用相关分析和Logistic多因素回归的方法分析HDL—C亚类、FERHDL与CAD的相关性。结果CAD组FERHnL显著高于对照组（P=0．003），HDL、HDk显著低于对照组（尸分别为0．034、0．040）。FERHDL、糖尿病、吸烟在本研究中与CAD最为相关；FERHDL能够反映脂蛋白颗粒的大小，它与HDL2（r=-0．668，P〈0．01）、HDL—C（r=-0．597，P〈0．01）呈负相关，与LDLh（r=0．493，P〈0．01）、LP（a）（r=0．189，P=0．043）呈正相关。结论CAD组与对照组相比，FERHDL水平明显升高，HDL—C、HDL2水平明显降低；男性、肥胖、血脂异常及CAD患者FERHDL水平明显升高；FERHDL可以反映脂蛋白颗粒的大小；FERHDL是冠状动脉病变的独立预测因子。

Objective To investigate the relationship between HDL, FERI-IDL and coronary artery disease. Methods A total of 116 hospitalized patients（77 men and 39 women）were enrolled in our study and were classified into CAD group（ n = 79） and control group（ n = 37） .Information about demographic factors,lifestyle（smoklng）, personal medical history（hypertension, dia- betes mellitus, lipids disorder and peripheral arterial disease）and medications were obtained. Lipids, apoproteins and FERHDL were measured. Results The CAD group had significantly higher values of FERHDL; History of diabetes mellitus, smoking and raised FERAL were sigrtifieantly related to CAD;FERm）L values indicated an inverse relation with I-IDL2（ r = -0.657, P 〈 0.001 ）and HDL（ r = - 0.142, P 〈 0.001 ） ; FERAL can also predict the size of lipoprotein subclasses. Conclusion Man, overweight indi- viduals, and patients with abnormal lipids or CAD had signifieandy higher FERAL values. FERHDL can reflect the size of lipoprotein subclasses.