高密度脂蛋白胆固醇低水平对心血管疾病的影响

The impact of low levels of high density lipoprotein cholesterol on cardiovascular disease

目的评价低高密度脂蛋白胆固醇(HDL-C)水平对心血管疾病的影响。方法心血管疾病患者作为实验组,志愿者作为对照组,然后两组各继续分为两个亚组:正常HDL-C亚组和低HDL-C亚组。对如下数据进行分析:血压(BP)、体重指数(BMI)、腰围(WC)、血糖、胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、氧化低密度脂蛋白(OX-LDL)、总HDL-C和亚群(小,中,和大)、对氧磷酶-1(PON1)活性、C反应蛋白(hs CRP)、尿酸、肿瘤坏死因子(TNF-α)、脂连蛋白、血管内皮生长因子(VEGF)和细胞间黏附分子(ICAM1)。结果对照组的低HDL-C亚组与正常HDL-C亚组相比,BP和TG升高,PON1活性和脂连蛋白降低。然而,在实验组的亚组差异显然更加明显,低HDL-C亚组糖化血红蛋白,TG,OX-LDL,C反应蛋白,VEGF和小HDL-C增加,大HDL-C和脂连蛋白降低。此外,实验组正常HDL-C亚组OX-LDL,大HDL-C,和脂连蛋白呈现相关关系。结论提高HDL-C水平以及抑制OX-LDL水平可以预防心血管疾病。

[ Objective ] To evaluate the impact of low levels of high density lipopro-tein cholesterol （HDL-C） on cardiovascular disease. [ Methods ] Patients with cardiov-ascular risk factors （n = 169） and control subjects （n = 73） were divided into 2 subgr-oups, one of normal HDL-c and the other of low HDL-c levels. The following data was analyzed： BP, BMI,waist circumference and serum glucose Total-c, TGs, LDL-c, oxidized LDL, total HDL-c and subpopulations （small, intermediate,and large）,paraoxonase-1 （PON1） activity, hsCRP, uric acid, TNF-a, adiponectin, VEGF, and iCAM 1. [ Results ] In the control subgroup with low HDL-c levels, significantly higher values of BP and TGs and lower values of PON1 activity and adiponectin were found, versus control normal HDL-c subgroup. However, differences in patients＇ subgroups were clearly more pronounced. Indeed, low HDL-c subgroup presented increased HbAlc, TGs, non-HDL-c, Ox-LDL, hsCRP, VEGF, and small HDL-c and reduced adiponectin and large HDL. In addition, Ox-LDL, large-HDL-e, and adiponectin presented interesting correlations with classical and nonclassical markers, mainly in the normal HDL-c patients＇ subgroup. [ Conclusion ] To raise HDL-c levels and functionality and to inhibit Ox-LDL levels are advisory preventive measures in this type of eardiovaseula risk populations.