磁共振波谱技术测定中国人群血脂亚组分的初步探讨

Preliminary Analysis of Blood Lipid Profile by Nuclear Magnetic Resonance Spectroscopy in Adult Chinese Population

目的:脂蛋白颗粒直径、各血脂亚组分是独立于低密度脂蛋白胆固醇(LDL-C)的动脉粥样硬化性心血管疾病(ASCVD)的危险因素。本研究采用磁共振波谱技术(nuclear magnetic resonance spectroscopy,NMRS)分析中国人群的血脂亚组分谱,建立NMRS检测中51个检测指标中国表观健康人群的正常参考范围。方法:本研究首先评估NMRS的稳定性,并在1091例中国人群中比较了NMRS与当前临床常规血脂检测共同指标的一致性。随后以其中691例健康人群数据,建立NMRS各项血脂指标正常参考区间,并进行性别亚组的差异分析。结果:NMRS血脂检测平台稳定性评估中,6项临床常规血脂指标(总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、载脂蛋白A1、载脂蛋白B)批间变异系数为1.39%~2.62%,并与临床常规生化方法学检测结果之间具有高度相关性(6项指标相关系数介于0.927~0.978)。691例健康成人的低密度脂蛋白颗粒平均粒径为19.93~21.20 nm,极低密度脂蛋白、中密度脂蛋白、低密度脂蛋白的总颗粒数参考区间分别为32.6~347.3 nmol/L、8.5~105.8 nmol/L、626.0~1829.6 nmol/L。建立5个极低密度脂蛋白亚组分、6个低密度脂蛋白亚组分、4个高密度脂蛋白亚组分的总胆固醇和甘油三酯浓度的中国表观健康成人参考区间。性别亚组分析显示,不同血脂组分在男性与女性间差异具有统计学意义。结论:NMRS检测可获得更丰富的血脂亚类谱,并建立中国健康成人的血脂各亚组分参考区间,为NMRS在临床的广泛应用打下坚实基础。

Objectives:Lipoprotein particles size and lipid subclasses are risk factors of ASCVD independent of LDL-C.In this study,blood lipid profile was determined by nuclear magnetic resonance(NMRS)in adult Chinese healthy population to establish the normal reference interval of adult healthy population in China.Methods:We evaluated NMRS-based lipid tests(with 51 parameters,including LDL size,lipid subclasses and lipoprotein particles size)in 1091 adult healthy Chinese people.The stability and consistency of NMRS-based lipid tests with routine lipid test were evaluated.691 healthy adult subjects were selected and their NMRS-based lipid test results were used to establish the normal reference interval of adult healthy population in China.The difference between male and female was evaluated.Results:The stability of NMRS-based lipid test was evaluated by 20 runs of identical sample(twice a day for 10 days).The data of stability of NMRS-based lipid test showed that the inter coefficient variation(CV)was 1.39%-2.62% among 6 routine clinical tests(TC,TG,LDL-C,HDL-C,Apo-A1,and Apo-B).6 routine clinical tests were significantly correlated with clinical chemistry assay(R2=0.927-0.978).The normal reference interval of LDL size ranged from 19.93 nm to 21.20 nm.The normal reference interval of VLDL,IDL,LDL particle number ranged from 32.6-347.3 nmol/L,8.5-105.8 nmol/L,626.0-1829.6 nmol/L,respectively.The normal reference interval of triglycerides and cholesterol contents in five VLDL subclasses,six LDL subclasses and four HDL subclasses were established.There were significant differences between male and female on lipid subclasses.Conclusions:NMRS-based lipid profiles assay could provide copious and precise information.Present study established the normal reference interval of lipid profiles in healthy adult Chinese population.Parameters such as LDL-P,could supply supplemental information with great clinical implication in risk stratification,drug selection,and therapeutic evaluations for ASCVD management.