健康成年人小而密低密度脂蛋白胆固醇水平及其相关比值分析

Analysis of small dense low-density lipoprotein cholesterol level and the relationship with corresponding lipid components in healthy adults

目的探讨小而密低密度脂蛋白胆固醇(sdLDL-C)、sdLDL-C/低密度脂蛋白胆固醇(LDL-C)、sdLDL-C/高密度脂蛋白胆固醇(HDL-C)和sdLDL-C/载脂蛋白(apo)B在健康成年人中的水平及sdLDL-C与血脂组分的相关性。方法以2020年9—12月在首都医科大学附属北京安贞医院1151名健康体检的成年人为研究对象,其中男557名,女594名。根据空腹血脂水平入组,参考联合国世界卫生组织2018年对年龄的划分标准分为18~29岁(247名)、30~44岁(269名)、45~59岁(225名)、60~74岁(207名)、75~90岁(203名)5个年龄组。测定总胆固醇(TC)、甘油三酯(TG)、HDL-C、LDL-C、sdLDL-C、载脂蛋白(apo)A1及apoB的含量,分析sdLDL-C、sdLDL-C/LDL-C、sdLDL-C/HDL-C和sdLDL-C/apoB在不同性别和年龄人群中的分布情况,使用Pearson或Spearman相关性分析以上4个指标与其他血脂组分的相关性。结果男性组sdLDL-C、sdLDL-C/LDL-C、sdLDL-C/HDL-C和sdLDL-C/apoB[分别为(0.56±0.23)mmol/L、0.24±0.07、0.49±0.22、0.27±0.07]均高于女性组[分别为(0.48±0.18)mmol/L、0.20±0.06、0.36±0.17、0.23±0.07](P均<0.001)。不同年龄组的男性和女性sdLDL-C、sdLDL-C/LDL-C、sdLDL-C/HDL-C和sdLDL-C/apoB比较,差异均有统计学意义(P均<0.001)。在18~29岁、30~44岁及45~59岁年龄组男性sdLDL-C均高于女性(P均<0.05)。sdLDL-C/LDL-C、sdLDL-C/HDL-C和sdLDL-C/apoB在18~29岁、30~44岁、45~59岁及60~74岁年龄组均高于女性组(P均<0.05)。全部受试对象的sdLDL-C水平与TC、TG、LDL-C、apoB、非HDL-C和残粒脂蛋白胆固醇水平呈正相关(r=0.50、0.45、0.67、0.68、0.61、0.11,P均<0.01),与HDL-C与apoA1呈负相关(r=-0.17、-0.10,P<0.01)。结论健康成年人sdLDL-C、sdLDL-C/LDL-C、sdLDL-C/HDL-C和sdLDL-C/apoB水平在不同年龄、不同性别间均存在差异,血清中sdLDL-C水平与apoB水平具有较高的相关性。

Objective To investigate the small and dense low density lipoprotein cholesterol(sdLDL-C)level,ratios of sdLDL-C/low density lipoprotein cholesterol(LDL-C),sdLDL-C/high density lipoprotein cholesterol(HDL-C)and sdLDL-C/apolipoprotein B(apoB),and their correlation with lipid components in healthy adults.Methods A total of 1151 healthy adults,who underwent physical examination in Beijing Anzhen Hospital Affiliated to Capital Medical University from September to December 2020(557 men and 594 women),were included in this study.They were divided into five age groups:18-29 years old(n=247),30-44 years old(n=269),45-59 years old(n=225),60-74 years old(n=207)and 75-90 years old(n=203)according to the age classification standard of the United Nations World Health Organization in 2018.The levels of total cholesterol(TC),triglyceride(TG),HDL-C,LDL-C,sdLDL-C,apoA1 and apoB were measured,and the distribution of sdLDL-C,sdLDL-C/LDL-C,sdLDL-C/HDL-C and sdLDL-C/apoB in different sex and age groups were analyzed.Pearson/Spearman correlation was used to analyze the correlation between the above four indexes and other blood lipid components.Results SdLDL-C,sdLDL-C/LDL-C,sdLDL-C/HDL-C and sdLDL-C/apoB were higher in male group([0.56±0.23]mmol/L,0.24±0.07,0.49±0.22,0.27±0.07)than those in female group([0.48±0.18]mmol/L,0.20±0.06,0.36±0.17,0.23±0.07)(all P<0.01).SdLDL-C,sdLDL-C/LDL-C,sdLDL-C/HDL-C and sdLDL-C/apoB were different among different age groups of male and female participants(all P<0.001).SdLDL-C level was significantly higher in males than in females among 18-29 years old group,30-44 years old group,45-59 years old group(all P<0.05).SdLDL-C,sdLDL-C/LDL-C,sdLDL-C/HDL-C and sdLDL-C/apoB were higher in males of 18-29 years old group,30-44 years old group,45-59 years old group and 60-74 years old group than in females of corresponding age groups(all P<0.05).The level of sdLDL-C of all participants was positively correlated with TC,TG,LDL-C,apoB,non-HDL-C and remnant cholesterol(r=0.50,0.45,0.67,0.68,0.61,0.11,all P<0.01),and negatively correlated with HDL-C and apoA1(r=-0.17 and-0.10,P<0.01).Conclusions The levels of sdLDL-C,sdLDL-C/LDL-C,sdLDL-C/HDL-C and sdLDL-C/apoB in healthy adults are different in healthy adults of different ages and sex.There is a high correlation between sdLDL-C and apoB.