Causal associations between intermediate very-low-density lipoprotein cholesterol-to-total lipids ratio and peptic ulcer:A bidirectional Mendelian randomization study

BACKGROUND Previous epidemiologic investigations have consistently demonstrated a strong association between the ratio of cholesterol to total lipids in medium very-lowdensity lipoprotein(VLDL)and the occurrence of peptic ulcers(PU).However,the precise causal relationship between these factors remains ambiguous.Consequently,this study aims to elucidate the potential correlation between the ratio of cholesterol to total lipids in medium VLDL and the incidence of peptic ulcer.AIM To investigate the ratio of cholesterol to total lipids in medium very-low-density lipoprotein(VLDL)association with PU via genetic methods,guiding future clinical research.METHODS Genome-wide association study(GWAS)datasets for the ratio of cholesterol to total lipids in intermediate VLDL and peptic ulcer were retrieved from the IEU OpenGWAS project(https://gwas.mrcieu.ac.uk).For the forward Mendelian randomization(MR)analysis,72 single nucleotide polymorphisms(SNPs)were identified as instrumental variables.These SNPs were selected based on their association with the ratio of cholesterol to total lipids in intermediate VLDL,with peptic ulcer as the outcome variable.Conversely,for the inverse MR analysis,no SNPs were identified with peptic ulcer as the exposure variable and the ratio of cholesterol to total lipids in intermediate VLDL as the outcome.All MR analyses utilized inverse variance weighted(IVW)as the primary analytical method.Additionally,weighted median and MR-Egger methods were employed as supplementary analytical approaches to assess causal effects.Egger regression was used as a supplementary method to evaluate potential directional pleiotropy.Heterogeneity and multiplicity tests were conducted using the leave-one-out method to evaluate result stability and mitigate biases associated with multiple testing.RESULTS The genetically predicted ratio of cholesterol to total lipids in medium VLDL was significantly associated with an elevated risk of peptic ulcer(IVW:OR=2.557,95%CI=1.274-5.132,P=0.008).However,no causal association of peptic ulcer with the ratio of cholesterol to total lipids in medium VLDL was observed in the inverse Mendelian randomization analysis.CONCLUSION In conclusion,our study reveals a significant association between the ratio of cholesterol to total lipids in medium VLDL and an elevated risk of peptic ulcers.However,further validation through laboratory investigations and larger-scale studies is warranted to strengthen the evidence and confirm the causal relationship between these factors.

EFFECTS OF HARVEST STAGE ON THE TOTAL LIPID AND FATTY ACID COMPOSITION OF FOUR CYLINDROTHECA STRAINS

Four strains of Cylindrotheca (B156, B164, B196, and B200) were harvested at three phases in the growth curve and their total lipid and fatty acid composition were determined. Total lipid reached highest values in the late stationary phase in B156 (24.0%), B164 (26.6%) and B200 (17.3%), in the exponential phase in B196 (15.5%). Saturated fatty acids increased with the development of the culture in B156 and B196, and reached their highest values in the late stationary phase in B156 (41.7%) and B196 (45.1%), in the early stationary phase in B164 (45.4%) and B200 (37.6%). Monounsaturated fatty acids increased with the development of the culture in B196 and B200, and reached their highest values in the late stationary phase in B196 (32.4%) and B200 (32.8%), in the early stationary phase in B164 (31.0%) and in the exponential phase in B156 (29.3%). Polyunsaturated fatty acids decreased in the later phases of the culture in B164, B196 and B200, and peaked in the exponential phase in B164 (29.5%), B196 (42.9%) and B200 (37.3%), and in the early stationary phase in B156 (32.0%).

TOTAL LIPID AND FATTY ACID COMPOSITION OF EIGHT STRAINS OF MARINE DIATOMS

Fatty acid composition and total lipid content of 8 strains of marine diatoms ( Nitzschia frustrula, Nitzschia closterium, Nitzschia incerta, Navicula pelliculosa,Phaeodactylum tricornutum, Synedra fragilaroides ) were examined. The microalgae were grown under defined conditions and harvested at the late exponential phase. The major fatty acids in most strains were 14:0 (1.0%-6.3%), 16:0 (13.5%-26.4%), 16:1n-7 (21.1%-46.3%) and 20:5n-3 (6.5%-19.5%). The polyunsaturated fatty acids 16:2n-4, 16:3n-4, 16:4n-1 and 20:4n-6 also comprised a significant proportion of the total fatty acids in some strains. The characteristic fatty acid composition of diatoms is readily distinguishable from those of other microalgal groups. Significant concentration of the polyunsaturated fatty acid 20:5n-3 (eicosapentaenoic acid) was present in each strain, with the highest proportion in B222 (19.5%).

EFFECT OF LIGHT INTENSITY ON THE TOTAL LIPID AND FATTY ACID COMPOSITION OF SIX STRAINS OF MARINE DIATOMS

The effect of light intensity (1500 lx and 5000 lx) on the total lipid and fatty acid composition of six strains of marine diatoms Cylindrotheca fusiformis (B211), Phaeodactylum tricornutum (B114, B118 and B221) Nitzschia closterium (B222) and Chaetoceros gracilis (B13) was investigated. The total lipids of B13, B114, and B211 grown at 5000 lx were lower than those grown at 1500 lx. No evident changes were observed in B118, B221 and B222. Fatty acid composition changed considerably at different light intensity although no consistent correlation between the relative proportion of a single FA and light intensity. The major fatty acids of the 6 strains were 14:0, 16:0, 16:1(n-7) and 20:5(n-3). Cylindrotheca fusiformis had high percentage of 20:4n-6 (9.2-10.9%). The total polyunsaturated fatty acid in all 6 strains decreased with increasing light intensity. The percentage of the highly unsaturated fatty acid eicosapentaenoic acid (EPA) decreased with increasing light intensity in all strains except Chaetoceros gracilis.

Responses in growth, lipid accumulation,and fatty acid composition of four oleaginous microalgae to different nitrogen sources and concentrations

Nitrogen deficiency is an effective strategy for enhancing lipid production in microalgae. Close relationships exist among lipid production, microalgal species, and nitrogen sources. We report growth, lipid accumulation, and fatty acid composition in four microalgae （Chloroeoccum ellipsoideum UTEX972, Chlorococcum nivale LB2225, Chlorococcum tatrense UTEX2227, and Scenedesmus deserticola JNU19） under nitrate- and urea-nitrogen deficiencies. We found three patterns of response to nitrogen deficiency： Type-A （decrease in biomass and increase in lipid content）, Type-B （reduction in both biomass and lipid content）, and Type-C （enhancement of both biomass and lipid content）. Type-C microalgae are potential candidates for large-scale oil production. Chlorococcum ellipsoideum, for example, exhibited a neutral lipid production of up to 239.6 mg/（L＇d） under urea-nitrogen deficiency. In addition, nitrogen deficiency showed only a slight influence on lipid fractions and fatty acid composition. Our study provides useful information for further screening hyper-lipid microalgal strains for biofuel production.

Temperature effects on lipid properties of microalgae Tetraselmis subcordiformis and Nannochloropsis oculata as biofuel resources

Microalgae Tetraselmis subcordiformis and Nannochloropsis oculata were cultured at 15,20,25,30,and 35℃ and their properties as potential biofuel resources were examined.The results indicate that T.subcordiformis and N.oculata grew best at 20℃ and 25℃ and yielded the highest total lipids at 20℃and 30℃,respectively.With increased temperature,neutral lipid and polyunsaturated fatty acids(FAs)decreased while saturated FAs increased,accompanied by increased monounsaturated FAs(MUFAs) in T.subcordiformis and decreased MUFAs in N.oculata;meanwhile,the predicted cetane number of FA methyl esters increased from 45.3 to 47.6 in T.subcordiformis and from 52.3 to 60.3 in N.oculata.Therefore,optimizing culture temperatures is important for improving microalgal biodiesel production.

蒲公英总黄酮通过调控肠道菌群对小鼠肥胖的抑制作用机制

目的 探讨蒲公英总黄酮通过调控肠道菌群对高脂饮食诱导的小鼠肥胖的抑制作用机制。方法 将24只C57BL/6J小鼠随机分为空白组、模型组和蒲公英总黄酮组,每组8只。除空白组外,其余两组小鼠予以高脂饮食饲养,同时蒲公英总黄酮组小鼠予蒲公英总黄酮[400 mg/(kg·d)]灌胃,每天1次,连续8周。实验期间,记录每组小鼠的采食量。末次给药后,对小鼠的体重、脂肪质量、血脂水平及肝脏和附睾脂肪病理变化进行评价,观察蒲公英总黄酮对小鼠肥胖的治疗效果;通过扩增子测序检测小鼠肠道菌群丰度及结构的变化;利用实时荧光定量PCR技术分析蒲公英总黄酮对小鼠脂肪代谢相关基因的影响。结果 与模型组比较,蒲公英总黄酮组小鼠的体重显著降低(P<0.05);血清总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平均显著降低(P<0.01),高密度脂蛋白胆固醇水平显著升高(P<0.01);腹股沟白色脂肪组织和附睾白色脂肪组织的脂肪指数均显著降低(P<0.05);肝细胞脂肪变性及脂肪细胞病变明显改善;细胞色素c氧化酶亚基7A1和细胞色素c氧化酶亚基8B mRNA的表达均显著上调(P<0.05)。菌群检测结果显示,与模型组比较,蒲公英总黄酮组小鼠的菌群多样性有上升趋势,Sobs指数和β多样性均显著升高(P<0.05);经黏液真杆菌属Blautia、norank_f_Ruminococcaceae、嗜胆菌属Bilophila、另枝菌属Alistipes、classi-fied_f_Ruminococcaceae、副拟杆菌属Parabacteroides、norank_f_Desulfovibrionaceae、厌氧短杆菌属Anaerotruncus的菌群相对丰度显著升高(P<0.05),粪杆菌属Faecalibaculum、丹毒梭菌属Erysipelatoclostridium、GCA-900066575、梭菌属Tuzzerella、乳杆菌属Lactobacillus、norank_f_norank_o_RF39、achnospiraceae_FCS020_group的菌群相对丰度显著下降(P<0.05)。结论 蒲公英总黄酮能降低肥胖小鼠的体重、脂肪质量与血脂水平,修复肥胖小鼠肝脏及附睾脂肪的病理损伤,这一作用与其改善因高脂饮食导致的肠道菌群紊乱有关。

地菍总黄酮对高脂饮食联合链脲佐菌素诱导糖尿病肾病小鼠脂质过氧化的影响

[目的]探讨地菍总黄酮(total Flavonoids from Melastoma dodecandrum Lour.,TFMD)对糖尿病肾病(DN)小鼠脂质过氧化的作用,对TFMD在肾脏功能保护及抗脂质过氧化方面的药用价值进行探索,为瑶药地菍的临床应用研究提供试验依据。[方法]将90只SPF级雄性C57BL/6J小鼠随机分成2组:空白组(n=10)及造模组(n=80)。空白组小鼠给予普通饲料,造模组小鼠给予高脂饲料,连续饲养6周后,各组小鼠禁食不禁水12 h后,造模组小鼠腹腔注射链脲佐菌素(STZ)0.05 g/kg,空白组小鼠注射等剂量柠檬酸钠缓冲液,连续注射5 d后,分别在末次注射72 h及1周后测量各组小鼠空腹血糖(FBG)。将连续2次FBG≥16.7 mmol/L的小鼠随机分为5组:DN模型组(高脂饲料)、二甲双胍组(高脂饲料+0.5 g/kg二甲双胍)及TFMD高(高脂饲料+1.2 g/kg TFMD)、中(高脂饲料+0.8 g/kg TFMD)、低(高脂饲料+0.6 g/kg TFMD)剂量组,每组10只,连续给药10周。给药过程中观察小鼠一般生理状况,每周检测FBG。给药10周后,使用代谢笼收集各组小鼠24 h尿液,剪尾采血检测各组小鼠FBG,计算各组小鼠肾脏指数;同时检测各组小鼠尿液中尿蛋白(UP)和尿微量白蛋白(MAU)、血清尿素氮(BUN)和血清肌酐(SCr)水平及肾脏组织中谷胱甘肽(GSH)、超氧化物歧化酶(SOD)活性和丙二醛(MDA)水平。Western blotting检测各组小鼠肾脏组织Nephrin、podocin、PTGS2、ACSL4蛋白的表达量;制作各组小鼠肾脏组织HE及PAS染色切片并观察病理改变。[结果]与空白组相比,DN模型组小鼠体重、GSH和SOD水平均极显著降低(P<0.01),FBG、肾脏指数、MAU、UP、SCr、BUN及MDA水平均极显著升高(P<0.01),肾脏组织Nephrin、podocin蛋白表达量均极显著降低(P<0.01),PTGS2、ACSL4蛋白表达量显著升高(P<0.05),肾脏组织光镜下可见严重损伤,表明DN模型构建成功。与DN模型组相比,TFMD能改善DN小鼠的消瘦状况,极显著或显著降低小鼠肾脏指数及FBG(P<0.01;P<0.05),极显著降低小鼠体内UP、MAU、SCr、BUN水平(P<0.01),显著提高小鼠肾脏组织Nephrin、podocin水平(P<0.05),TFMD组小鼠肾脏组织损伤得到不同程度恢复。与DN模型组相比,TFMD显著或极显著提高小鼠肾脏组织GSH和SOD活性(P<0.05;P<0.01),极显著或显著降低MDA水平(P<0.01;P<0.05),显著或极显著下调肾脏组织中脂质过氧化相关蛋白PTGS2、ACSL4的表达(P<0.05;P<0.01),提升机体抗氧化能力及减缓机体脂质过氧化及其产物堆积。[结论]TFMD可明显延缓高脂饮食联合STZ诱导小鼠DN的发生发展进程,其机制与调控脂质过氧化及氧化应激、调控PTGS2/ACSL4信号通路相关。

Influences of blood lipids on the occurrence and prognosis of hemorrhagic transformation after acute cerebral infarction: a case-control study of 732 patients

Background: To study the influence of blood lipid levels on hemorrhagic transformation(HT) and prognosis after acute cerebral infarction(ACI).Methods: Patients with ACI within 72 h of symptoms onset between January 1 st, 2015, and December 31 st, 2016, were retrospectively analyzed. Patients were divided into group A(without HT) and group B(HT). The outcomes were assessed after 3 months of disease onset using the modified Rankin Scale(m RS). An m RS score of 0–2 points indicated excellent prognosis, and an m RS score of 3–6 points indicated poor prognosis.Results: A total of 732 patients conformed to the inclusion criteria, including 628 in group A and 104 in group B. The incidence of HT was 14.2%, and the median onset time was 2 d(interquartile range, 1–7 d). The percentages of patients with large infarct size and cortex involvement in group B were 80.8% and 79.8%, respectively, which were both significantly higher than those in group A(28.7 and 33.4%, respectively). The incidence rate of atrial fibrillation(AF) in group B was significantly higher than that in group A(39.4% vs. 13.9%, P<0.001). The adjusted multivariate analysis results showed that large infarct size, cortex involvement and AF were independent risk factors of HT, while total cholesterol(TC) was a protective factor of HT(OR=0.359, 95% CI 0.136–0.944, P=0.038). With every 1 mmol/L reduction in normal TC levels, the risk of HT increased by 64.1%. The mortality and morbidity at 3 months in group B(21.2% and 76.7%, respectively) were both significantly higher than those in group A(8.0% and 42.8%, respectively). The adjusted multivariate analysis results showed that large infarct size(OR=12.178, 95% CI 5.390–27.516, P<0.001) was an independent risk factor of long-term unfavorable outcomes, whereas low-density lipoprotein cholesterol(LDL-C) was a protective factor(OR=0.538, 95% CI 0.300–0.964, P=0.037). With every 1 mmol/L reduction in normal LDL-C levels, the risk of an unfavorable outcome increased by 46.2%. Major therapies, including intravenous recombinant human tissue plasminogen activator(r TPA), intensive lipid-lowering statins and anti-platelets, were not significantly related to either HT or long-term, post-ACI poor prognosis.Conclusions: For patients with large infarct sizes, especially those with cortex involvement, AF, or lower levels of TC, the risk of HT might increase after ACI. The risk of a long-term unfavorable outcome in these patients might increase with a reduction in LDL-C.

Stabilization of membrane bound ATPases and lipid peroxidation by carotenoids from Chlorococcum humicola in Benzo(a)pyrene induced toxicity

Objective:To identify the alleralinn of the membrane polenlial and llie effect of carolenoid extracts from Chlorococcum hnmicola(C.humicola) on membrane hound ATPases and lipid peroxidation.Methods:The lolal carotenoids were extracted from C.humicola.Four groups of Swiss albino mice were treated as control,Benzo(a)pyrene[B(a)P],total carotenoids,B(a)P+ total caralenoids respectively for a period of 60 days.Membrane lipid peroxidation and ATPases(Total ATPases,Ca^(2+)-ATPases.Mg^(2+)-ATPases.Na^+K^+- ATPasei were determined in lung,liver and erythrocyte samples.Results:The activity of lolal ATPase was found to be significantly increased in the B(a)P treated liver and lung tissue.Erythrocyte membrane also showed higher ATPase activity which was significantly reverted on total carolenoid treatment.Conclusions: It can be concluded that the changes in membrane potential favour the functional deterioration of physiological system.The overall findings demonstrates that the animals post treated with carolenoid extract from C.humicola may maintains the alterations in membrane bound ATPase and lipid peroxidation in tissues against the carcinogenic chemical and hence aid in establishing the membrane potential action.Then-fore C.humicola can be further extended to exploits its possible application for various health benefits as neulraceulicals and food additives.

盐度和pH对平凡舟形藻生长和油脂积累的影响

为研究盐度和pH对淡水硅藻生长和油脂含量的影响,对一株分离自野外采集水样中的平凡舟形藻(Navicula trivialis)进行研究,通过设置不同盐度0、0.03、0.06、0.12、0.18和0.24 mol/L和不同pH 4.5、6.0、7.5、8.5、9.5和10.5进行胁迫,测定各处理对平凡舟形藻的生长、叶绿素a含量、叶绿素荧光参数和油脂含量的影响。结果表明:盐浓度为0.12 mol/L、pH 7.5时,平凡舟形藻细胞密度和叶绿素a含量最高;盐浓度为0.24 mol/L、pH 7.5时,总脂含量最高,分别为34.93%和33.5%。结果表明,平凡舟形藻对不同盐度和pH的适应性不同,这在一定程度上影响其生长和油脂含量。

淮南市健康体检人群的血脂水平调查研究

选择淮南市某医院2022年7月到2023年6月收治的200例体检者作为研究对象,分为脂肪肝组(100例)、非脂肪肝组(100例)。研究结果显示,脂肪肝组与非脂肪肝组血清总胆固醇(Total Cholesterol,TC)指标、甘油三酯(Triglyceride,TG)指标、体重指数(Body Mass Index,BMI)指标差异有统计学意义(P<0.05)。轻度组、中度组、重度组TC指标、TG指标、BMI指标差异有统计学意义(P<0.05)。淮南市健康体检人群以中老年脂肪肝多见,血脂水平及BMI与脂肪肝具有一定的相关性。

The Impact of Statin Intolerance in Lipid Clinic Patients

Context: Cardiovascular disease is a very common and serious problem in the western world. Statin drug therapy is used in primary, secondary prevention and familial hypercholesterolemia. However, these are frequently associated with adverse effects, causing poor adherence and thus putting patients at risk for future cardiovascular events. Aim: The objective of this study was to review the statin intolerance in lipid patients and to assess the impact of alternative lipid lowering therapy on lipid parameters and cardiovascular outcome in statin intolerant patients. Methodology: 50 patients attending the out-patient lipid clinic of our hospital with statin intolerance were identified. Clinical data on the study patients were gathered retrospectively relating to statin intolerance and the clinical effectiveness of alternative lipid lowering therapy on lipid parameters and cardiovascular outcome. Results: Rosuvastatin was the most intolerable whereas pravastatin or fluvastatin was the most tolerable statin in our study patients. Myalgia was the commonly reported adverse effect of statin. The low dose statin monotherapy or combination of low dose statin and ezetemibe was the most tolerable alternative lipid lowering therapy in statin intolerant patients. After an average period of 10 months of initiation of alternative lipid lowering therapy;combination of low dose statin plus ezetimibe showed the largest reduction in serum total cholesterol and low-density lipoprotein (LDL) cholesterol levels. Conclusions: Pravastatin should be preferred in statin intolerant patients. A combination of low dose statin plus ezetimibe appeared to be the most tolerable and clinically effective therapy in statin intolerant patients.

Protective Effects and Action Mechanism of Total Flavonoids of POLYGONI PERFOLIATI HERBA on Rats with Nonalcoholic Steatohepatitis

[Objectives]To study the protective effects and mechanism of POLYGONI PERFOLIATI HERBA on rats with nonalcoholic steatohepatitis( NASH). [Methods] Sixty rats were randomly divided into normal group,model group,metformin group( 0. 5 mg/kg),and high dose,medium dose,and low dose groups of total flavonoids of POLYGONI PERFOLIATI HERBA( 600,300,150 mg/kg). The standard feed was given to the normal group,and the model group and the total flavonoids groups were fed with high-fat diet for 13 weeks to establish the NASH rat model. At the 8 th week,the metformin group and the POLYGONI PERFOLIATI HERBA total flavonoids groups were given with the corresponding drug treatment for 6 weeks,blood was taken from the eyeball to collect liver tissue. Biochemical method was used to determine ALT,AST,TC,TG,HDL-c,LDL-c,SOD,MDA,GSH-Px activity or content in serum and HOMA-IR,and ELISA was used to measure the TNF-α,IL-1β and IL-6 content in liver tissue; Western blotting was used to detect the expression levels of AMPK,p-AMPK and ACC in liver tissue. [Results] Total flavonoids of POLYGONI PERFOLIATI HERBA could significantly decrease the activity or content of ALT,AST and MDA in serum of NASH rats( P < 0. 05,P < 0. 01),and enhance the activity of SOD and GSH-Px( P < 0. 05,P < 0. 01),reduce serum TC,TG,LDL-c levels and insulin resistance index,increase HDL-c levels( P < 0. 05,P < 0. 01); down-regulate liver IL-1β,IL-6,TNF-α,ACC levels and up-regulate p-AMPK expression( P < 0. 05,P < 0. 01). [Conclusions]The total flavonoids of POLYGONI PERFOLIATI HERBA have a good protective effect on NASH rats,and its mechanism may be related to the functions of regulating the lipid metabolism,alleviating insulin resistance,inhibiting oxidative stress,inhibiting inflammatory reaction and regulating AMPK and ACC protein expression.

血浆致动脉粥样硬化指数与脑小血管病总负荷的相关性研究进展

脑小血管病(CSVD)是一组由不同病因造成的临床症状和影像学表现相似的疾病,它主要影响着脑内的小动脉及小静脉等高级血管网。目前,CSVD的病理生理机制仍不完全清楚,但动脉粥样硬化(AS)是众所周知的脑部血管疾病的主要病理机制之一,而血脂在AS的发病机制中又起着非常重要的作用。随着大量学者的深入研究,目前认为血浆致动脉粥样硬化指数(AIP)及其相关传统血脂指标与CSVD联系密切。此研究从AIP与CSVD的发生发展入手,深入探讨了AIP及相关传统血脂指标与CSVD各分型之间的相关性,整合CSVD影像学总负荷来体现CSVD的严重程度,进一步探讨AIP及传统血脂指标与CSVD总负荷的相关性,最终确定了AIP与CSVD严重程度的相关性。本文对AIP及其相关传统指标与CSVD总负荷的相关性研究进展做一综述,全面阐述了血脂对CSVD总负荷的影响,为临床建立CSVD总负荷综合性评价指标提供新依据。

代谢相关脂肪性肝病患者心肺运动能力与肝脏脂肪变严重程度关系的横断面研究

目的探讨代谢相关脂肪性肝病(metabolic associated fatty liver disease,MAFLD)患者肝脏脂肪变严重程度与心肺运动能力的相关性。方法采用横断面研究,以2018年3月至2022年7月在佛山市第一人民医院感染科脂肪肝中心就诊的400例经超声诊断为MAFLD的患者为研究对象,根据脂肪衰减参数(controlled attenuation parameter,CAP)将患者分为轻度组(240 dB/m<CAP≤265 dB/m)、中度组(265 dB/m<CAP≤295 dB/m)和重度组(CAP>295 dB/m),收集患者体重指数(body mass index,BMI)、肝功能[包括总胆红素、直接胆红素、间接胆红素、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、γ-谷氨酰转移酶(γ-glutamyl transferase,GGT)]及代谢指标[包括甘油三酯、总胆固醇、胰岛素、空腹血糖、高密度脂蛋白(high-density lipoprotein,HDL)、低密度脂蛋白(low density lipoprotein,LDL)]等临床资料,并进行心肺运动试验。采用有序多分类Logistic回归分析MAFLD严重程度的影响因素。采用Pearson相关分析血脂水平和峰值公斤摄氧量的相关性。结果轻度组、中度组、重度组患者的BMI[(20.68±1.50)kg/m^(2)比(21.56±1.19)kg/m^(2)比(23.13±1.91)kg/m^(2)]、LSM[(8.07±0.93)kPa比(10.18±1.13)kPa比(13.96±1.61)kPa]、HDL[(1.16±0.08)mmol/L比(1.13±0.09)mmol/L比(1.02±0.09)mmol/L]、LDL[(3.28±0.14)mmol/L比(3.34±0.17)mmol/L比(3.51±0.14)mmol/L]、甘油三酯[(1.59±0.08)mmol/L比(1.62±0.06)mmol/L比(1.90±0.20)mmol/L]、总胆固醇[(4.43±0.43)mmol/L比(4.74±0.46)mmol/L比(5.06±0.21)mmol/L]、体脂肪[(31.79±9.47)g/cm^(2)比(33.83±7.67)g/cm^(2)比(34.76±6.95)g/cm^(2)]和体脂肪百分比[(26.20±3.56)%比(28.55±5.73)%比(31.08±4.46)%]差异均有统计学意义(P均<0.05)。有序多分类Logistic回归分析表明BMI(OR=1.16,95%CI:1.05~1.27,P=0.003)、甘油三酯(OR=1.15,95%CI:1.00~1.32,P=0.043)、LDL(OR=1.73,95%CI:1.12~2.67,P=0.013)、LSM(OR=1.36,95%CI:1.19~1.54,P<0.001)、体脂肪(OR=1.04,95%CI:0.84~1.25,P<0.001)和体脂肪百分比(OR=1.07,95%CI:1.03~1.12,P=0.001)为影响MAFLD患者肝脏脂肪变严重程度的危险因素,HDL是保护因素(OR=0.07,95%CI:0.03~0.18,P<0.001)。心肺运动结果表明,峰值公斤摄氧量[轻度组比中度组比重度组:(21.39±1.04)ml/(min·kg)比(20.93±1.11)ml/(min·kg)比(19.51±1.26)ml/(min·kg)]、峰值氧脉搏[轻度组比中度组比重度组:(6.18±0.31)ml/次比(5.97±0.33)ml/次比(5.68±0.19)ml/次]和峰值代谢当量(轻度组比中度组比重度组:6.05±0.25比5.82±0.33比5.57±0.25)随着肝脏脂肪变程度增加而进一步降低(P均<0.05)。峰值公斤摄氧量与HDL水平呈正相关(r=0.40,P<0.0001),与LDL、总胆固醇和甘油三脂水平呈负相关(r值分别为-0.44、-0.40、-0.47,P<0.001)。结论MAFLD患者血脂水平和肝脏脂肪变严重程度与患者的心肺运动能力密切相关。

残余脂蛋白胆固醇与慢性完全闭塞性病变患者侧支循坏的相关性分析

目的:本研究主要探索残余脂蛋白胆固醇(remnant-like particle cholesterol, RLP-c)与慢性完全闭塞性病变(chronic total occlusion, CTO)患者侧支循环的相关性。方法:本研究主要回顾性纳入549例CTO患者,依据rentrop分级系统将纳入人群分为两组,即侧支循环充分组(rentrop 2-3级)412例与侧支循环不充分组(rentrop 0-1级)137例。通过多因素回归分析探索RLP-c与侧支循环的相关性。结果:本研究共纳入549例CTO患者,其中侧支循环不充分组137例。与侧支循环充分组相比,侧支循环不充分组RLP-c浓度较高[0.7(0.4, 1.0)vs. 0.5(0.4, 0.7),P<0.001]。不仅在单因素回归分析中,RLP-c与侧支循环形成不良紧密相关(OR=4.658,95%CI:2.731~7.945,P<0.001),通过多因素回归分析校正其他混杂因素影响后,RLP-c仍是侧支循环形成不良的独立危险因素(OR=4.944,95%CI:2.828~8.645,P <0.001)。进一步依据3分位数将RLP-c调整成分类变量后,上述关系仍成立。最后受试者工作特征曲线进一步证实RLP-c可有效预测侧支循环形不充分的发生(曲线下面积0.664,95%CI:0.613~0.716,P <0.001)。结论:独立于传统血脂参数,RLP-c与CTO患者侧支循环形不充分独立相关。

低分子肝素联合胰岛素治疗高脂血症性胰腺炎的临床疗效及对血清炎症介质的影响

目的探究低分子肝素与胰岛素联合治疗高脂血症性胰腺炎的临床疗效。方法方便选取山东省济南市章丘区中医医院于2021年8月—2023年10月收治的86例高脂血症性胰腺炎患者为研究对象,采用密闭信封法分为对照组(n=43)和研究组(n=43)。所有患者均进行常规治疗,对照组在此基础上使用胰岛素注射液,研究组在对照组基础上使用低分子肝素钙,两组均治疗1周。对比两组患者临床疗效、不良反应发生率、血脂水平、血淀粉酶水平、血清炎症介质水平。结果研究组治疗有效率高于对照组,差异有统计学意义(P<0.05);治疗后,研究组血脂、血淀粉酶、炎症因子水平低于对照组,差异有统计学意义(P均<0.05);两组患者不良反应发生率对比,差异无统计学意义(P>0.05)。结论高脂血症性胰腺炎患者应用低分子肝素联合胰岛素治疗,能够提高治疗有效率,并改善炎症反应,从而降低血脂、血淀粉酶水平,且不会增加不良反应发生率。

血清TC、TG及ApoB在输血后脂质代谢监测中的应用价值

目的探讨血清总胆固醇(TC)、甘油三酯(TG)及载脂蛋白B(ApoB)在输血后脂质代谢监测中的应用价值。方法回顾性纳入2022年7月至2023年10月南京医科大学附属淮安第一医院收治的外伤失血性休克患者152例,依据脂质代谢诊断标准将152例患者分为脂质代谢正常组86例、脂质代谢异常组66例。比较两组一般资料、TC、TG及ApoB水平变化;分析影响输血后脂质代谢异常的危险因素,绘制ROC曲线评估TC、TG及ApoB单独及联合检测对输血后脂质代谢异常的预测价值。结果两组年龄、性别、吸烟史、饮酒史、糖尿病史、高血压史占比、输血量比较,差异无统计学意义(P>0.05);脂质代谢异常组年高密度脂蛋白胆固醇水平低于脂质代谢正常组,低密度脂蛋白胆固醇水平高于脂质代谢正常组,差异有统计学意义(P<0.05)。脂质代谢异常组TC、TG及ApoB水平均明显高于脂质代谢正常组,差异有统计学意义(P<0.05)。经logistic多因素分析显示:高密度脂蛋白胆固醇(男性<0.91 mmol/L,女性<1.1 mmol/L)、低密度脂蛋白胆固醇(>4.14 mmol/L)、TC(<2.4 mmol/L,>5.7 mmol/L)、TG(<0.4 mmol/L,>1.8 mmol/L)及ApoB(男性<0.43 g/L,>1.28 g/L,女性<0.42 g/L,>1.12 g/L)是影响输血后脂质代谢异常的危险因素(P<0.05)。依据ROC曲线可知,TC、TG及ApoB联合预测输血后脂质代谢异常的敏感度和特异度分别为89.84%、88.24%,AUC为0.898,高于三指标单独检测(P<0.05)。结论TC、TG及ApoB在输血后脂质代谢异常患者中呈高表达,三指标联合检测可全面、客观地反映输血后脂质代谢异常情况,为临床诊断、治疗提供更为准确、可靠的依据。

甲状腺结节发生与糖脂代谢水平的相关性分析

目的分析甲状腺结节发生与糖脂代谢水平的相关性。方法选取厦门弘爱医院(2022年1—12月)接受甲状腺检查者100例,根据患者的检查结果不同分组,其中检查结果为甲状腺结节的患者50例为研究组,检查结果为未发生甲状腺结节的患者50例为对照组。分析患者的基础资料,明确甲状腺结节发生与糖脂代谢水平[空腹血糖(fasting plasma glucose,FPG)、总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)及高密度脂蛋白胆固醇(high density lipid-cholesterol,HDL-C)]的相关性。结果研究组FPG、TC、TG和LDL-C水平较对照组更高,差异有统计学意义(P<0.05)。而在HDL-C指标相比之下,差异无统计学意义(P>0.05)。因FT3、FT4、TSH均有不确定值为等级资料行Spearman秩相关分析。TSH与FPG、TC、LDL-C、HDL-C均呈正相关(r值分别为0.105、0.635、0.143、0.704、0.619,P<0.01),而FT3与FPG、TC、LDL-C、HDL-C均呈负相关(r值分别为-0.568、-0.676、-0.352、-0.702、-0.764,P<0.01),FT4与FPG、TC、LDL-C、HDL-C均呈负相关(r值分别为-0.401、-0.547、-0.425、-0.639、-0.493,P<0.01)。结论血清FPG、TC、TG、LDL-C升高,HDL-C降低,为甲状腺结节诱发因素。