Monocyte to High-density Lipoprotein Cholesterol Ratio as a Predictor of Nonalcoholic Fatty Liver Disease in Childhood Obesity

Objective Inflammation is involved in the development and progression of nonalcoholic fatty liver disease(NAFLD).The monocyte to high-density lipoprotein cholesterol ratio(MHR)has emerged as a marker for various inflammation-related diseases.The aim of the present study was to investigate the association between the MHR and NAFLD in a population with childhood obesity.Methods Based on hepatic ultrasound,a total of 504 children with obesity(357 with NAFLD and 147 without NAFLD)were included in the study.The correlation between the MHR and NAFLD risk factors was assessed by Pearson’s and Spearman’s analyses.Multivariate stepwise logistic regression analyses were conducted to explore the association between the MHR and the risk of NAFLD.Results The MHR in patients with NAFLD was significantly greater than that in patients without NAFLD[0.52(0.44-0.67)versus 0.44(0.34-0.57),P<0.001].Multivariate stepwise logistic regression analysis demonstrated that the MHR[odds ratio(OR):1.033,95%confidence interval(CI):1.015-1.051;P<0.001]was an independent predictor of NAFLD in childhood obesity patients,as were age(OR:1.205,95%CI:1.059-1.371;P=0.005],waist circumference[OR:1.037,95%CI:1.008-1.067;P=0.012],and alanine transaminase[OR:1.067,95%CI:1.045-1.089;P<0.001].Additionally,MHR quartiles showed a significant positive association with the incidence of NAFLD after adjusting for potential confounding factors.Conclusion The present study showed that the MHR may serve as an available and useful indicator of NAFLD in individuals with childhood obesity.

Monocyte to high-density lipoprotein cholesterol ratio as a predictor of the activity of thyroid-associated ophthalmopathy

AIM:To evaluate the relationship between monocyte to high-density lipoprotein cholesterol ratio(MHR)and the disease activity of thyroid-associated ophthalmopathy(TAO).METHODS:A total of 87 patients were classified into two groups based on clinical activity score(CAS)scoring criteria:high CAS group(n=62,the CAS score was≥3);low CAS group(n=25,the CAS score was<3).In addition,a group of healthy people(n=114)were included to compared the MHR.Proptosis,MHR,average signal intensity ratio(SIR),average lacrimal gland(LG)-SIR,average extraocular muscles(EOM)area from 87 patients with TAO were calculated in magnetic resonance imaging(MRI),and compared between these two groups.Correlation testing was utilized to evaluate the association of parameters among the clinical variables.RESULTS:Patients in high CAS group had a higher proptosis(P=0.041)and MHR(P=0.048).Compared to the healthy group,the MHR in the TAO group was higher(P=0.001).Correlation testing declared that CAS score was strongly associated with proptosis and average SIR,and MHR was positively associated with CAS score,average SIR,and average LG-SIR.The area under the receiver operating characteristic curve(AUC)of MHR was 0.6755.CONCLUSION:MHR,a novel inflammatory biomarker,has a significant association with CAS score and MRI imaging(average SIR and LG-SIR)and it can be a new promising predictor during the active phase of TAO.

Total cholesterol to high-density lipoprotein ratio and nonalcoholic fatty liver disease in a population with chronic hepatitis B

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)is characterized by hypertriglyceridemia,increased low-density lipoprotein cholesterol levels,and reduced highdensity lipoprotein cholesterol(HDL-C)particles.Previous studies have shown that the total cholesterol to high-density lipoprotein cholesterol ratio(TC/HDL-C)was superior to other lipid metabolism biomarkers for predicting NAFLD risk and could be a new indicator of NAFLD.However,the association between TC/HDL-C and NAFLD in patients with hepatitis B virus(HBV)has not yet been determined.AIM To investigate the association between TC/HDL-C and NAFLD in a population with chronic hepatitis B(CHB).METHODS In this study,183 HBV-infected patients were enrolled.All participants underwent blood chemistry examinations and abdominal ultrasound.Univariate and multivariate logistic regression models,curve fitting analysis,and threshold calculation were used to assess the relationship between TC/HDL-C and NAFLD.RESULTS The overall prevalence of NAFLD was 17.49%(n=32)in the 183 CHB participants.The TC/HDL-C of non-NAFLD and NAFLD patients were 3.83±0.75 and 4.44±0.77,respectively(P<0.01).Logistic regression analysis showed that TC/HDL-C was not associated with NAFLD after adjusting for other pertinent clinical variables.However,at an optimal cutoff point of 4.9,a non-linear correlation between TC/HDL-C and NAFLD was detected.The effect size of the left and right sides of the inflection point were 5.4(95%confidence interval:2.3-12.6,P<0.01)and 0.5(95%confidence interval:0.1-2.2,P=0.39),respectively.On the left side of the inflection point,TC/HDL-C was positively associated with NAFLD.However,no significant association was observed on the right side of the inflection point.CONCLUSION This study demonstrated a non-linear correlation between TC/HDL-C and NAFLD in a population with CHB.TC/HDL-C was positively associated with NAFLD when TC/HDL-C was less than 4.9 but not when TC/HDL-C was more than 4.9.

Research progress of monocyte/high density lipoprotein ratio in cardiovascular diseases

In recent years,monocyte to high density lipoprotein cholesterol ratio(MHR)has attracted wide attention as a new marker of inflammatory response.This indicator includes two aspects:inflammatory response and lipid accumulation,which are the two most basic characteristics of Atherosclerosis(AS).AS is closely related to the occurrence of Cardiovascular diseases(CVD).A large number of existing studies have confirmed that MHR is an inflammatory marker that can dynamically reflect the trend of inflammation,can reflect the chronic inflammatory response in blood vessels,and can evaluate the occurrence,development and prognosis of cardiovascular disease in a non-invasive manner.This article reviews recent studies on the role of monocytes and high-density lipoproteins in chronic inflammation of blood vessels,as well as the current status of research on MHR and cardiovascular disease in the light of recent literature.

Is triglyceride to high-density lipoprotein cholesterol ratio a surrogates for insulin resistance in youth?

As elevated triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio has been described as predictor for cardio metabolic disease with insulin resistance (IR) in the background, the aim was to assess the relationship between this ratio and IR in youth. Oral glucose tolerance test was performed in 318 Brazilian students (175 girls, 11.2 ± 3.2 years, BMI_z-score 1.2 ± 1.4 SD). Measurements: BMI, waist circumference (WC), blood pressure (BP), lipids, insulin and high sensitivity Creactive protein (hsCRP). Excessive weight and abdominal obesity were defined using BMI_z-score and WC and IR by Homeostasis model assessment-insulin resistance (HOMA-IR). TG/HDL-C median was 2.37. There was an association between TG/ HDL-C and WC, systolic and diastolic BP, insulin, HOMA-IR, hsCRP, (p < 0.001). Stratified TG/HDL-C into two groups, based on a cut off point of 2.73 (Group 1: <2.73 and Group 2: ≥2.73). Ad- justing for age, gender, ethnicity TG/HDL-C was an independent variable predicting IR (PR = 1.44;CI: 1.07 - 1.96;p = 0.018). For every 1 (cm) in WC increased there was an addition of 0.04 of the value of TG/HDL-C and in those with TG/HDL-C ≥ 2.73 for every 10 (cm) increase in WC there was an improve of 4% in the ratio. In conclusion: In youth, the TG/HDL-C ratio could be a useful index for identifying groups with IR.

Association between sensitivity to thyroid hormones and non-highdensity lipoprotein cholesterol levels in patients with type 2 diabetes mellitus

BACKGROUND Dyslipidemia and type 2 diabetes mellitus(T2DM)are chronic conditions with substantial public health implications.Effective management of lipid metabolism in patients with T2DM is critical.However,there has been insufficient attention given to the relationship between thyroid hormone sensitivity and dyslipidemia in the T2DM population,particularly concerning non-high-density lipoprotein cholesterol(non-HDL-C).AIM To clarify the association between thyroid hormone sensitivity and dyslipidemia in patients with T2DM.METHODS In this cross-sectional study,thyroid hormone sensitivity indices,the thyroid feedback quantile-based index(TFQI),the thyroid-stimulating hormone index(TSHI),the thyrotrophic T4 resistance index(TT4RI),and the free triiodothyronine(FT3)/free thyroxine(FT4)ratio were calculated.Logistic regression analysis was performed to determine the associations between those composite indices and non-HDL-C levels.Random forest variable importance and Shapley Additive Explanations(SHAP)summary plots were used to identify the strength and direction of the association between hyper-non-HDL-C and its major predictor.RESULTS Among the 994 participants,389(39.13%)had high non-HDL-C levels.Logistic regression analysis revealed that the risk of hyper-non-HDL-C was positively correlated with the TFQI(OR:1.584;95%CI:1.088-2.304;P=0.016),TSHI(OR:1.238;95%CI:1.034-1.482;P=0.02),and TT4RI(OR:1.075;95%CI:1.006-1.149;P=0.032)but was not significantly correlated with the FT3/FT4 ratio.The relationships between composite indices of the thyroid system and non-HDL-C levels differed according to sex.An increased risk of hyper-non-HDL-C was associated with elevated TSHI levels in men(OR:1.331;95%CI:1.003-1.766;P=0.048)but elevated TFQI levels in women(OR:2.337;95%CI:1.4-3.901;P=0.001).Among the analyzed variables,the average SHAP values were highest for TSHI,followed by TT4RI.CONCLUSION Impaired sensitivity to thyroid hormones was associated with high non-HDL-C levels in patients with T2DM.

Non-HDL-C/HDL-C和NHR与冠状动脉病变严重程度的相关性

目的探讨非高密度脂蛋白胆固醇/高密度脂蛋白胆固醇比值(non-high-density lipoprotein cholesterol to high density lipoprotein cholesterol ratio,non-HDL-C/HDL-C)和中性粒细胞计数/高密度脂蛋白胆固醇比值(neutrophil to high-density lipoprotein cholesterol ratio,NHR)与冠状动脉病变严重程度的相关性。方法选取2022年1月至2023年6月因胸闷、胸痛于华北理工大学附属医院心内科住院初次行冠状动脉造影检查的患者284例,根据冠状动脉造影结果分为冠状动脉病变组(n=223)和对照组(n=61)。收集两组临床资料(一般资料和实验室资料),计算non-HDL-C/HDL-C和NHR,比较两组临床资料。根据Gensini评分将冠状动脉病变组分为低、高分值两个亚组,Gensini评分<30分为低分值亚组、Gensini评分≥30分为高分值亚组,比较两亚组实验室资料。采用Spearman相关性分析探讨冠状动脉病变患者Gensini评分与non-HDL-C/HDL-C、NHR的相关性。应用多因素Logistic回归分析探讨冠状动脉病变患者高Gensini评分的影响因素,并绘制受试者工作特征(receiver operating characteristic,ROC)曲线以评价non-HDL-C/HDL-C和NHR对冠状动脉病变患者高Gensini评分的预测价值。结果冠状动脉病变组non-HDL-C/HDL-C和NHR水平高于对照组(均P<0.05);Gensini评分高分值亚组non-HDL-C/HDL-C、NHR水平高于低分值亚组(均P<0.05)。相关性分析显示,non-HDL-C/HDL-C、NHR与Gensini评分均呈正相关(均P<0.05)。多因素Logistic回归分析显示,NHR升高是冠状动脉病变患者高Gensini评分的独立危险因素(OR=1.650,95%CI:1.262-2.158,P<0.05)。绘制ROC曲线,non-HDL-C/HDL-C和NHR预测冠状动脉病变严重程度的ROC曲线下面积分别为0.657(95%CI:0.582-0.732,P<0.01)和0.736(95%CI:0.666-0.807,P<0.01)。结论non-HDL-C/HDL-C、NHR与冠状动脉病变严重程度呈正相关,且NHR是冠状动脉病变患者高Gensini评分的独立预测因子。

TG/HDL-C、TyG及其衍生指数与白蛋白尿异常的相关性研究

目的:探讨体检人群甘油三酯/高密度脂蛋白胆固醇(triglyceride/high density lipoprotein cholesterol ratio,TG/HDL-C)、甘油三酯-葡萄糖乘积(riglyceride-glucose index,TyG)指数及其衍生指数水平与白蛋白尿异常的相关性,同时分析TG/HDL-C、TyG以及TyG-BMI(riglyceride-glucose index-body mass index,TyG-BMI)预测白蛋白尿的能力。方法:获取2022年1月至12月体检中心年龄在18岁以上3739例受检者进行回顾性分析,将研究对象分为白蛋白尿异常组(n=841)和对照人群(n=2898),将TG/HDL-C、TyG以及TyG-BMI按四分位数进行分组,采用logistic回归模型分析与体检人群白蛋白尿异常风险之间的关系。采用限制性立方样条回归模型分析不同水平TG/HDL-C、BMI、TyG以及TyG-BMI与白蛋白尿的剂量反应关系。通过受试者工作特征曲线分析单一指标与联合指标对白蛋白尿的预测价值。结果:除平均血红蛋白浓度、高密度脂蛋白胆固醇外,异常组年龄、中性粒细胞、单核细胞、血小板、血白细胞计数、平均红细胞体积、红细胞分布宽度SD、红细胞分布宽度、血小板压积、总蛋白、白蛋白、谷氨酰转肽酶、空腹血糖、糖化血红蛋白、总胆固醇、低密度脂蛋白胆固醇、甘油三酯(triglyceride,TG)、体质指数(body mass index,BMI)、收缩压、舒张压、脉率、碱性磷酸酶、TyG指数、TyG-BMI、TG/HDL-C均高于对照组。调整混杂因素后,逻辑回归结果显示,与第2、第3分位数相比,TG/HDL-C、TyG、TyG-BMI指数第4四分位数组发生风险最高,其分别为1.895倍(95%CI=1.355~2.653)、2.377倍(95%CI=1.657~3.417)、2.319(95%CI=1.666~3.237)。BMI、TyG-BMI指数与白蛋白尿异常呈明显的非线性剂量反应关系,曲线呈近似“U”型,TyG、TG/HDL-C与白蛋白尿异常之间的剂量反应关系呈逐渐递增趋势,曲线呈近似“J”型。受试者工作特征(receiver operating characteristic,ROC)曲线结果显示,TyG-BMI预测能力优于其他3个指标,其AUC值为0.640。除TyG-BMI+TG/HDL-C之外,其余联合预测能力均优于单一预测指标,TyG-BMI+TG/HDL-C+TyG指数预测白蛋白尿的能力最优,AUC为0.6504。结论:TyG指数、TG/HDL-C比值升高与白蛋白尿异常密切相关,均对白蛋白尿具有一定的预测价值。综合考虑,TyG-BMI+TG/HDL-C+TyG指数是较佳白蛋白尿预测联合指标。

LDL-C/HDL-C的比值对冠脉疾病诊断的意义

目的探讨LDL-C/HDL-C比值在粥样硬化性冠脉疾病辅助诊断中的应用价值。方法选择冠心病组43例,正常对照组100例,应用全自动快速电泳系统确定低密度脂蛋白(LDL)、极低密度脂蛋白(VLDL)和高密度脂蛋白(HDL)各区带的百分含量,并输入血清总胆固醇值,计算各种脂蛋白中胆固醇含量;在全自动生化仪上用匀相法同时测定LDL-C、HDL-C值。结果电泳法与匀相法同时测定LDL-C、HDL-C的相关性良好(r=0.930,r=0.827,P<0.001);LDL-C/HDL-C比值在冠心病组和正常对照组之间存在显著差异(P<0.001);诊断阈值为3.89,此时诊断灵敏度为79.1%,特异性为79.8%。结论LDL-C/HDL-C比值是粥样硬化性冠脉疾病重要的危险因子之一,明显优于胆固醇或其他血脂的单个含量指标,且随比值的增加,患冠脉疾病的危险性相应增大。

LDL-C/HDL-C及TG/HDL-C比值对冠心病的预测价值的评价

目的 探讨LDL C HDL C比值、TG HDL C比值与冠心病之间的相关性。方法 分析 10 4例经冠脉造影确诊的冠心病患者 (CHD组 )及 92例冠脉造影阴性者 (对照组 )LDL C HDL C比值及TG HDL C比值对冠心病的诊断价值。结果 冠心病组患者LDL C HDL C比值、TG HDL C比值水平及异常率均明显高于对照组 ,相关分析显示 ,LDL C HDL C比值及TG HDL C比值与冠心病相关 ,前者与CHD回归关系更强 ,且两比值之间呈正相关。结论 LDL C HDL C及TG HDL C比值可作为预测CHD的指标。与TG HDL C相比 ,LDL C HDL

TG/HDL-C和HDL-C对不同体型冠心病患者的诊断价值

目的探讨三酰甘油/高密度脂蛋白胆固醇(TG/HDL-C)和HDL-C对不同体型冠状动脉粥样硬化性心脏病(冠心病)患者的诊断价值。方法入选2008年8月~2009年8月于西安交通大学第一附属医院心血管内科住院治疗的急性冠脉综合征患者212例。同时选取年龄、性别匹配的健康对照者174例。按照体质指数(BMI)和是否发生急性冠脉综合征分为:正常组(99例,BMI 18.5~23.9 kg/m^2)、肥胖组(75例,≥28 kg/m^2)、冠心病组(79例)、肥胖冠心病组(133例)。入选者检测总胆固醇(TC)、TG、HDL-C、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A(apo A)和载脂蛋白B(apo B),并计算TG/HDL-C比值。结果肥胖冠心病组男性、高血压病史、糖尿病史和吸烟比例明显高于其他3组,TG和TG/HDL-C明显高于其他3组,差异有统计学意义(P均<0.05)。以是否发生冠心病为因变量,以TG/HDL-C为自变量,经多因素Logistic回归分析,TG/HDL-C是肥胖者发生冠心病的危险因素(OR=1.825,95%CI:1.294~2.573);校正年龄、性别、TC、TG、HDL-C、LDL-C、apo A和apo B后,TG/HDL-C对于肥胖者冠心病发病无影响。以是否发生冠心病为因变量,以TG/HDL-C为自变量,经多因素Logistic回归分析,TG/HDL-C是非肥胖者发生冠心病的危险因素(OR=1.952,95%CI:1.323~2.878);校正年龄、性别、TC、TG、HDL-C、LDL-C、apo A和apo B后,TG/HDL-C对于非肥胖者冠心病发病无影响。TG/HDL-C诊断肥胖冠心病ROC曲线下面积为0.726,HDL-C为0.794;TG/HDL-C诊断体型正常冠心病的ROC曲线下面积为0.751,HDL-C为0.779。结论 TG/HDL-C不是冠心病发病的独立危险因素,TG/HDL-C和HDL-C诊断不同体型冠心病患者的效能较好。

NLR、PLR及LDL-C/HDL-C与急性冠脉综合征在院主要不良心脏事件的关联

目的 探讨中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）及低密度脂蛋白与高密度脂蛋白比值（LDL-C/HDL-C）与急性冠脉综合征（ACS）在院主要不良心脏事件的关系,以及对ACS患者在院主要不良心脏事件发生的预测作用.方法 将340例患者依据临床症状、辅助检查及冠脉造影分为正常对照组及ACS组,ACS组以临床诊断及预后分为UA组、NSTEMI组、STEMI组、MACEs组;ACS组又以NLR=5.44分为高NLR组、低NLR组,以PLR=129.70分为高PLR组、低PLR组,以LDL-C/HDL-C=2.75分为高LDL-C/HDL-C组、低LDL-C/HDL-C组.检测外周血白细胞分类计数、血生化,并计算NLR、PLR和LDL-C/HDL-C.应用SPSS 22.0软件进行统计分析.结果 ①NLR在正常对照组、UA组、NSTEMI组、STEMI组、MACEs组中依次升高（1.79±0.81、2.82±2.30、5.47±4.97、7.63±6.89、10.85±8.50）,且正常对照组与UA组、NSTEMI组、STEMI组、MACEs组之间差异有统计学意义（P＜0.05）,UA组与NSTEMI组、STEMI组、MACEs组之间差异有统计学意义（P＜0.05）,NSTEMI组与STEMI组、MACEs组之间差异有统计学意义（P＜0.05）,STEMI组与MACEs组之间差异有统计学意义（P＜0.05）.PLR值在正常对照组、UA组、NSTEMI组、STEMI组、MACEs组依次升高（104.15±34.79、119.73±43.22、150.12±88.33、178.24±123.49、192.13±116.25）,且MACEs组、STEMI组与正常对照组及UA组差异具有统计学意义（P＜0.05）.ACS患者LDL-C/HDL-C值高于正常对照组（2.77±0.98比2.16±0.75）,且差异有统计学意义（P＜0.05）.②高NLR组患者在院主要不良心脏事件发生率明显高于低NLR组（31.3％比6.1％）,差异有统计学意义（P＜0.05）;高PLR组患者在院主要不良心脏事件发生率高于低PLR组（22.1％比11.0％）,差异有统计学意义（P＜0.05）.③多因素Logistic回归分析显示,年龄、高血压、NLR、LDL-C/HDL-C均是ACS的独立危险因素.结论 NLR、LDL-C/HDL-C是ACS的独立危险因素,NLR、PLR对ACS患者在院发生主要不良心脏事件有预测作用.

TG/HDL-C比值与冠心病患者致病风险的关系及诊断价值

目的探讨三酰甘油/高密度脂蛋白胆固醇(TG/HDL-C)比值与冠心病(CHD)患者致病风险的关系及诊断价值。方法选取2017年6月—2019年6月于辽宁省人民医院就诊的CHD患者100例(CHD组)及非CHD患者(非CHD组)100例作为研究对象。比较两组TG/HDL-C比值和一般资料的差异,采用多因素logistic回归分析TG/HDL-C比值对CHD的致病风险,受试者工作特征(ROC)曲线评价其诊断价值。结果CHD组的TG/HDL-C比值、TG水平、高血压病史及CHD家族史占比均明显高于非CHD组,而HDL-C水平明显低于非CHD组,差异均有统计学意义(均P<0.05)。多因素logistic回归分析显示,TG(OR=1.021,P<0.001)、TG/HDL-C比值(OR=4.231,P=0.006)、高血压病史(OR=5.724,P<0.001)、CHD家族史(OR=3.614,P<0.001)均是CHD发病的独立危险因素,而HDL-C(OR=0.196,P=0.010)为其保护因素。ROC曲线分析显示TG、HDL-C和TG/HDL-C比值中以TG/HDL-C比值的曲线下面积(AUC)最大(AUC=0.985,P<0.05)。结论CHD患者的TG/HDL-C比值明显高于非CHD患者,其对CHD的诊断价值较高,且是CHD发病的的独立危险因素。

TG/HDL-C、PCSK9、LAP与胰岛素抵抗的相关性及其预测糖尿病前期进展的价值

目的分析甘油三酯与高密度脂蛋白胆固醇比值(TG/HDL-C)、前蛋白转化酶枯草溶菌素9(PCSK9)、脂质蓄积指数(LAP)与胰岛素抵抗的关系及其预测糖尿病前期进展的价值。方法选取川北医学院附属医院收治的糖尿病前期患者205例,根据其是否进展为糖尿病分为进展组(n=33)和未进展组(n=172);比较2组的TG/HDL-C、PCSK9、LAP、胰岛素抵抗指数(HOMA-IR);Pearson相关分析TG/HDL-C、PCSK9、LAP与HOMA-IR的关系;多因素Logistic回归分析糖尿病前期进展的影响因素;决策分析曲线(DCA)分析TG/HDL-C、PCSK9、LAP及三者联合的临床获益度;临床影响曲线(CIC)分析在各个阈概率(Pt)下被TG/HDL-C、PCSK9、LAP联合检测划分为高风险的人数与实际人数的符合情况。结果进展组TG/HDL-C、PCSK9、LAP、HOMA-IR均高于未进展组(均P<0.05);TG/HDL-C、PCSK9、LAP与HOMA-IR呈正相关(r=0.798、0.786、0.800,均P<0.05);TG/HDL-C、PCSK9、LAP是糖尿病前期进展的独立危险因素(均P<0.05);在一个较大的Pt范围内TG/HDL-C、PCSK9联合LAP较三者单独应用具有更高的临床获益度,CIC曲线横轴从0.6后,三者联合划分为高风险的人数与实际人数具有较高的符合率。结论TG/HDL-C、PCSK9、LAP与胰岛素抵抗有关,且是影响糖尿病前期患者病情转归的危险因素,三者联合预测患者临床获益具有更好的价值。

UA、HDL-C、ApoA1/HDL在不同帕金森亚型患者中的差异及其与认知功能的相关性分析

目的研究尿酸(UA)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1与高密度脂蛋白比值(ApoA1/HDL)在不同帕金森亚型中的表达差异及其与认知功能的相关性。方法选取该院2016年10月至2018年10月门诊治疗的100例老年帕金森患者,针对不同的帕金森疾病患者的一般资料及认知功能障碍之间的差异进行对比,同时对比不同帕金森亚型患者及不同认知障碍情况患者血清UA、HDL-C、ApoA1/HDL之间的差异,分析血清UA、HDL-C、ApoA1/HDL水平与患者认知功能之间的相关性。结果不同帕金森亚型患者的性别、年龄、体质量指数之间的差异无统计学意义(P>0.05),而不同亚型帕金森患者的简易智能精神状态检查量表(MMSE)评分、蒙特利尔认知评估量表(MoCA)评分之间的差异有统计学意义(P<0.05);不同亚型帕金森患者的血清UA、HDL-C、ApoA1/HDL水平及不同认知情况的帕金森患者的血清UA、HDL-C、ApoA1/HDL水平之间的差异有统计学意义(P<0.05)。结论帕金森患者的认知功能与血清UA、HDL-C、ApoA1/HDL水平呈负相关,且随着帕金森患者合并临床症状的不断累积,其UA、HDL-C、ApoA1/HDL水平显著下降。

TG/HDL-C与胰岛素抵抗的相关性研究

目的探讨TG/HDL-C与胰岛素抵抗(IR)的相关性。方法选取杭州市某社区40~65岁的自然居民960例为研究对象,收集体格检查、实验室检测资料,计算稳态模型评估的IR指数(HOMA-IR)。分析IR影响因素以及其对IR的预测效能。结果960例受试者中,IR(HOMA-IR≥2.69)389例,非IR 571例。经单因素logistic回归分析显示,年龄、BMI、腰围、臀围、收缩压、舒张压、腹内脂肪面积(VFA)、皮下脂肪面积、TG、TC、HDL-C、LDL-C、TG/HDL-C、TC/HDL-C、LDL-C/HDL-C与IR有关(均P<0.05);经多因素logistic回归分析显示,腰围、收缩压、VFA、TG、TG/HDL-C是IR的独立影响因素(均P<0.05)。单独TG/HDL-C、TG预测IR的效能较低,AUC分别为0.674、0.664;TG/HDL-C、收缩压、腰围联合预测IR的AUC为0.755,TG、收缩压、腰围联合预测IR的AUC为0.751,较单独TG/HDL-C、TG预测IR的效能明显提升。结论TG/HDL-C是IR的独立影响因素,其与腰围、收缩压联合预测IR的效能较好。

血清HS-CRP LDL-C/HDL-C在冠心病中的临床意义

目的通过检测冠心病（CHD）患者体内超敏C．反应蛋白（hs．CRP）、低密度脂蛋白（LDL—C）和高密度脂蛋白（HDL．C）水平，研究HS．CRP与LDL．C／HDL．C冠心病及冠心病病变程度中的临床意义。方法根据冠状动脉（简称冠脉）造影结果的Gensini评分，将患者分为四组：（1）冠脉造影正常组（64例）：Gensini评分0分。（2）冠脉轻度病变组（61例）：Gensini评分〈10分。（3）中度病变组（32例）：Gensini评分10—30分。（4）重度病变组（61例）：Gensini评分〉30分。比较四组hS-CRP及LDL-C／HDL—C升高与冠心病的相关程度。结果冠心病组患者的hs-CRP浓度和LDL．C／HDL—C均显著高于冠脉正常组（P〈0．05）。另外，hS-CRP浓度在冠脉中度病变组显著高于冠脉轻度病变组（P〈0．05）；冠脉重度病变组显著高于冠脉中度病变组（P〈0．05）。结论血hS—CRP和LDL-C／HDL-C均与冠脉病变密切相关，而且hS—CRP与病变的严重程度（据Gensini评分）呈正相关，可作为对冠脉病变程度的估测指标。虽血液中LDL—C／HDL．C与冠状动脉病变密切相关，但很难完全据此指标来预测其病变程度。

急性心肌梗死患者血清TC/HDL-C水平与冠脉病变程度关系研究

目的探讨急性心肌梗死（AMI）患者血清总胆固醇／高密度脂蛋白胆固醇比值（TC／HDL-C）与冠脉病变程度的关系。方法随机选取2010年～2012年急性心肌梗死患者行经皮冠状动脉介入治疗者60例，并根据TC／HDL-C水平按四分位法随机分为4组。观察4组患者冠脉造影结果，分析TC／HDL-C与冠状动脉评分之间的关系。结果随着TC／HDL-C水平的升高，患者3支血管病变的比例增大，各组间差异有统计学意义（哟〈0．05）。血浆TC／HDL-C水平与冠脉病变Gensini积分呈正相关（r=0．775，P〈0．05）。结论急性心肌梗死患者TC／HDL-C水平越高，其冠脉病变程度越重，心血管事件发生率越高。TC／HDL—C可以作为判断急性心肌梗死病情和冠脉病变程度的一个指标。

2型糖尿病患者血清TG/HDL-C与UACR的相关性研究

目的:探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清致动脉硬化因子三酰甘油/高密度脂蛋白胆固醇比值(triglyceride/high-density lipoprotein cholesterol ratio,TG/HDL-C)与尿白蛋白/肌酐比值(urinary albumin-tocreatinine ratio,UACR)的相关性。方法:选择2020年1—12月在南通市中医院、南通市第一人民医院就诊的T2DM门诊患者91例,行血清TG、HDL-C、尿微量白蛋白、尿肌酐检测,并计算TG/HDL-C及UACR值。91例患者按UACR值分为正常白蛋白尿组(<30 mg/g,36例)、微量白蛋白尿组(30~<300 mg/g,31例)与大量白蛋白尿组(≥300 mg/g,24例),比较3组TG/HDL-C,并采用Pearson回归分析TG/HDL-C与UACR的相关性。结果:(1)正常白蛋白尿组、微量白蛋白尿组及大量白蛋白尿组血清TG/HDL-C分别为1.49±1.20、2.20±1.13、3.22±2.44,两两比较差异均有统计学意义(均P<0.05)。(2)T2DM患者UACR与TG/HDL-C呈正相关(r=0.413,P<0.001)。结论:T2DM患者UACR与TG/HDL-C密切相关,提示糖尿病靶器官损害与动脉硬化密切相关,早期发现动脉硬化并进行干预对延迟糖尿病肾脏并发症有一定意义。

Novel parameter based on lipid indicators ratio improves prognostic value of plasma lipid levels in resectable colorectal cancer patients

BACKGROUND At present,the value of lipid indicators in evaluating the prognosis of colorectal cancer is still relatively limited.AIM To evaluate the value of a novel parameter for colorectal cancer(CRC)prognosis scoring based on preoperative serum lipid levels.METHODS Four key serum lipid factors,namely,high-density lipoprotein cholesterol(HDLC),low-density lipoprotein cholesterol(LDL-C),apolipoprotein A1(Apo A1),and apolipoprotein B(Apo B),were detected.Two representative ratios,HDL-C-LDLC ratio(HLR)and Apo A1-Apo B ratio(ABR)were calculated.The relationship of these parameters with the prognosis of CRC patients including progression-free survival(PFS)and overall survival(OS)was analyzed by Kaplan-Meier plot and Cox proportional hazards regression.A novel lipoprotein cholesterol-apolipoprotein(LA)score based on HLR and ABR was established and its value in prognosis evaluation for CRC patients was explored.RESULTS Multivariate Cox proportional hazards regression analysis of PFS and OS showed that HDL-C,Apo A1,HLR,and ABR were positively associated with the prognosis of CRC patients.LA score was independently associated with a good prognosis in resectable CRC patients.Data processing of a dummy variable showed that the prognosis of patients with higher LA scores is better than that with lower LA scores.CONCLUSION The newly established LA score might serve as a better predictor of the prognosis of resectable CRC patients.