总胆固醇/高密度脂蛋白比值在心血管疾病中的研究进展

目前心血管疾病在全世界仍有着较高的发病率和死亡率,既往研究已证实血脂是心血管疾病的独立危险因素,与动脉粥样化性心血管疾病(ASCVD)密切相关。总胆固醇/高密度脂蛋(TC/HDL-C)比值属于血脂指标的衍生指标,临床研究已表明其与心血管疾病的诊断及预后相关。近些年研究发现,部分人群TC/HDL-C比值与低密度脂蛋白(LDL-C)和非高密度脂蛋白(non-HDL-C)水平存在不一致的现象,这提示TC/HDL-C比值可能为LDL-C和non-HDL-C提供额外血脂信息,为降脂治疗提供新的思路。本文就TC/HDL-C比值在心血管疾病中的应用及最新进展做一系统综述。

利用人血浆高密度脂蛋白治疗内毒素血症

内毒素血症是困扰医学界的一大难题，尽管人们对内毒素结构、生物学活性及其致病机制、内毒素血症的病理生理过程等有关的认识取得了显著的进展，经典的抗感染治疗不能有效控制脓毒血症的发病率及死亡率。人血浆高密度脂蛋白是一种很有希望的拮抗内毒素血症的生物制剂，精制脱毒后治疗内毒素血症应有临床应用前景。

脑梗死患者血清高密度脂蛋白亚组分的分析

目的:观察脑梗死患者血清高密度脂蛋白亚组分的变化。方法:以琼脂糖凝胶为载体,在弱碱性条件下电泳将血清各脂蛋白分离,苏丹黑染色,干燥后以坐标卡尺固定,纵向扫描3cm,分析软件修图,删除非HDL峰,将HDL峰以阳极端为零点,按迁移距离自阳极端分割成7种亚组分分析,结果作小样本团t检验统计。结果:脑梗死组6-8mm组分处明显低于对照组(P<0.05);10-12mm和12-14mm亚组分处明显高于对照组(P<0.05)。结论:远离阳级端的组分即颗粒大、带电荷少的HDL,组分为梗塞发生的危险因素。

清热化痰祛瘀方对高脂血症大鼠肝SR-BImRNA及蛋白表达的影响

目的研究清热化痰祛瘀方对高脂血症大鼠肝脏高密度脂蛋白受体(SR-BI)mRNA及蛋白表达的影响。方法将SD大鼠随机分为正常组、模型组及清热化痰祛瘀方小、中、大剂量组和阳性药对照组(立普妥组)。除正常组外,其余大鼠采用脂肪乳剂灌胃的方法建立大鼠高脂血症模型,各组给予相应的干预措施。治疗6周后,采用RT-PCR和Western Blot方法检测大鼠肝组织中SR-BI mRNA和蛋白表达的水平。结果与正常组比较,模型组大鼠肝组织中SR-BI mRNA和蛋白表达明显下调(P<0.01)。与模型组比较,清热化痰祛瘀方中、大剂量组大鼠肝组织中SR-BI mRNA表达和蛋白水平升高(P<0.05,P<0.01),立普妥组SR-BI mRNA表达和蛋白水平亦明显上调(P<0.05)。中、大剂量组上调SR-BI mRNA的表达优于小剂量组(P<0.05)。清热化痰祛瘀方大剂量组上调SR-BI mRNA表达的水平优于立普妥组(P<0.05)。结论清热化痰祛瘀方调脂、抗动脉粥样硬化的作用可能与其调控SR-BI mRNA和蛋白表达有关。

氟伐他汀钠与普鲁脂芬治疗原发性高脂蛋白血症的对比研究

目的:对比研究氟伐他汀与普鲁脂芬治疗原发性高脂蛋白血症的疗效。方法:346例原发性高脂蛋白血症患者(Ⅱa或Ⅱb),采用氟伐他汀钠组176例,每日晚一次用药,每次20mg,普鲁脂芬组170例,每日3次,口服药每次100mg,疗程12周。结果:氟伐他汀钠和普鲁脂芬组用药前后比较,血清胆固醇(TC)平均降低25%和15%,低密度脂蛋白-胆固醇(LDL-C)平均降低32%和12%,甘油三脂(TG)平均降低22%和40%,高密度脂蛋-胆固醇(HDL-C)平均升高5%和14%。结论:氟伐他汀钠降低血清TC和LDL-C的作用比普鲁脂芬更好(P<0.001),降低血清TG和升高HDL-C的作用,普鲁脂芬比氟伐他汀钠更好(P<0.001),两组不良反应情况相似,但氟伐他汀钠较轻。

冠心病与血清脂质和血液流变学的关系探讨

本文对55例冠心病患者和5O例正常人作了甘油三酯、胆固醇、载脂蛋白AI,载脂蛋白B、高密度脂蛋白和高密度脂蛋白亚组分含量的测定,同时还作了全血比粘度、聚集指数、血浆比粘度、红细胞压积等血液流变学指标的测定。冠心病组和正常对照组比较,经统计学处理有显著性差异(P<0.01)。并用灵敏性和特异性两个指数将血清脂质血流变学进行比较。在血清脂质中HDL_2—Ch在病人组改变最为明显,其灵敏性为71％,特异性为92％在血液粘度中以低切粘度改变最为明显,其灵敏性为67％,特异性为88％。HDL_2—Ch可作为冠心病发病首选危险因子。血液粘度对冠心病的辅助诊断有一定参考价值,并可作为冠心病的治疗和预后判断指标,HDL_2—Ch和血液低切粘度结合起来应用,对冠心病的诊断、治疗和预后具有重要指导意义。

4218例体检人群血脂、血糖检测结果分析

目的:分析4218例体检人群血脂、血糖检测结果方法2008年来我社区卫生服务中心进行健康体检的人群,年龄18～82岁,共4218例,检测血脂和空腹血糖。结果4218例体检人群血清测定中,TC≥6.22mmol者596例,占14.13%;TG≥1.70mmol者737例,占17.47%;LDL-C≥4.14mmol/L者797例,占18.90%;HDL-C≤1.04mmol/L者614例,占14.56%;GLU≥6.1mmol/L者213例,占5.05%。各年龄组中,血脂随增龄而偏高,特别在31～60岁组为明显。血糖偏高多在40岁以后,60岁以上老年人血糖偏高者增多。结论4218例体检人群血脂异常、血脂边缘异常和空腹血糖偏高的患病率高,随增龄而增高,

高血压患者血清HDL3水平与颈动脉粥样硬化斑块稳定性的临床分析

目的通过测定血清高密度脂蛋白3(HDL3),探讨其血清水平与高血压患者合并颈动脉斑块稳定程度的相关性。方法纳入明确诊断高血压患者140例作为观察组,根据颈动脉B超提示结果,将研究对象分为高血压无斑块组(n=32)、高血压合并稳定斑块组(n=40)、高血压合并易损斑块组(n=68)。选取同期年龄、性别相匹配的80例健康者作对照组,采用免疫比浊法检测血清HDL3水平。应用多因素logistic回归分析HDL3与高血压合并颈动脉粥样硬化斑块稳定程度的关系。结果高血压患者血清HDL3水平明显高于健康对照组(P <0.05)。观察组3个亚组血清HDL3水平差异有统计学意义,易损斑块组HDL3水平明显低于其他两组(P <0.05)。logistic回归分析显示血清LDL、HDL3水平是高血压患者颈动脉形成不稳定粥样硬化斑块的危险因素(P <0.05)。结论血清HDL3水平降低是高血压患者形成不稳定颈动脉粥样硬化斑块的危险因素之一。

Metabolic syndrome and gallstone disease

AIM： To investigate the association between metabolic syndrome （NetS） and the development of gallstone disease （GSD）. METHODS： A cross-sectional study was conducted in 7570 subjects （4978 men aged 45.0：1：8.8 years, and 2592 women aged 45.3：1：9.5 years） enrolled from the physical check-up center of the hospital. The subjects included 918 patients with gallstones （653 men and 265 women） and 6652 healthy controls （4325 men and 2327 women） without gallstones. Body mass index （BII）, waist circumference, blood pressure, fasting plasma glucose （FPG） and serum lipids and lipoproteins levels were measured. Colorimetric method was used to measure cholesterol, high-density lipoprotein cho- lesterol （HDL-C） and low-density lipoprotein cholesterol （LDL-C）. Dextrose oxidizing enzyme method was used to measure FPG. Subjects were asked to complete a questionnaire that enquired about the information on demographic data, age, gender, histories of diabetes mellitus, hypertension, and chronic liver disease and so on. Metabolic syndrome was diagnosed according to the Adult Treatment Panel HI （ATP ]3） criteria. Gall- stones were defined by the presence of strong intralu- minal echoes that were gravity-dependent or attenu- ated ultrasound transmission. RESULTS： Among the 7570 subjects, the prevalence of the gallstone disease was 12.1% （13.1% in men and 10.2% in women）. BMI, waist circumference, systolic blood pressure, diastolic blood pressure, fasting blood glucose and serum triglyceride （TG） in cases group were higher than in controls, while serum high-density lipid was lower than in controls. There were significant differences in the waist circumference, blood pressure, FPG and TG between cases and controls. In an age- adjusted logistic regression model, metabolic syndrome was associated with gallstone disease. The age-adjust- ed odds ratio of MetS for GSD in men was 1.29 [95% confidence interval （CI）, 1.09-1.52; P = 0.0030], and 1.68 （95% CI, 1.26-2.25; P = 0.0004） in women; the overall age-adjusted odds ratio of NetS for GSD was 1.42 （95% CI, 1.23-1.64; P 〈 0.0001）. The men with more metabolic disorders had a higher prevalence of gallstone disease, the trend had statistical significance （P 〈 0.0001）. The presence of 5 components of the MetS increased the risk of gallstone disease by 3.4 times （P 〈 0.0001）. The prevalence of GSD in women who had 5 components of NetS was 5 times higher than in those without Nets component. The more the components of Mets, the higher the prevalence of GSD （P 〈 0.0001）. The presence of 5 components of the Mets increased the risk of gallstone disease by 4.0 times. CONCLUSION： GSD appears to be strongly associated with MetS, and the more the components of NetS, the higher the prevalence of GSD.

Yi-Qi-Zeng-Min-Tang,a Chinese medicine,ameliorates insulin resistance in type 2 diabetic rats

AIM:To investigate the effects of the Chinese herbal decoction,Yi-Qi-Zeng-Min-Tang(YQZMT),on insulin resistance in type 2 diabetic rats.METHODS:Sprague-Dawley rats were divided into two dietary regiments by feeding either normal pellet diet(NPD) or high fat diet(HFD).Four weeks later,the HFD-fed rats were injected intraperitoneally with lowdose streptozotocin(STZ).Rats with non-fasting blood glucose level ≥ 16.67 mmol/L were considered type 2 diabetic and further divided into five subgroups:the type 2 diabetes model group,low-dose,medium-doseand high-dose YQZMT groups,and rosiglitazone group.Age-matched NPD-fed rats served as controls.YQZMT or rosiglitazone were administered for 8 wk.Intraperitoneal glucose and insulin tolerance tests were performed before and after the treatment to measure the glucose tolerance and insulin sensitivity.Serum levels of biochemical parameters,adipocytokines,such as tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),as well as free fatty acids(FFAs),were also analyzed.RESULTS:There was significant elevation of insulin resistance and serum levels of fasting glucose(12.82 ± 1.08 mmol/L vs 3.60 ± 0.31 mmol/L,P < 0.01),insulin(7197.36 ± 253.89 pg/mL vs 4820.49 ± 326.89 pg/mL,P < 0.01),total cholesterol(TC)(8.40 ± 0.49 mmol/L vs 2.14 ± 0.06 mmol/L,P < 0.01),triglyceride(2.24 ± 0.12 mmol/L vs 0.78 ± 0.05 mmol/L,P < 0.01),low-density lipoprotein cholesterol(LDL-c)(7.84 ± 0.51 mmol/L vs 0.72 ± 0.04 mmol/L,P < 0.01) and decrease in high-density lipoprotein cholesterol(HDL-c)(0.57 ± 0.03 mmol/L vs 1.27 ± 0.03 mmol/L,P < 0.01) in the low-dose STZ and high-fat diet induced type 2 diabetic group when compared with the control group.Administration of YQZMT induced dose-and timedependent changes in insulin resistance,glucose and lipid profile,and reduced levels of FFA,TNF-α and IL-6 in the type 2 diabetic rats.After the treatment,compared with the diabetic group,the insulin resistance was ameliorated in the high-dose YQZMT(2.82 g/100 g per day) group,with a significant reduction in serum glucose(12.16 ± 1.00 mmol/L vs 17.65 ± 2.22 mmol/L,P < 0.01),homeostasis model assessment of basal insulin resistance(22.68 ± 2.37 vs 38.79 ± 9.02,P < 0.05),triglyceride(0.87 ± 0.15 mmol/L vs 1.99 ± 0.26 mmol/L,P < 0.01),TC(3.31 ± 0.52 mmol/L vs 6.50 ± 1.04 mmol/L,P < 0.01) and LDL-c(2.47 ± 0.50 mmol/L vs 6.00 ± 1.07 mmol/L,P < 0.01),and a signif icant increase in HDL-c(0.84 ± 0.08 mmol/L vs 0.50 ± 0.03 mmol/L,P < 0.01).But the body weight was not changed signif icantly.CONCLUSION:YQZMT,which ameliorates insulin resistance and does not cause increase in body weight,may be a suitable therapeutic adjunct for the treatment of type 2 diabetes.

High-density lipoprotein as a potential carrier for delivery of a lipophilic antitumoral drug into hepatoma cells

AIM: To investigate the possibility of recombinant highdensity lipoprotein (rHDL) being a carrier for delivering antitumoral drug to hepatoma cells. METHODS: Recombinant complex of HDL and aclacinomycin (rHDL-ACM) was prepared by cosonication of apoproteins from HDL (Apo HDL) and ACM as well as phosphatidylcholine. Characteristics of the rHDL-ACM were elucidated by electrophoretic mobility, including the size of particles, morphology and entrapment efficiency. Binding activity of rHDL-ACM to human hepatoma cells was determined by competition assay in the presence of excess native HDL. The cytotoxicity of rHDL-ACM was assessed by MTT method. RESULTS: The density range of rHDL-ACM was 1.063-1.210 g/mL, and the same as that of native HDL. The purity of all rHDL-ACM preparations was more than 92%. Encapsulated efficiencies of rHDL-ACM were more than 90%. rHDL-ACM particles were typical sphere model of lipoproteins and heterogeneous in particle size. The average diameter was 31.26±5.62 nm by measure of 110 rHDL-ACM particles in the range of diameter of lipoproteins. rHDL-ACM could bind on SMMC-7721 cells, and such binding could be competed against in the presence of excess native HDL. rHDL-ACM had same binding capacity as native HDL. The cellular uptake of rHDL-ACM by SMMC-7721 hepatoma cells was significantly higher than that of free ACM at the concentration range of 0.5-10 μg/mL (P<0.01). Cytotoxicity of rHDL-ACM to SMMC-7721 cells was significantly higher than that of free ACM at concentration range of less than 5 ug/mL (P<0.01) and IC50 of rHDL-ACM was lower than IC50 of free ACM (1.68 nmol/L vs3 nmol/L). Compared to L02 hepatocytes, a normal liver cell line, the cellular uptake of rHDL-ACM by SMMC-7721 cells was significantly higher (P<0.01) and in a dose-dependent manner at the concentration range of 0.5-10 μg/mL.Cytotoxicity of the rHDL-ACM to SMMC- 7721 cells was significantly higher than that to L02 cells at concentration range of 1-7.5μg/mL (P<0.01). IC50 for SMMC-7721 cells (1.68 nmol/L) was lower than that for L02 cells (5.68 nmol/L), showing a preferential cytotoxicity of rHDL-ACM for SMMC-7721 cells. CONCLUSION: rHDL-ACM complex keeps the basic physical and biological binding properties of native HDL and shows a preferential cytotoxicity for SMMC-7721 hepatoma to normal L02 hepatocytes, HDL is a potential carrier for delivering lipophilic antitumoral drug to hepatoma cells.

High-density lipoproteins:an emerging target in the prevention of cardiovascular disease

High-density lipoproteins （HDLs） have been well established to protect against the development of atherosclerotic cardiovascular disease. It has become apparent that in addition to the promotion of reverse cholesterol transport, HDLs possess a number of additional functional properties that may contribute to their beneficial influence on the arterial wall. A number of exciting therapeutic strategies have been developed that target HDL and its ability to protect against the development of atherosclerotic plaque. This paper will review how the promotion of the functional properties of HDL inhibits the formation of atherosclerotic plaque and stabilises lesions in patients with established disease.

Is the ratio of apoB/apoA-1 the best predictor for the severity of coronary artery lesions in Chinese diabetics with stable angina pectoris？ An assessment based on Gensini scores

Background There is a paucity of data about the best lipid ratio predicting the severity of coronary artery disease （CAD） in patients with diabetes mellitus. We determined the relationship between five conventional lipid ratios and the extent of coronary artery lesions in Chinese Type 2 diabetics with stable angina pectoris （SAP）. Methods A prospective cohort study within 373 type 2 diabetic patients diag- nosed with stable CAD by coronary angiography was performed. All patients were classified into three groups according to the tertiles of Gensini scores （GS, low group 〈 8 points n = 143; intermediate group 8-28 points, n = 109; high group 〉 28 points, n = 121）. Association between the ratios of apolipoprotein （apo） B and apoA-1, total cholesterol and high density lipoprotein cholesterol （TC/HDL-C）, triglycerides and HDL-C （TG/HDL-C）, low density lipoprotein cholesterol and HDL-C （LDL-C/HDL-C）, Non-HDL-C/HDL-C and GS were evaluated using the receivers operating characteristic （ROC） curves and multivariate logistic regression models. Results The ratio of apoB/apoA-1, TC/HDL-C, LDL-C/HDL-C, and Non-HDL-C/HDL-C were correlated with Gensini scores. Area under the ROC curves for predicting high Gensini scores in the ratios of apoB/apoA-1, TC/HDL-C, LDL-C/HDL-C and Non-HDL-C/HDL-C were 0.62, 0.60, 0.59 and 0.60, respec- tively （P 〈 0.005 for all）. According to multivariate logistic regression analysis after adjusted with demographic characteristic and other lipid parameters, the ratio of apoB/apoA-1 is qualified as an independent discriminator for the severity of CAD. However, after fiu-ther adjusting different baseline variables, such as left ventricular ejective fraction, hemoglobin Alc, leukocytes count and serum creatinine, none of the above lipid ratios remained. Conclusions Compared with other lipid parameters, the ratio of apoB/apoA-1 appears to be more significantly correlated with the extent of coronary artery lesions in Chinese diabetics, but it was not an independent predictor in these settings.

Atherosclerosis： from biology to pharmacological treatment

A recent explosion in the amount of cardiovascular risk has swept across the globe. Primary prevention is the preferred method to lower cardiovascular risk. Lowering the prevalence of obesity is the most urgent matter, and is pleiotropic since it affects blood pressure, lipid profiles, glucose metabolism, inflammation, and atherothrombotic disease progression. Given the current obstacles, success of primary prevention remains uncertain. At the same time, the consequences of delay and inaction will inevitably be disastrous, and the sense of urgency mounts. Pathological and epidemiological data confirm that atherosclerosis begins in early childhood, and advances seamlessly and inexorably throughout life. Risk factors in childhood are similar to those in adults, and track between stages of life. When indicated, aggressive treatment should begin at the earliest indication, and be continued for many years. For those patients at intermediate risk according to global risk scores, C-reactive protein, coronary artery calcium, and carotid intima-media thickness are available for further stratification. Using statins for primary prevention is recommended by guidelines, is prevalent, but remains under prescribed. Statin drugs are unrivaled, evidence-based, major weapons to lower cardiovascular risk. Even when low density lipoprotein cholesterol targets are attained, over half of patients continue to have disease progression and clinical events. Though clinical evidence is incomplete, altering or raising the blood high density lipoprotein cholesterol level continues to be pursued. The aim of this review is to point out the attention of key aspects of vulnerable plaques regarding their pathogenesis and treatment.

Prevalence of Metabolic Syndrome and Its Associations with Other Metabolic Disorders and Cardiovascular Changes in Health Examination Population in Beijing

Objective To investigate the prevalence of metabolic syndrome(MS) and its associations with other metabolic disorders and cardiovascular changes in health examination population in Beijing.Methods Totally,10 916 individuals who received health examination in Health Examination Center of Peking Union Medical College Hospital were enrolled.The height,weight,blood pressure,serum levels of triglyceride,high-density lipoprotein cholesterol(HDL-C),and fasting blood glucose were recorded.MS was diagnosed based on the working criteria of Chinese Diabetes Society 2004(CDS2004).Meanwhile,other metabolic disorders,including fatty liver and hyperuricemia,were recorded.The cardiovascular changes were reflected by the reports of electrocardiogram(ECG) ST-T changes and atherosclerosis of retinal arteries.Results The overall prevalence rate of MS was 6.1%(666/10 916) in the population.The prevalence rate of MS in male was much higher than that in female(9.0% vs.2.7%,P=0.000).For individuals with MS,the prevalence rates of fatty liver and hyperuricemia were significantly higher than those without MS,respectively(70.4% vs.35.4%,P=0.000;29.9% vs.17.7%,P=0.000).As for cardiovascular changes,the prevalence rates of ECG ST-T changes and atherosclerosis of retinal arteries were significantly higher in individuals with MS than those without MS,respectively(13.8% vs.11.7%,P=0.012;12.0% vs.6.8%,P=0.000).Conclusions The prevalence of MS in Beijing population is high.The individuals with MS have a higher risk for other metabolic disorders and cardiovascular changes.

Measurement of serum paraoxonase-1 activity in the evaluation of liver function

Paraoxonase-1 (PON1) is an esterase and lactonase synthesized by the liver and found in the circulation associated with high-density lipoproteins. The physiological function of PON1 seems to be to degrade specific oxidized cholesteryl esters and oxidized phospholipids in lipoproteins and cell membranes. PON1 is, therefore, an antioxidant enzyme. Alterations in circulating PON1 levels have been reported in a variety of diseases involving oxidative stress including chronic liver diseases. Measurement of serum PON1 activity has been proposed as a potential test for the evaluation of liver function. However, this measurement is still restricted to research and has not been extensively applied in routine clinical chemistry laboratories. The reason for this restriction is due to the problem that the substrate commonly used for PON1 measurement, paraoxon, is toxic and unstable. The recent development of new assays with non-toxic substrates makes this proposal closer to a practical development. The present editorial summarizes PON1 biochemistry and function, its involvement with chronic liver impairment, and some aspects related to the measurement of PON1 activity in circulation.

Glycation of high-density lipoprotein triggers oxidative stress and promotes the proliferation and migration of vascular smooth muscle cells

Background In type 2 diabetes mellitus （T2DM）, high-density lipoprotein （HDL） impairs its anti-atherogenic properties and even develops to a pro-inflammatory and pro-atherogenic phenotype because of abnormal compositions and modifications. In this study, we ex- amined the effects and the related mechanisms of glycation of HDL on the proliferation and migration of vascular smooth muscle cells （VSMCs）. Methods ＆ Results Glycated HDL （G-HDL） was modified with D-glucose （25 mmol/L） in vitro. Diabetic HDL （D-HDL） was isolated from T2DM patients. Rat VSMCs were isolated from the thoracic aortas. Human VSMCs were obtained from ScienCell Research Laboratories. Alpha-actin was detected through immunofiuorescence. VSMC proliferation was assayed by Cell Count. VSMC migration was determined by transwell chamber and scratch-wound assay. Intracellular reactive oxygen species （ROS） was detected based on ROS-medi- ated 2＇,7＇-dichlorofluorescein （DCFH-DA） fluorescence. Compared to native HDL （N-HDL）, G-HDL remarkably promoted VSMC prolif- eration and migration in the dose and time-dependent manners. In addition, G-HDL enhanced ROS generation in VSMCs. However, the ROS scavenger, N-acetylcysteine, efficiently decreased ROS production and subsequently inhibited the proliferation of VSMCs induced by G-HDL. Similarly, D-HDL from T2DM patients also promoted ROS release and VSMC proliferation and migration. Conclusions HDL either glycated in vitro or isolated from T2DM patients triggered VSMC proliferation, migration, and oxidative stress. These results might partly interpret the higher morbidity of cardiovascular disease in T2DM patients.

Metabolism of high density lipoproteins in liver cancer

Liver plays a vital role in the production and catabolism of plasma lipoproteins. It depends on the integrity of cellular function of liver, which ensures homeostasis of lipid and lipoprotein metabolism. When liver cancer occurs these processes are impaired and high-density lipoproteins are changed.

MODIFIED CLASSIC RISK FACTORS FOR CORONARY ARTERY DISEASE IN CHINESE HAN POPULATION

Objective To investigate the levels of cardiovascular disease risk factors and their relations to clinical phenotype associated with coronary artery disease(CAD).Methods The subjects were recruited from five independent cardiovascular centers.Coronary angiography was employed to define the CAD with stenosis in each major vessel ≥70% and control with stenosis <10% in every lesion.The classic risk factors including family history,body mass index,smoking habits,hypertension,diabetes mellitus,and serum lipid levels were surveyed according to established criteria.Associations between risk levels and clinical phenotypes were assessed by case control and correlation analysis.Results A total of 762 individuals were collected,including 481 men and 281 women,aged from 17 to 81(mean 60±10) years.The patients with CAD accounted for 55.5% of all participants,and controls 44.5%,respectively.Compared with the pattern in published data,our study showed that mean serum high density lipoprotein cholesterol(HDL-C) level was significantly lower(P<0.001) and triglycerides was significantly higher(P<0.001),while total cholesterol(TC) and low density lipoprotein cholesterol levels were comparative(both P>0.05).The prevalence of low HDL-C(<40 g/L) and hypertriglyceridemia(>150 g/L) were 27.2% and 41.4%,respectively.Mean serum levels of HDL-C and apolipoprotein A1 were significantly higher in female subjects than in male(P<0.001).Lower HDL-C functioned as an independent risk factor for CAD only in men(RR=2.8,95%CI:1.5-4.2,P<0.001),yet increased non-HDL cholesterol combined with diabetes mellitus and obesity seemed to play a key role in the development ofCAD in women.Similarity in risk association with CAD was found for hypertension and TC/HDL ratio in male and female subjects,while family history had no relationship with the presence of CAD.Conclusion It is remarkable that emphasis of intervention in future should be given on the prevalent low serum HDL-C and its strong risk correlation with the presence of CAD in male subjects of Chinese Han population.