Background Diabetes mellitus （DM） is associated with coronary artery disease （CAD） progression. Although previous studies have demonstrated the association of lipid and lipoprotein ratios with CAD, no data are cur...Background Diabetes mellitus （DM） is associated with coronary artery disease （CAD） progression. Although previous studies have demonstrated the association of lipid and lipoprotein ratios with CAD, no data are currently available concerning the relationship between lipid and lipoprotein ratios and the severity of new on-set CAD in diabetics. Therefore, the aim of the present study was to investigate the usefulness of lipid and lipoprotein ratios in predicting the severity of CAD in patients with type 2 DM （T2DM）. Methods A total of 380 consecutive T2DM patients with new on-set CAD were enrolled in the present study. Then, they were classified into the three groups ac-cording to Gensini score （GS） tertiles. The relationship between lipid and lipoprotein ratios currently used and the GS was investigated. Results Positive correlations of natural log-transformed GS （lnGS） with apolipoprotein B to apoA-I ratio （apoB/apoA-I）, non-high-density lipoprotein cholesterol to apoA-I ratio （non-HDL-C/apoA-I）, and low-density lipoprotein cholesterol to apoA-I ratio （LDL-C/apoA-I） were found （r = 0.18, 0.13, 0.12, respectively, all P 〈 0.05）. Multivariate logistic analysis indicated apoB/apoA-I as the strongest predictor for high GS （OR = 5.67, 95% CI： 1.45-23.92, P = 0.003）. Area under receivers operating characteristic curve of apoB/apoA-I was 0.63 （95% CI： 0.60-0.66, P = 0.001） for predicting high GS. The optimal cutoff value of apoB/apoA-I to predict high GS was 0.72 with the sensitivity of 61.2% and the specificity of 62.1%. Conclusions Lipid and lipoprotein ratios might be useful for predicting the severity of new on-set CAD in T2DM patients, and the apoB/apoA-I appeared as the most significant predictor in this population.展开更多
The lipid profile remains an important laboratory assessment to prevent cardiovascular disease. Interpretation of the non-fasting lipid profile has significantly changed based on new information concerning the pathoge...The lipid profile remains an important laboratory assessment to prevent cardiovascular disease. Interpretation of the non-fasting lipid profile has significantly changed based on new information concerning the pathogenesis of atherosclerosis. In particular, the assessment of risk from cholesterol containing particles following triglyceride metabolism (termed remnant cholesterol) can now be done from a lipid profile. In addition, non-HDL cholesterol as calculated from the lipid profile will provide a complete assessment of total circulating cholesterol containing particles. Furthermore, the formula for measurement of LDL cholesterol from a lipid profile has now been revised so that triglyceride levels exert less interference. Finally, the old concept that the “higher the HDL-c, the better” is no longer tenable. New data indicate that the optimal high density lipoprotein level is below 100 mg/dl for both male and female patients. Correct interpretation of the lipid profile will optimize anti-atherosclerotic therapy and reduce the number one cause of death in the United States.展开更多
目的分析小而密低密度脂蛋白胆固醇(small and dense low density lipoprotein cholesterol,sdLDL-C)水平及低密度脂蛋白受体(low density lipoprotein receptor,LDLR)rs688基因多态性与脑血管病(cerebrovascular disease,CeVDs)的关系...目的分析小而密低密度脂蛋白胆固醇(small and dense low density lipoprotein cholesterol,sdLDL-C)水平及低密度脂蛋白受体(low density lipoprotein receptor,LDLR)rs688基因多态性与脑血管病(cerebrovascular disease,CeVDs)的关系。方法选取2021年6月至2023年2月就诊于福建医科大学附属泉州第一医院神经内科并确诊为CeVDs的183例患者作为实验组,并根据CeVDs类型分为缺血性脑卒中(ischemic stroke,IS)组(n=74)、短暂性脑缺血发作(transient ischemic attack,TIA)组(n=33)、蛛网膜下腔出血(subarachnoid hemorrhage,SAH)组(n=29)、出血性脑卒中(intracerebral hemorrhage stroke,ICH)组(n=47)4个亚组;另选取本院同期健康体检者51名作为对照组。所有研究对象均行血压(收缩压、舒张压)、生化指标[空腹血糖(fasting blood glucose,FBG)、总胆固醇(total cholesterol,TC)、甘油三酯(triglycerides,TG)]、血浆脂蛋白胆固醇组分[高密度脂蛋白胆固醇(highdensity lipoprotein cholesterol,HDL-C)、中间密度脂蛋白胆固醇(intermediate density lipoprotein cholesterol,IDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、sdLDL-C、大而轻低密度脂蛋白胆固醇(large and light low-density lipoprotein cholesterol,lbLDL-C)、极低密度脂蛋白胆固醇(very low density lipoprotein cholesterol,VLDL-C)]及LDLR rs688的基因多态性检测。比较实验组与对照组临床资料、生化指标、血浆脂蛋白组分,分析LDLR rs688基因多态性与CeVDs及sdLDL-C水平的关系。结果实验组及各亚组收缩压、舒张压均高于对照组,差异有统计学意义(P<0.05);实验组及各亚组与对照组FBG、TG、TC水平比较差异无统计学意义。实验组及各亚组sdLDL-C水平均高于对照组,差异有统计学意义(P<0.05);实验组及各亚组与对照组VLDL-C、IDL-C、HDL-C、LDL-C、lbLDL-C水平比较差异均无统计学意义。实验组及IS组、TIA组与对照组TC、CC、TT基因型频率和等位基因频率比较及ICH组与对照组等位基因频率比较差异有统计学意义(P<0.05);SAH组、ICH组与对照组TC、CC、TT基因型频率及SAH组与对照组等位基因频率比较差异均无统计学意义。对照组内TT、TC、CC基因型的sdLDL-C水平比较差异无统计学意义;IS、SAH、ICH组组内TT、TC、CC基因型sdLDL-C水平比较差异有统计学意义(P<0.05),其中IS组TT基因型的sdLDL-C水平高于TC、CC基因型,且TC基因型sdLDL-C水平高于CC基因型(P<0.05);TIA组TC基因型的sdLDL-C水平均高于CC基因型(P<0.05);SAH组TT基因型的sdLDL-C水平均低于TC基因型,TC基因型高于CC基因型(P<0.05),TT与CC基因型sdLDL-C水平比较差异无统计学意义;ICH组TT、TC基因型的sdLDLC水平均高于CC基因型,差异有统计学意义(P<0.05),TT与TC基因型sdLDL-C水平比较差异无统计学意义。多因素Logistic回归分析结果显示,收缩压和sdLDL-C高水平是CeVDs发生的独立危险因素(OR>1,P<0.05)。结论LDLR rs688基因多态性与IS、SAH和ICH型CeVDs发病有关,sdLDL-C是CeVDs的独立危险因素,可作为早期预测CeVDs发生的生物标志物。展开更多
Life expectancy in patients with rheumatoid arthritis(RA)is reduced compared to the general population owing to an increase in cardiovascular diseases(CVD)not fully explained by traditional cardiovascular risk factors...Life expectancy in patients with rheumatoid arthritis(RA)is reduced compared to the general population owing to an increase in cardiovascular diseases(CVD)not fully explained by traditional cardiovascular risk factors.In recent years,interest has been focused on the alterations in lipid metabolism in relation to chronic inflammation as one of the possible mechanisms involvedin the pathogenesis of atherosclerosis of RA patients.Research regarding this issue has revealed quantitative alterations in lipoproteins during the acute-phase reaction,and has also demonstrated structural alterations in these lipoproteins which affect their functional abilities.Although many alterations in lipid metabolism have been described in this regard,these structural changes associated with inflammation are particularly important in high-density lipoproteins as they affect their cardioprotective functions.In this respect,excessive oxidation in low-density lipoprotein(LDL)and increased lipoprotein(a)with a predominance of smaller apolipoprotein(a)isoforms has also been reported.This article will discuss proinflammatory high-density lipoproteins(pi HDL),oxidized LDL and lipoprotein(a).Elevated concentrations of these lipoproteins with marked pro-atherogenic properties have been observed in RA patients,which could help to explain the increased cardiovascular risk of these patients.展开更多
Objective:The study was conducted to evaluate the effect of liver diseases on serum Lp(a) levels and also to study the relationship between Lp(a) levels with other lipid parameters and liver function tests in 32 hyper...Objective:The study was conducted to evaluate the effect of liver diseases on serum Lp(a) levels and also to study the relationship between Lp(a) levels with other lipid parameters and liver function tests in 32 hyperbilirubinemia patients with total bilirubin】3mg/dL.The results were compared with 20 healthy age matched individuals. Methods:Serum obtained from venous blood sample are used for estimating total cholesterol(TC), triglyceride(TG),high density lipoprotein cholesterol(HDL-c),low density lipoprotein cholesterol(LDL-c ), very low density lipoprotein cholesterol(VLDL-c),total protein(TP),albumin(ALB),total bilirubin,direct bilirubin,aspartate amino tranferase(AST),alanine amino transferase(ALT),alkaline phosphatase(ALP), gamma glutamyl transferase(GGT),lipoprotein(a)[Lp(a)],serum phospholipids.Results:There was significant decrease in serum Lp(a) levels in liver disease patients and the decrease was direcdy correlated with reduced serum albumin levels and inversely with liver function parameters.Conclusion:Thus the present study indicates hepatic synthetic damage has possible biochemical basis for the reduction of serum Lp(a)展开更多
基金This work was partly supported by National Natural Scientific Foundation （81070171, 81241121）, Specialized Research Fund for the Doctoral Program of Higher Education of China （20111106110013）, Capital Special Foundation of Clinical Application Research （Z 121107001012015）, Capital Health Development Fund （2011400302）, and Beijing Natural Science Foundation （7131014） awarded to Dr. Jian-Jun LI.
文摘Background Diabetes mellitus （DM） is associated with coronary artery disease （CAD） progression. Although previous studies have demonstrated the association of lipid and lipoprotein ratios with CAD, no data are currently available concerning the relationship between lipid and lipoprotein ratios and the severity of new on-set CAD in diabetics. Therefore, the aim of the present study was to investigate the usefulness of lipid and lipoprotein ratios in predicting the severity of CAD in patients with type 2 DM （T2DM）. Methods A total of 380 consecutive T2DM patients with new on-set CAD were enrolled in the present study. Then, they were classified into the three groups ac-cording to Gensini score （GS） tertiles. The relationship between lipid and lipoprotein ratios currently used and the GS was investigated. Results Positive correlations of natural log-transformed GS （lnGS） with apolipoprotein B to apoA-I ratio （apoB/apoA-I）, non-high-density lipoprotein cholesterol to apoA-I ratio （non-HDL-C/apoA-I）, and low-density lipoprotein cholesterol to apoA-I ratio （LDL-C/apoA-I） were found （r = 0.18, 0.13, 0.12, respectively, all P 〈 0.05）. Multivariate logistic analysis indicated apoB/apoA-I as the strongest predictor for high GS （OR = 5.67, 95% CI： 1.45-23.92, P = 0.003）. Area under receivers operating characteristic curve of apoB/apoA-I was 0.63 （95% CI： 0.60-0.66, P = 0.001） for predicting high GS. The optimal cutoff value of apoB/apoA-I to predict high GS was 0.72 with the sensitivity of 61.2% and the specificity of 62.1%. Conclusions Lipid and lipoprotein ratios might be useful for predicting the severity of new on-set CAD in T2DM patients, and the apoB/apoA-I appeared as the most significant predictor in this population.
文摘The lipid profile remains an important laboratory assessment to prevent cardiovascular disease. Interpretation of the non-fasting lipid profile has significantly changed based on new information concerning the pathogenesis of atherosclerosis. In particular, the assessment of risk from cholesterol containing particles following triglyceride metabolism (termed remnant cholesterol) can now be done from a lipid profile. In addition, non-HDL cholesterol as calculated from the lipid profile will provide a complete assessment of total circulating cholesterol containing particles. Furthermore, the formula for measurement of LDL cholesterol from a lipid profile has now been revised so that triglyceride levels exert less interference. Finally, the old concept that the “higher the HDL-c, the better” is no longer tenable. New data indicate that the optimal high density lipoprotein level is below 100 mg/dl for both male and female patients. Correct interpretation of the lipid profile will optimize anti-atherosclerotic therapy and reduce the number one cause of death in the United States.
文摘Life expectancy in patients with rheumatoid arthritis(RA)is reduced compared to the general population owing to an increase in cardiovascular diseases(CVD)not fully explained by traditional cardiovascular risk factors.In recent years,interest has been focused on the alterations in lipid metabolism in relation to chronic inflammation as one of the possible mechanisms involvedin the pathogenesis of atherosclerosis of RA patients.Research regarding this issue has revealed quantitative alterations in lipoproteins during the acute-phase reaction,and has also demonstrated structural alterations in these lipoproteins which affect their functional abilities.Although many alterations in lipid metabolism have been described in this regard,these structural changes associated with inflammation are particularly important in high-density lipoproteins as they affect their cardioprotective functions.In this respect,excessive oxidation in low-density lipoprotein(LDL)and increased lipoprotein(a)with a predominance of smaller apolipoprotein(a)isoforms has also been reported.This article will discuss proinflammatory high-density lipoproteins(pi HDL),oxidized LDL and lipoprotein(a).Elevated concentrations of these lipoproteins with marked pro-atherogenic properties have been observed in RA patients,which could help to explain the increased cardiovascular risk of these patients.
文摘Objective:The study was conducted to evaluate the effect of liver diseases on serum Lp(a) levels and also to study the relationship between Lp(a) levels with other lipid parameters and liver function tests in 32 hyperbilirubinemia patients with total bilirubin】3mg/dL.The results were compared with 20 healthy age matched individuals. Methods:Serum obtained from venous blood sample are used for estimating total cholesterol(TC), triglyceride(TG),high density lipoprotein cholesterol(HDL-c),low density lipoprotein cholesterol(LDL-c ), very low density lipoprotein cholesterol(VLDL-c),total protein(TP),albumin(ALB),total bilirubin,direct bilirubin,aspartate amino tranferase(AST),alanine amino transferase(ALT),alkaline phosphatase(ALP), gamma glutamyl transferase(GGT),lipoprotein(a)[Lp(a)],serum phospholipids.Results:There was significant decrease in serum Lp(a) levels in liver disease patients and the decrease was direcdy correlated with reduced serum albumin levels and inversely with liver function parameters.Conclusion:Thus the present study indicates hepatic synthetic damage has possible biochemical basis for the reduction of serum Lp(a)
