The New Molecular Entity Evolocumab, One Kind of PCSK9 Inhibitor, Reduce Plasma Small Size LDL-Cholesterol Levels by Using a New Standardized Method of Measuring LDL Size

Aims: There has been no evidence on the effects of evolocumab, protein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, on small size LDL. We observationally investigated the efficacy and side effects of evolocumab on the LDL subfraction particle diameter using PAGE system for lipoprotein analysis. Methods: We defined 30 patients with high-risk hyperlipidemia. As for analysis of LDL subfraction profile, we used polyacrylamide gel electrophoresis three methods: 1) 3% nondenatured poly-acrylamide gel electrophoresis method (3%PAGE), 2) 2% - 16% nondenatured poly-acrylamide gradient gel electro-phoresis method (2% - 16% GGE) and 3) 2.7% - 5% GGE. Evolocumab 140 mg/day administered together with statin significantly improved serum total cholesterol (TC), triglyceride (TG), high-dense lipoprotein-cholesterol (HDL-C), and LDL-C after four-week treatment. Results: TC, TG, HDL-C and LDL-C levels were improved by, respectively, 33%, 20%, 10%, and 54%. The mean LDL size significantly increased from 25.6 ± 0.4 nm to 26.4 ± 0.8 nm. The small dense LDL-cholesterol (sdLDL-C), large buoyant LDL-cholesterol (lbLDL-C), and mid-band lipoprotein-cholesterol were reduced, respectively. Therefore, the preliminary study on this paper can be the first step into a new insight on the world of lipid metabolism. Conclusion: Short-term administration of evolocumab addedons to statin therapy, significantly reduced small size LDL levels.

Relationship between Adiposity, Low-Density Lipoprotein Particles Size and Cardiovascular Risk among Adult Obese Cameroonians

Background: Despite the evidence about the increasing prevalence of dyslipidemia among adult obese Cameroonians, little is known about the Low-Density Lipoprotein (LDL) particles which influence lipid metabolism and affect cardiovascular status. The present study aims to assess the relationship between adiposity, LDL particles size and cardiovascular risk (CVR) among adult obese Cameroonians. Methods: A cross-sectional study was conducted from September 2015 to March 2016 on apparently healthy adults (n = 1006), aged 20 - 70 years and living in the West and North-West regions of Cameroon. Anthropometric measurements, blood pressure (BP), fasting blood glucose (FBG) and lipid profile markers were analyzed and LDL particle phenotypes (LDL phenotype A;LDL phenotype I;LDL phenotype B) were characterized using small, dense LDL-cholesterol (sdLDL-c) levels. Abdominal fat accumulation (AFA) was defined as waist circumference (WC) ≥ 88 cm (men) and ≥90 cm (women) and the CVR was assessed using Framingham score method. Results: In the overall population, 36.6% were overweight, 33.1% were obese and 69.1% were overweight/obese with AFA. The prevalence of LDL phenotype B was 19.8%, 37.5% and 42.8% respectively in normal-weight, overweight and obese. Among the obese, sdLDL and triglycerides levels correlated significantly with WC (r = 0.768;p Conclusion: Among obese Cameroonians, anthropometric markers of adiposity (BMI and WC) were strongly correlated to LDL phenotype B which was associated with high CVR dependently of AFA. SdLDL particles could exacerbate the CVR in obese Cameroonians subjects.

新诊断2型糖尿病血脂谱特点及低密度脂蛋白颗粒直径的影响因素分析

目的探讨新诊断2型糖尿病患者的血脂谱及低密度脂蛋白(low density lipoprotein,LDL)颗粒直径的特点,分析LDL颗粒直径的影响因素。方法对240例新诊断2型糖尿病患者和60例非糖尿病个体进行体重指数、腰臀比、血糖、血脂谱的比较,以多元逐步回归模型分析LDL颗粒直径的影响因素。结果新诊断糖尿病组血脂异常者171例,发生率为71.3%,新诊断糖尿病组与对照组比较,三酰甘油升高,HDL-c降低,LDL-c升高,LDL颗粒直径减小,差别均存在统计学意义(P<0.05),LDL颗粒直径与体重指数,HDL-c正相关,与舒张压,空腹血糖负相关(P<0.05)。结论新诊断2型糖尿病患者有较高的血脂异常发生率,其血脂异常的特点为高三酰甘油,低密度脂蛋白胆固醇升高,高密度脂蛋白胆固醇降低和LDL颗粒直径缩小,以小而密表型为主,LDL颗粒直径的缩小与舒张压、空腹血糖和HDL-c有关。

冠心病患者血浆小而密低密度脂蛋白的分布特征

目的观察冠心病患者血浆低密度脂蛋白(lowdensitylipoprotein,LDL)亚组分的分布特征。方法采用密度梯度超速离心法分离24例冠心病患者和13例对照组血浆中脂蛋白的各亚组分:大而轻LDL(LDL1),中间LDL(LDL2),小而密LDL(LDL3,)的含量。结果①冠心病组与对照组在年龄、性别、身高、体重、总胆固醇、甘油三酯、高密度脂蛋白胆固醇(highdensitylipoproteincholesterol,HDL-C)、载脂蛋白A(apolipoproteinA,ApoA)和载脂蛋白B(apolipoproteinB,ApoB)和LDL等指标差异均无统计学意义(P>0.05);②冠心病组的亚组分LDL1的含量少,LDL3的含量多;对照组则相反,亚组分LDL1的含量多,LDL3的含量小;而且两组差异有统计学意义。而介于两者之间的亚组分LDL2的含量两组几乎一样。结论LDL3与冠心病的发生、发展有关;LDL3测定仍可作为预测冠心病危险性的指标之一,也是观察疗效的指标之一。

过氧化低密度脂蛋白对家兔脑动脉硬化和脂蛋白分子颗粒的影响

为了阐明过氧化低密度脂蛋白（ＯＸ－ＬＤＬ）能否引起家兔体内脑动脉粥样硬化的形成，以及该物质对血浆脂蛋白ＬＤＬ（ＰｌａｓｍａＬｏｗＤｅｎｓｉｔｙＬｉｐｏｐｒｏｔｅｉｎ）脂质生化学和其分子超微结构的影响。分以下３组，即生理盐水对照组、正常ＬＤＬ（Ｎ－ＬＤＬ）组以及脂质过氧化ＬＤＬ（ＯＸ－ＬＤＬ）组，用一定量的上述液体分别注射各自的家兔耳静脉内，每日１次，共５周。发现Ｎ－ＬＤＬ组与对照组，血浆中ＬＰＯ和ＡｐｏＢ的含量以及血浆ＬＤＬ分子颗粒和脑动脉超微结构均未见明显变化，而ＯＸ－ＬＤＬ组不仅血浆中ＬＰＯ和ＡｐｏＢ含量经周逐渐增加，血浆ＬＤＬ分子颗粒也逐渐增大，脑动脉粥样硬化形成也很明显。说明ＯＸ－ＬＤＬ是引起体内脑动脉硬化形成的原因之一。

非对称场流分离技术在蛋黄浆质低密度脂蛋白粒径表征中的应用

通过自组装的非对称场流分离系统(AF4)与紫外可见光检测器联用分离表征了笼养鸡蛋、柴鸡蛋、鹌鹑蛋和鸭蛋蛋黄浆质中的低密度脂蛋白(LDL)。在近似蛋黄浆质生理条件下,研究了进样量、交叉流流速、膜的类型对AF4蛋黄浆质中LDL分离表征的影响;考察了该方法的精密度。在优化的AF4分析条件下,检测出了笼养鸡蛋、柴鸡蛋、鹌鹑蛋和鸭蛋蛋黄浆质中LDL的水力学粒径分布。LDL的AF4洗脱峰高和峰面积的日内精密度分别为1.3%和1.9%(n=7),日间精密度分别为2.4%和2.3%(n=7)。研究结果表明,该方法可用于分离禽类蛋黄浆质中的LDL,同时能够得到LDL水力学粒径分布。

影响急性脑梗死后非溶栓患者出血转化的相关因素

目的探究影响急性脑梗死后非溶栓患者出血转化的相关因素。方法选取攀枝花学院附属医院2013年12月-2015年12月收治的急性脑梗死后非溶栓患者120例。根据患者是否发生出血转化，分为出血转化组（n=41）和非出血转化组（n=79）。对两组的吸烟史、饮酒史、高脂血症、血压、空腹血糖、低密度脂蛋白胆固醇（LDL—C）、高密度脂蛋白胆固醇（HDL—C）等进行单因素和多因素分析。结果出血转化组有吸烟史、饮酒史、高脂血症及心房颤动者多于非出血转化组（x^2=47．71，24．04，16．38，27．27；P〈0．01）；与非出血转化组相比，出血转化组的LDL—C及空腹血糖水平较高（t=4．65、5．74，P〈0．01），脑梗死面积较大（x^2=35．60，P〈0．01）；多因素分析显示，心房颤动（OR=4．14，95％CI=2．06～8．31，P〈0．01）、空腹血糖（OR=2．92，95％CI=1．36—6．26，P〈0．01）、LDL—C（OR=4．81，95％CI=2．72～8．49，P〈0．01）及大面积梗死（鲫=3．00，95％CI=1．60～5．63，P〈0．01）为急性脑梗死后非溶栓患者出血转化的独立危险因素。结论心房颤动、空腹血糖水平、LDL—C及大面积脑梗死是急性脑梗死后非溶栓患者出血转化的独立危险因素。