Editorial on hemoglobin A1c, blood pressure, and lowdensity lipoprotein cholesterol goals in diabetics

The American Diabetes Association (ADA) 2013 guidelines state that a reasonable hemoglobin A1c goal for many nonpregnant adults with diabetes is less than 7.0% a hemoglobin A1c level of less than 6.5% may be considered in adults with short duration of diabetes, long life expectancy, and no significant cardiovascular disease if this can be achieved without significant hypoglycemia or other adverse effects of treatment. A hemoglobin A1c level less than 8.0% may be appropriate for patients with a history of severe hypoglycemia, limited life expectancy, advanced macrovascular and microvascular complications, extensive comorbidities, and long-standing diabetes in whom the hemoglobin A1c goal is difficult to attain despite multiple glucoselowering drugs including insulin. The ADA 2013 guidelines recommend that the systolic blood pressure in most diabetics with hypertension should be reduced to less than 140 mmHg. These guidelines also recommend use of an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in the treatment of hypertension in diabetics unless they are pregnant. Diabetics at high risk for cardiovascular events should have theirserum low-density lipoprotein (LDL) cholesterol lowered to less than 70 mg/dL with statins. Lower-risk diabetics should have their serum LDL cholesterol reduced to less than 100 mg/dL. Combination therapy of a statin with either a fibrate or niacin has not been shown to provide additional cardiovascular benefit above statin therapy alone and is not recommended. Hypertriglyceridemia should be treated with dietary and lifestyle changes. Severe hypertriglyceridemia should be treated with drug therapy to reduce the risk of acute pancreatitis.

Hepatitis C virus clearance and less liver damage in patients with high cholesterol, low-density lipoprotein cholesterol and APOE ε4 allele

BACKGROUND Cholesterol is related to improvements in the rate of sustained virological response and a robust immune response against the hepatitis C virus(HCV).APOE gene polymorphisms regulate cholesterol levels modifying the course of the HCV infection.The relationship between cholesterol,APOE alleles,and the outcome of HCV infection has not been evaluated in the admixed population of Mexico.AIM To investigate the role of APOE-ε2,-ε3,and-ε4 alleles and the metabolic profile in the outcome of HCV infection.METHODS A total of 299 treatment-na?ve HCV patients were included in this retrospective study.Patients were stratified in chronic hepatitis C(CHC)(n=206)and spontaneous clearance(SC)(n=93).A clinical record was registered.Biochemical tests were assessed by dry chemistry assay.APOE genotypes were determined using a Real-Time polymerase chain reaction assay.RESULTS Total cholesterol,low-density lipoprotein cholesterol(LDL-c),triglycerides,and hypercholesterolemia were higher in SC than CHC patients as well as the frequency of the APOEε4 allele(12.4%vs 7.3%).SC patients were overweight(54.8%).Theε4 allele was associated with SC(OR=0.55,95%CI:0.31-0.98,P=0.042)and mild fibrosis(F1-F2)in CHC patients(OR 0.091,95%CI 0.01-0.75,P=0.020).LDL-c≥101.5 mg/dL(OR=0.20,95%CI:0.10-0.41,P<0.001)and BMI≥26.6 kg/m2(OR=0.37,95%CI:0.18-0.76,P<0.001)were associated with SC status;while ALT≥50.5 IU/L was negatively associated(OR=5.67,95%CI:2.69-11.97,P<0.001).CONCLUSION In SC patients,the APOEε4 allele and LDL-c conferred a protective effect in the course of the HCV infection in the context of excess body weight.

Antitumoral activity of low density lipoprotein-aclacinomycin complex in mice bearing H_(22) tumor

INTRODUCTIONCancer cells,which proliferate rapidly need largeamounts of cholesterol for new membrane synthesis,and high LDL receptor (LDLR) activity.LDL hasbeen proposed as a useful discriminatory vehicle forthe delivery of cytotoxic drugs to tumor cells.LDL presents many advantages as drug

A Modified Chitosan Adsorbent for Selective Removal of Low Density Lipoprotein

A modified chitosan adsorbent was synthesized through a simple preparation procedure, and it demonstrated good adsorption performance for selective removal of low density lipoprotein in human plasma. Phase inversion technique was employed to form chitosan beads, to which epoxy groups were then introduced by reacting with ethyleneglycol diglycidylether, and tryptophan was subsequently coupled to the epoxy-activated beads.

Effects of Oxidized Low Density Lipoprotein onthe Expression and Function of ABCA1 in Macrophages

Summary:In the present study, we examined the regulation of the expression and function of ABCA1 by modified LDL (ox-LDL) in vitro. After incubation with apoA-I for 24 h, RAW264.7 cells effluxed 37.65 % cholesterol loaded by acetyl LDL (ac-LDL), and 9.78 % cholesterol in ox-LDL group. The level of ABCA1 mRNA increased about three times either when cells were incubated with 100 μg /mL ac-LDL or with 100 μg /mL ox-LDL. However, the level of ABCA1 protein rose by 1.57 times in ac-LDL group and 1.26 times in ox-LDL group. These results demonstrated that ox-LDL had different effect on the expression and function of ABCA1, ox-LDL might decrease the cholesterol efflux mediated by ABCA1 through other unknown mechanisms.

Inhibition of Oxidative Modification of Human Low Density Lipoprotein by Resveratrol

To further investigate whether resveratrol, a polyphenolic compound in red wine, affects the oxidation of human low density lipoprotein (LDL), LDL purified from normolipidemic subjects was subjected to Cu\+\{2+\}induced or azo compoundinitiated oxidative modification. The extent of LDL modification was assessed by measuring the formation of thiobarbituric acid reactive substances (TBARS) and the relative electrophoretic mobilities (REM) of LDL. Resveratrol (50 mol/L) reduced TBARS and REM of LDL during Cu\+\{2+\}induced oxidation by 70.5% and 42.3%, respectively (P<0.01), and prolonged the lag phase associated with the oxidative modification of LDL by copper ion or azo compound. These in vitro results suggest that resveratrol may afford LDL protection against oxidative modification, possibly by acting as a free radical scavenger.

Mussel-inspired approach towards heparin immobilized cellulose hydrogel for ive removal of low density lipoprotein from whole blood

Objective This work is designed to fabricate a new low density lipoprotein(LDL)absorbent through a mussel-inspired approach and to evaluate the blood compatibility and adsorption clearance,capacity and selectivity of this technique in vitro.Methods Heparin immobilized cellulose(HeTaCe)hydrogels were fabricated through a mussel-inspired approach.Fourier transform infrared spectroscopy,X-ray photoelectron spectroscopy,thermo gravimetric analysis were used to characterize the chemical compositions of the hydrogels.

Selective Removal of Low-Density Lipoproteins from Blood by Induced Precipitation with AAS in Vitro(Ⅰ)

1 INTRODUCTION It’s evident that high level of cholesterol in blood is associated with the formation and devel-opment of familial hypercholestrolemia(FH)and atherosclerosis(AS).In general,choles-terol in blood is mainly combined with low-density lipoproteins(LDL),very low-densitylipoproteins(VLDL)and high density lipoproteins(HDL).About 60%-80% cholesterolexists in LDL and VLDL.LDL and VLDL have been recognized as the principal

The rate of patients at high risk for cardiovascular disease with an optimal low-density cholesterol level: a multicenter study from Thailand

Background Hypercholesterolemia is a major risk factor for cardiovascular events in patients with established atherosclerotic disease (EAD) and in those with multiple risk factors (MRFs). This study aimed to investigate the rate of optimal low-density lipoprotein (LDL) cholesterol level in a multicenter registry of patients at high risk for cardiovascular events. Methods A multicenter registry of EAD and MRF patients was conducted. Demographic data,medical history,cardiovascular risk factors,anthropometric data,laboratory data,and medications were recorded and analyzed. We classified patients according to target LDL levels based on recommendation by the European Society of Cardiology (ESC) 2011 into Group 1 which is EAD and diabetes or chronic kidney disease (CKD)–target LDL below 70 mg/dL,and Group 2 which is MRF without diabetes or CKD–target LDL below 100 mg/dL. The rate of optimal LDL level in patients with Group 1 and Group 2 was analyzed and stratified according to the treatment pattern of lipid-lowering medications. Results A total of 3100 patients were included. Of those,51.7% were male. Average age was 65.8 ± 9.7 years. Average LDL level was 96.3 ± 32.6 mg/dL. A vast majority (92.7%) received statin and 9.3% received ezetimibe. Optimal LDL level was achieved in 20.3% of patients in Group 1 (LDL < 70 mg/dL),and in 46.6% in Group 2 (LDL < 100 mg/dL). The overall rate of optimal LDL control was 23% since 89.6% of study population belongs to Group 1. The rate of optimal LDL was not different between high and low potency statin. Factors that were associated with optimal LDL control were older age,the presence of coronary artery disease or peripheral artery disease. Conclusions The rates of optimal LDL level were unacceptably low in this study population. As such,a strategy to improve LDL control in high-risk population should be implemented.

Adsorption/Desorption of Low-density Lipoprotein on a Heparinized Surface of Gold Sensors

Heparin has been considered to be a potentially useful ligand for low-density lipoprotein（LDL） detection and analysis in a clinical context.In order to construct an affinity surface for preferential adsorption of LDL,heparin-modified gold surface（GS-Hep） was fabricated by a self-assembling method and hydrophobic-modified gold surfaces（GS-Hydro） was used as a control.The morphologies of the modified gold surfaces were investigated by atomic force microscopy（AFM） and the quantity of heparin bound to gold surface was assayed by the toluidine blue（TB） colorimetric method.Water contact angles were determined to investigate wettability on GS-Hep and GS-Hydro.Surface plasmon resonance（SPR） technique was used subsequently to detect the selective binding of LDL with heparin.And the investigation on the effect of pH on LDL adsorption suggests that lower pH lead to higher quantities of LDL adsorption on GS-Hep.Compared with GS-Hydro,GS-Hep is selective for LDL from both single and binary protein solutions.Moreover,adsorbed LDL on GS-Hep could be washed off by injecting elution solution,such as NaCl solution,for the purpose of the regeneration of GS-Hep for further LDL adsorption.

Relationship between the low density lipoprotein receptor gene polymorphism and serum lipid levels in the Guangxi Bai Ku Yao population

Objectives Bai Ku Yao(White-trousers Yaos)is a special branch of Yao minority in China.They are now living in both Lihu and Baxu villages,Nandan County, Guangxi,China.The population size is about 30,000.The special customs and culture of Bai Ku Yao,including their special clothing,intra-ethnic marriages and alcohol intake are still completely conserved to the present day.In previous epidemiologic studies,we found that the serum lipid levels and the prevalence of hyperlipidaemia were lower in Bai Ku Yao than in Han Chinese from the same region.This ethnic difference in serum lipid profiles is still not well known.We hypothesized that there may be significant differences in some genetic polymorphismsssociation of low density lipoprotein receptor (LDL-R) genepolymorphism and several environmental factors with serum lipid levels in the Guangxi Bai Ku Yao and Han populations.Methods A total of 1024 subjects of Bai Ku Yao and 792 participants of Han Chinese were stud- ied by a stratified randomized cluster sampling.Epidemiological survey was carried out using internationally standardized methods.Information on demographics,socioeconomic status, and lifestyle factors was collected with standardized questionnaires. The height,weight,waist circumference,blood pressure, and serum total cholesterol(TC),triglyceride(TG), high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),apolipoprotein(Apo) A1, and ApoB were measured.Body massindex(BMI,kg/m2) was calculated.Genotyping of the LDL-RAvaⅡwas performed by polymerse chain reaction and restriction fragment length polymorphism combined with gel electrophoresis,and then confirmed by direct sequencing.Results(l)The height,weight,serum TC,HDL-C,LDL-C,ApoAl levels and the ratio of ApoAl to ApoB were lower in Bai Ku Yao than in Han Chinese(P【0.01 for all),whereas the percentage of subjects who consumed alcohol or smoked cigarettes was higher in Bai Ku Yao than in Han Chinese(P【0.01 for each).(2) The frequency of A+ allele in Bai Ku Yao was 34.5%,and the frequencies of A-A-,A-A+ and A+A + genotypes were 42.6%,45.9%and 11.5%;respectively. The frequency of A+ allele in Han Chinese was 19.3%(P【0.001),and the frequencies of A-A-,A-A + and A+A+ genotypes were 64.9%,31.6%and 3.5%(P【0.001);respectively. The frequencies of A-A-,A-A+ and A+A+ genotypes in Bai Ku Yao were significant difference between males and females,between normal TC and high TC subgroup, and between normal LDL-C and high LDL-C subgroup (P【0.05 for all),whereas the frequencies of A- and A+ ? alleles in Han Chinese were significant difference between males and females(P【0.05).(3) Serum LDL-C levels in Bai Ku Yao were significant difference among the A-A-, A-A+ and A+A+ genotypes(P【0.05),the A+ carriers had higher serum LDL-C levels.Serum HDL-C levels in Han Chiese were significant difference among the A-A-,A-A + and A+A+ genotypes(P【0.01),the A+ carriers had higher serum HDL-C levels.(4) After adjusting other factors,the prevalence of LDL-C abnormality was still higher in Han Chiese than in Bai Ku Yao.The prevalence of TC abnormality in Han Chinese was almost twice high as in Bai Ku Yao. The age and diet were common risk factor for TC abnormality. No effect of AvaⅡgenotype or alcohol consumption on the TC abnormality was found,but the combination of geno-type and alcohol consumption can increase the prevalence of TC abnormality[Exp(B) =(1.154)].Age was negatively cor- related with TG level.Conclusions Serum TC and LDL-C levels were lower in Bai Ku Yao than in Han Chinese.There were significant differences in the AvaⅡallele and genotype frequencies between the he A+ carriers in Bai Ku Yao had higher serum LDL-C levels,whereas the A+ carriers in Han had higher serum HDL-C levels.Interactions between alcohol consumption or cigarette smoking and the LDL-R AvaⅡgenotype were also observed.The differences in the serum lipid profiles between the two ethnic groups might partly result from different genotypic frequency of LDL-R AvaⅡpolymorphism or differentgene-enviromental interactions.Bai Ku Yao and Han population,the frequency of A + allele was higher in Bai Ku Yao than in Han.T between the two ethnic groups.Therefore,the aim of the present study was to detect the

苍柴调中方辅助改善肝郁脾虚型肥胖2型糖尿病的疗效及对胰岛素抵抗、FFA、LDL-C水平的影响

目的:探讨苍柴调中方辅助改善肝郁脾虚型肥胖2型糖尿病(T2DM)的疗效,并分析其对胰岛素抵抗、游离脂肪酸(FFA)、低密度脂蛋白胆固醇(LDL-C)水平的影响。方法:选取2020年4月至2023年4月该院收治的肝郁脾虚型肥胖T2DM患者100例,根据随机数字表法分为两组,各50例。对照组患者使用二甲双胍治疗,观察组患者在对照组基础上联合苍柴调中方辅助治疗。观察两组患者的治疗效果,比较两组患者治疗前后中医症状积分、糖代谢指标[空腹血糖(FBG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]、血清FFA、LDL-C、肿瘤坏死因子α(TNF-α)水平的差异,并对不良反应发生率进行统计。结果:观察组患者的治疗总有效率高于对照组,不良反应发生率低于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组患者倦怠乏力、精神抑郁、脘腹闷胀及大便黏滞等中医症状积分均低于对照组,差异均有统计学意义(P<0.05)。与治疗前比较,两组患者治疗后的FBG、HOMA-IR、FINS水平均明显降低,其中观察组患者治疗后的FINS、FBG及HOMA-IR水平低于对照组,差异均有统计学意义(P<0.05)。观察组患者治疗后的血清LDL-C、FFA、TNF-α水平均低于对照组,差异均有统计学意义(P<0.05)。结论:苍柴调中方辅助治疗可明显提高肝郁脾虚型肥胖T2DM患者的治疗效果,改善胰岛素抵抗,下调血清FFA、LDL-C水平。

目标范围内时间和sdLDL-C水平与2型糖尿病患者发生冠心病的相关性分析

目的 分析葡萄糖目标范围内时间(TIR)和小而密低密度脂蛋白胆固醇(sd LDL-C)水平与2型糖尿病患者发生冠心病的相关性。方法 本研究为回顾性研究,收集2020年12月至2022年1月河北省邢台市人民医院2型糖尿病患者73例作为2型糖尿病组,收集同期2型糖尿病伴冠心病患者54例作为2型糖尿病伴冠心病组。比较2组患者临床资料、sdLDL-C、胆固醇(TC)、甘油三酯(TG)及TIR的差异。采用多因素Logistic回归分析2型糖尿病患者发生冠心病的危险因素。采用受试者工作特征(ROC)曲线评估TIR和sdLDL-C水平对2型糖尿病患者发生冠心病的预测价值。结果 与2型糖尿病患者相比,2型糖尿病伴冠心病组患者年龄、高血压患病率、TG、sdLDL-C明显升高(P <0.05),TIR明显降低(P <0.05)。多因素Logistic回归分析显示sdLDL-C是2型糖尿病患者发生冠心病的独立危险因素。ROC曲线分析显示,TIR和sdLDL-C对2型糖尿病患者发生冠心病的预测曲线下面积(AUC)分别为0.62(95%CI:0.52~0.72,P=0.021),0.649(95%CI:0.555~0.744,P=0.004),两者联合检测,AUC为0.681(95%CI:0.589~0.773,P=0.001)。结论 2型糖尿病伴冠心病患者TIR明显低于2型糖尿病患者,血清sdLDL-C水平明显高于2型糖尿病患者,sdLDL-C是2型糖尿病患者发生冠心病的独立危险因素,TIR联合sdLDL-C对2型糖尿病发生冠心病的预测能力更高。

急性脑梗死患者不同性质颈动脉粥样斑块及预后的sdLDL-C、Lp-PLA2水平观察

目的 观察急性脑梗死(ACI)患者的小而密低密度脂蛋白胆固醇(sdLDL-C)、脂蛋白相关磷脂酶A2(Lp-PLA2)水平,探讨其与颈动脉粥样斑块稳定性的关系,以期为早期识别和改善患者预后提供思路。方法 依据颈部血管超声检查粥样斑块性质结果,164例急性脑梗死患者(观察组)中无粥样斑块者49例、稳定粥样斑块者58例、不稳定粥样斑块者57例,以47例健康体检者为对照,比较2组的同型半胱氨酸(Hcy)、sdLDL-C、Lp-PLA2表达水平。统计患者入院时的美国国立卫生院卒中量表(NIHSS)得分,随访患者发病30 d的预后情况,并分析影响ACI预后的相关因素。结果 脑梗死患者的空腹血糖、甘油三酯、sdLDL-C/LDL-C、sdLDL-C/TC、Lp-PLA2水平均高于对照组,HDL-C水平低于对照组;有粥样斑块者的Hcy、sdLDL-C水平高于无粥样斑块者及对照组;不稳定粥样斑块者的TC、LDL-C水平高于无粥样斑块者及对照组,差异均有统计学意义(P<0.05)。预后不良组的不稳定粥样斑块发现率(45.78%)高于预后良好组(23.46%),入院时NIHSS评分及血糖、sdLDL-C、sdLDL-C/LDL-C、sdLDL-C/TC、Lp-PLA2水平均高于预后良好组,差异均有统计学意义(P<0.05)。结论 sdLDL-C、Lp-PLA2水平与急性脑梗死患者颈动脉粥样斑块的稳定性密切相关,对预后判断有积极意义。

银杏素调节TGF⁃β1/Smad通路对ox⁃LDL诱导血管内皮细胞损伤的影响

目的探讨银杏素调节转化生长因子⁃β1(TGF⁃β1)/Smad信号通路对ox⁃LDL诱导血管内皮细胞损伤的影响。方法将人脐静脉血管内皮细胞HUVEC分为对照组(未处理的HUVEC细胞)、模型组(50μg/mL ox⁃LDL处理的HUVEC细胞)、银杏素组(50μg/mL ox⁃LDL+12.5μmol/L银杏素处理HUVEC细胞)、SRI⁃011381组(50μg/mL ox⁃LDL+10μmol/L的TGF⁃β1/Smad激活剂SRI⁃011381处理HUVEC细胞)、银杏素+SRI⁃011381组(50μg/mL ox⁃LDL+12.5μmol/L银杏素+10μmol/L的SRI⁃011381共同处理HUVEC细胞)。ELISA试剂盒检测HUVEC细胞丙二醛(MDA)、谷胱甘肽(GSH)、超氧化物歧化酶(SOD)、IL⁃6、IL⁃1β、TNF⁃α水平;CCK⁃8法检测HUVEC细胞增殖;流式细胞术检测HUVEC细胞凋亡率;Western blot检测细胞上皮间质转化(EMT)、TGF⁃β1/Smad通路相关蛋白表达。结果与对照组相比,模型组IL⁃1β、IL⁃6、TNF⁃α、MDA水平、细胞凋亡率、TGF⁃β1、Smad3、神经型钙黏附蛋白(N⁃cadherin)、波形蛋白(Vimentin)蛋白水平显著增加(P<0.05),A值、GSH、SOD水平、上皮钙黏附素(E⁃cadherin)蛋白水平显著降低(P<0.05);与模型组相比,银杏素组IL⁃1β、IL⁃6、TNF⁃α、MDA水平、细胞凋亡率、TGF⁃β1、Smad3、N⁃cadherin、Vimentin蛋白水平显著下降(P<0.05),A值、GSH、SOD水平、E⁃cadherin蛋白水平显著升高(P<0.05),而SRI⁃011381组趋势相反,SRI⁃011381减弱了银杏素对ox⁃LDL诱导的HUVEC细胞损伤的抑制作用。结论银杏素可能通过下调TGF⁃β1/Smad信号通路对ox⁃LDL诱导的血管内皮细胞损伤起到改善作用。

DWI-ASPECTS评分联合血清Hcy、LDL-C、Lp-PLA2对急性脑梗死静脉溶栓患者预后不良的预测价值

目的分析弥散加权成像-阿尔伯塔卒中项目早期计算机断层扫描(DWI-ASPECTS)评分联合血清同型半胱氨酸(Hcy)、低密度脂蛋白胆固醇(LDL-C)、脂蛋白磷脂酶A2(Lp-PLA2)对急性脑梗死(ACI)静脉溶栓患者预后不良的预测价值。方法回顾性分析2021年3月至2023年9月山东大学齐鲁医院德州医院收治的102例ACI患者的临床资料,静脉溶栓3个月后以改良Rankin量表(mRS)评估患者预后,根据mRS评分将患者分为预后良好组(mRS评分≤2分)与预后不良组(mRS评分>2分)。比较两组基线资料及血清Hcy、LDL-C、Lp-PLA2水平及DWI-ASPECTS评分。绘制受试者工作特征(ROC)曲线分析DWI-ASPECTS评分联合血清Hcy、LDL-C、Lp-PLA2对ACI静脉溶栓患者预后不良的预测价值。结果预后不良组有35例患者,预后良好组有67例患者。预后不良组美国国立卫生研究院卒中量表(NIHSS)评分及Hcy、LDL-C、Lp-PLA2水平高于预后良好组,DWI-ASPECTS评分低于预后良好组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,DWI-ASPECTS评分联合Hcy、LDL-C、Lp-PLA2评估ACI静脉溶栓患者预后不良的曲线下面积(AUC)大于DWI-ASPECTS评分、Hcy、LDL-C、Lp-PLA2单独预测的AUC(Z=3.548、3.316、3.996、4.009,P<0.05)。结论DWI-ASPECTS评分及血清Hcy、LDL-C、Lp-PLA2均对ACI静脉溶栓患者预后不良具有一定的预测价值,且其联合检测可提高预测价值。

血脂康联合阿利西尤单抗对他汀类药物不耐受动脉粥样硬化性心血管疾病患者LDL-C达标率和其他血脂指标影响

目的探讨对他汀类药物不耐受动脉粥样硬化性心血管疾病患者应用血脂康联合阿利西尤单抗的价值。方法选取2022年6月—2023年9月收治的对他汀类药物不耐受的动脉粥样硬化性心血管疾病80例,根据治疗方法不同将其分为研究组和对照组2组各40例。研究组给予血脂康联合阿利西尤单抗治疗,对照组给予阿利西尤单抗治疗。比较2组治疗前和治疗4、8、12周后低密度脂蛋白胆固醇(LDL-C)、其他血脂指标[总胆固醇、高密度脂蛋白胆固醇(HDL-C)和三酰甘油],治疗4周后LDL-C达标率和降低>50%达标率,以及治疗期间不良反应发生情况。结果与治疗前比较,治疗4、8和12周后2组LDL-C均降低,且治疗4、8和12周后研究组LDL-C低于对照组(P<0.05)。与治疗前比较,治疗4、8和12周后2组总胆固醇和三酰甘油均降低,HDL-C升高(P<0.05)。治疗4、8和12周后,研究组总胆固醇较对照组降低(P<0.05)。治疗4周后,研究组LDL-C达标率和降低>50%达标率高于对照组(P<0.05)。治疗期间,2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论血脂康联合阿利西尤单抗应用于他汀类药物不耐受动脉粥样硬化性心血管疾病患者利于改善血脂水平,提高LDL-C达标率,且安全性较高。

LDL-C、HDL-C动态评估在急性脑梗死溶栓患者预后中的意义

目的:探讨动态评估低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及其比值在急性脑梗死(ACI)溶栓患者预后中的价值。方法:回顾性收集并分析2020年1月~2022年12月于太和县人民医院神经内科就诊并接受rt-PA静脉溶栓治疗的121例ACI患者临床资料,根据患者90 d后mRS评分状况分为预后不良组(n=33)和预后良好组(n=88),检测并比较两组患者溶栓内1 d、溶栓后1个月LDL-C、HDL-C水平差异,并运用受试者工作特征曲线(ROC)评估以上指标的预测价值。结果:预后不良组的NIHSS评分、梗死体积、发病至溶栓的时间、合并高血压比例均高于预后良好组(P<0.05),体质量指数(BMI)低于预后良好组(P<0.05);两组患者溶栓后1个月LDL-C、LDL-C/HDL-C比值较溶栓内1d均下降,HDL-C值上升(P<0.05);且预后良好组HDL-C上升幅度优于预后不良组(P<0.05);多因素Logistic回归分析结果显示,BMI低(OR=0.730,95%CI:0.552~0.966)、梗死体积大(OR=1.088,95%CI:1.014~1.167)、发病至溶栓的时间长(OR=1.012,95%CI:1.000~1.023)、合并高血压(OR=4.911,95%CI:1.599~15.083)、HDL-C差值小(OR=0.753,95%CI:0.571~0.992)是影响ACI患者预后不良的独立危险因素(P<0.05);HDL-C差值预测的AUC面积为0.718(P<0.05)。结论:动态评估HDL-C的水平变化对判断ACI患者静脉溶栓后不良预后具有重要的临床价值。

郑州地区表观健康人群sdLDL-C生物参考区间的建立与验证

目的 采用过氧化物酶法检测并建立郑州地区表观健康人群血清小而密低密度脂蛋白胆固醇(sdLDL-C)活性值参考区间,并进行验证。方法 选取2019年6月至2022年6月在该院特需中心体检健康的785例成年人为研究对象,并按照性别和年龄(18~<30岁、30~<40岁、40~<50岁、50~<60岁和≥60岁)进行分组。采用过氧化物酶法检测血清sdLDL-C活性值,采用Kolmogorov-Smirnov(K-S)法对各组数据进行正态性检验,采用双侧95%CI进行sdLDL-C活性值参考区间上下限的设定。另收集100例体检健康者血清样本进行参考区间验证,当比率值(R)≥90%,判断验证通过。结果 郑州地区表观健康人群sdLDL-C活性值呈正态分布,男性为(0.700±0.151)mmol/L,女性为(0.670±0.137)mmol/L,男女比较,差异有统计学意义(P<0.01)。女性各年龄组间血清sdLDL-C活性值比较,差异无统计学意义(P>0.05),男性各年龄组间血清sdLDL-C活性值比较,差异有统计学意义(P<0.05),进一步分析显示18~<30岁组、30~<40岁组和40~<50岁组间差异无统计学意义(P>0.05),50~<60岁组与≥60岁组间差异无统计学意义(P>0.05),因此将男性合并为18~<50岁组和≥50岁组。郑州地区表观健康人群血清sdLDL-C活性值参考区间为女性(18~80岁)0.400~0.938 mmol/L、男性(18~<50岁)0.440~1.004 mmol/L、男性(≥50岁)0.368~0.976 mmol/L。100例体检健康者的比率值为0.98,新建立的参考区间验证通过。结论 该研究初步建立和验证了郑州地区表观健康人群血清sdLDL-C活性值参考区间,为心血管疾病的发病风险评估以及诊断治疗提供参考依据。