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.

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.

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.

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.

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.

Lipoprotein in cholesterol transport: Highlights and recent insights into its structural basis and functional mechanism

Lipoproteins are protein-lipid macromolecular assemblies which are used to transport lipids in circulation and are key targets in cardiovascular disease （CVD）. The highly dynamic lipoprotein molecules are capable of adopting an array of conformations that is crucial to lipid transport along the cholesterol transport pathway, among which high-density lipopro- tein （HDL） and low-density lipoprotein （LDL） are major players in plasma cholesterol metabolism. For a more detailed illustration of cholesterol transport process, as well as the development of therapies to prevent CVD, here we review the functional mechanism and structural basis of lipoproteins in cholesterol transport, as well as their structural dynamics in the plasma lipoprotein （HDL and LDL） elevations, in order to obtain better quantitative understandings on structure-function relationship of lipoproteins. Finally, we also provide an approach for further research on the lipoprotein in cholesterol transport.

Regulation and deregulation of cholesterol homeostasis: The liver as a metabolic "power station"

Cholesterol plays several structural and metabolic roles that are vital for human biology. It spreads along the entire plasma membrane of the cell, modulating fluidity and concentrating in specialized sphingolipid-rich domains called rafts and caveolae. Cholesterol is also a substrate for steroid hormones. However, too much cholesterol can lead to pathological pictures such as atherosclerosis, which is a consequence of the accumu- lation of cholesterol into the cells of the artery wall. The liver is considered to be the metabolic power station of mammalians, where cholesterol homeostasis relies on an intricate network of cellular processes whose deregulations can lead to several life-threatening pathologies, such as familial and age-related hypercholesterolemia. Cholesterol homeostasis maintenance is carried out by: biosynthesis, via 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGR) activity; uptake, through low density lipoprotein receptors (LDLr); lipoprotein release in the blood; storage by esterification; and degradation and conversion into bile acids. Both HMGR and LDLr are transcribed as a function of cellular sterol amount by a family of transcription factors called sterol regulatory element binding proteins that are responsible for the maintenance of cholesterol homeostasis through an intricate mechanism of regulation. Cholesterol obtained by hepatic de novo synthesis can be esterified and incorporated into apolipoprotein B-100-containing very low density lipoproteins, which are then secreted into the bloodstream for transport to peripheral tissues. Moreover, dietary cholesterol is transferred from the intestine to the liver by high density lipoproteins (HDLs); all HDL particles are internalized in the liver, interacting with the hepatic scavenger receptor (SR-B1). Here we provide an updated overview of liver cholesterol metabolism regulation and deregulation and the causes of cholesterol metabolism-related diseases. Moreover, current pharmacological treatment and novel hypocho-lesterolemic strategies will also be introduced.

Differential impact of aging and gender on lipid and lipoprotein profiles in a cohort of healthy Chinese Singaporeans

Aim： To evaluate the impact of age and gender on lipid and lipoprotein profiles and the burden of dyslipidemia in a cohort of healthy Chinese Singaporean. Methods： A total of 1 775 healthy Chinese, 536 men and 1 239 women aged between 30 and 70 years old were involved in the present study. Results： Gender differences in all lipid and lipoprotein levels were clearly evident. Singaporean Chinese men have significantly higher levels of total cholesterol （TC）, triglyceride （TG）, low density lipoprotein-cholesterol （LDL-C） and total cholesterol/high density lipoprotein-cholesterol （TC/HDL-C）, and lower levels of HDL-C than women. Although lipid and lipoprotein levels in men did not change in the different age groups, those in women, especially TC, LDL-C and TC/HDL-C, were significantly higher in older women （〉 50 years old） than corresponding levels in younger women （30-46 years old）. Furthermore, TG was significantly correlated with lipids and lipoproteins differently in men and women. If 100 mg/dL of LDL-C were to be adopted as the therapeutic cut-off level, then the burden of care will be huge as approximately 90% of both Chinese men and women have LDL-C greater than 100 mg/dL. Condusion： In light of the findings of the present study, we suggest that preventive measures to promote the reduction in risk of coronary heart disease （CHD） must address the high proportion of men and women with high LDL-C, and that these measures should take into account both the gender and age factors. For men, reduction of high cholesterol must start early in life, whereas for women, steps must be taken earlier to mitigate the anticipated sharp increase in risk, especially after menopause.

Effect of Gengnianchun Recipe (更年春方) on Bone Mineral Density, Bone Biomechanical Parameters and Serum Lipid Level in Ovariectomized Rats

Objective： To observe the effect of Gengnianchun Recipe （更年春方, GNC） on bone mineral density （BMD）, bone biomechanical parameters and serum lipid level in the bilaterally ovariectomized （OVX） rats and to explore the prophylactic and therapeutic action of GNC on ovariectomy induced osteoporosis and hyperlipidemia. Methods： OVX SD rats, 10- 12 months old, were divided into different groups and fed with GNC 2 g/d, GNC 1 g/d and Nilestriol 0. 125 mg/week, respectively for 4 months to observe the change of BMD and bone biomechanical parameters of the lumbar vertebrae, and the serum levels of total cholesterol （TO）, triglyceride（TG）, high-density lipoprotein cholesterol （HDL-C） and low-density lipoprotein cholesterol （LDL-C）, and to compare the effect of the two drugs on the morphology of the uterus. Results： There was marked reduction in BMD and biomechanical parameters in lumbar vertebrae （ P〈0. 01 ） and increase of serum TO and LDL-C levels （ P〈0. 01 ） in rats after OVX. GNC or Nilestriol significantly improved the decreased BMD and biomechanical parameters of the lumbar vertebrae （ P〈0.05 or P〈0. 01 ）, and reduced the serum TO and LDL-C levels （ P〈0. 01 ）. In the Nilestriol group, the wet weight of uterus got increased obviously （ P〈0.01 ）, the number of uterine glands increased, uterine columnar epithelium thickened, and the mitotic figures in the epithelial stroma and myointimal cells augmented. But no such effect in wet weight and morphology of uterus was found in the GNC group. Conclusion： GNC could increase the BMD and biomechanical parameters of the lumbar vertebrae, reduce the serum TO and LDL-C levels, yet produce no adverse reaction in stimulating proliferation and hypertrophy of uterus.

Cholesterol metabolism in cholestatic liver disease and liver transplantation:From molecular mechanisms to clinical implications

The aim of this review is to enlighten the critical roles that the liver plays in cholesterol metabolism. Liver transplantation can serve as gene therapy or a source of gene transmission in certain conditions that affect cholesterol metabolism, such as low-density-lipoprotein(LDL) receptor gene mutations that are associated with familial hypercholesterolemia. On the other hand, cholestatic liver disease often alters cholesterol metabolism. Cholestasis can lead to formation of lipoprotein X(Lp-X), which is frequently mistaken for LDL on routine clinical tests. In contrast to LDL, Lp-X is non-atherogenic, and failure to differentiate between the two can interfere with cardiovascular risk assessment, potentially leading to prescription of futile lipid-lowering therapy. Statins do not effectively lower Lp-X levels, and cholestasis may lead to accumulation of toxic levels of statins. Moreover, severe cholestasis results in poor micellar formation, which reduces cholesterol absorption, potentially impairing the cholesterol-lowering effect of ezetimibe. Apolipoprotein B-100 measurement can help distinguish between atherogenic and non-atherogenic hypercholesterolemia. Furthermore, routine serum cholesterol measurements alone cannot reflect cholesterol absorption and synthesis. Measurements of serum non-cholesterol sterol biomarkers- such as cholesterol precursor sterols, plant sterols, and cholestanol- may help with the comprehensive assessment of cholesterol metabolism. An adequate cholesterol supply is essential for liver-regenerative capacity. Low preoperative and perioperative serum cholesterol levels seem to predict mortality in liver cirrhosis and after liver transplantation. Thus, accurate lipid profile evaluation is highly important in liver disease and after liver transplantation.

血清小而密低密度脂蛋白胆固醇和总抗氧化能力水平与脑梗死患者认知功能障碍的相关性分析

目的:探究脑梗死患者血清小而密低密度脂蛋白胆固醇(small dense low-density lipoprotein cholesterol, sdLDL-C)和总抗氧化能力(total antioxidant capacity, T-AOC)水平变化及其与认知功能障碍发生的关系。方法:选择148例脑梗死患者,依据发病后7 d是否出现认知功能障碍,分为非障碍组(n=77)和障碍组(n=71);分别采用过氧化氢酶法和比色法测定两组血清sdLDL-C和T-AOC水平,并进行比较;Pearson相关系数法分析脑梗死患者血清sdLDL-C、T-AOC水平与蒙特利尔认知评估(MoCA)评分相关性;二元Logistic回归分析影响脑梗死患者认知功能障碍发生的危险因素。结果:与非障碍组相比,障碍组血清sdLDL-C水平明显升高(P<0.05),T-AOC水平明显降低(P<0.05)。相关性分析显示,血清sdLDL-C水平与MoCA评分呈负相关(r=-0.516,P<0.05),T-AOC水平与MoCA评分呈正相关(r=0.446,P<0.05)。Logistic回归分析显示,高血压、糖尿病、病情严重程度、血清sdLDL-C和T-AOC是脑梗死患者认知功能障碍发生的独立影响因素(P<0.05)。结论:脑梗死患者血清sdLDL-C水平升高,T-AOC水平降低,二者是影响脑梗死患者并发认知功能障碍的独立影响因素。

常规体检指标对颈动脉硬化发生的预测价值

目的探讨常规体检指标如性别、年龄、血压、血脂、同型半胱氨酸等在颈动脉硬化发生的预测价值。方法采用回顾性研究方法。选取2016年1月至2021年12月连续6年在我院接受健康体检人群985例作为研究对象。收集受试者一般资料、体格检查指标、实验室检查指标、颈动脉超声结果等信息。受试者在随访中经颈动脉超声诊断为颈动脉内中膜厚度(cIMT)>1mm或有颈动脉斑块形成则被认为出现颈动脉粥样硬化进展并结束随访。受试者若未出现颈动脉粥样硬化进展,则直至2021年12月随访结束。将研究对象按随访过程中cIMT是否增加分为硬化组、进展组和对照组。分析颈动脉硬化发生的影响因素,并采用受试者操作特征曲线分析体检指标对颈动脉硬化的诊断效能。结果进展组在颈动脉硬化发病后TC、LDL-C、FBG、UA、Hcy和SBP均高于发生前,HDL-C低于发病前,差异有统计学意义(P<0.05);硬化组除HDL-C和Hcy指标差异没有统计学意义外,其他指标如男性比例、年龄、TC、TG、LDL-C、FBG、UA、SBP、DBP、BMI指标均高于对照组,差异有统计学意义(P<0.05);其中FBG、LDL-C和SBP为颈动脉硬化发生的独立风险因素(OR=5.505、4.222、1.071,P<0.05),以上指标联合诊断颈动脉硬化的曲线下面积高于各项单独检测,差异有统计学意义(P<0.01)。结论FBG、LDL-C和BMP与颈动脉硬化的发生密切相关,联合检测对颈动脉硬化有较好的诊断效能。

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。

老年高血压患者载脂蛋白A-Ⅰ与颈动脉粥样硬化的相关性分析

目的探讨老年高血压患者载脂蛋白A-Ⅰ与颈动脉粥样硬化的相关性,为老年高血压患者的危险因素进行早期干预提供参考依据。方法回顾性分析2022年4月至2023年4月于呼和浩特市第一医院门诊及住院治疗的老年高血压合并颈动脉粥样硬化患者的临床资料,将其作为观察组,另收集同期门诊及住院高血压患者的资料作为对照组。所有研究对象均进行血清载脂蛋白A-Ⅰ及颈血管彩超的检测。比较上述指标的变化情况,并分析老年高血压患者载脂蛋白A-Ⅰ与颈动脉粥样硬化的相关性。结果观察组研究对象载脂蛋白A-Ⅰ水平低于对照组,颈动脉血管彩超检查,观察颈内动脉、颈外动脉、颈总动脉的最大流速(V max)、最小流速(V min)、阻力指数RI、管径、内中膜厚度、斑块的大小、颈动脉狭窄差异均有统计学意义(P<0.05)。结论老年高血压患者载脂蛋白A-Ⅰ水平越低,颈动脉粥样硬化程度水平越高,且载脂蛋白A-Ⅰ与颈血管血流、颈动脉狭窄水平呈显著正相关。临床可应用载脂蛋白A-Ⅰ水平控制作为老年高血压合并颈动脉粥样硬化患者的早期干预指标,有助于延缓老年高血压患者颈动脉粥样硬化的发生,从而降低心脑血管病的发生率、致残率。

同型半胱氨酸、胱抑素C、高密度脂蛋白胆固醇与脑小血管病患者认知障碍的关系

目的 探讨同型半胱氨酸(Hcy)、胱抑素C(Cys C)、高密度脂蛋白胆固醇(HDL-C)与脑小血管病(CSVD)患者认知障碍的关系。方法 回顾性选取2021年8月至2023年6月浙江中医药大学附属温州市中医院收治的119例CSVD患者为研究对象,根据蒙特利尔认知评估量表(Mo CA)评分分为认知障碍组62例,认知正常组57例;比较两组患者临床资料。采用多因素logistic回归分析CSVD患者发生认知障碍的影响因素,采用ROC曲线分析HDL-C、Hcy、Cys C对CSVD患者发生认知障碍的预测效能,采用Pearson相关分析这些实验室指标与CSVD认知障碍患者Mo CA评分的相关性。结果 认知障碍组高血压、糖尿病比例以及Hcy、Cys C水平均高于认知正常组,HDL-C、白蛋白水平均低于认知正常组,差异均有统计学意义(均P<0.05)。高血压(OR=4.221)、糖尿病(OR=3.059)、HDL-C(OR=0.070)、Hcy(OR=1.176)、Cys C(OR=1.178)均是CSVD患者发生认知障碍的独立影响因素(均P<0.05)。HDL-C、Hcy、Cys C预测CSVD患者发生认知障碍的AUC分别为0.723、0.807、0.799。HDL-C与CSVD认知障碍患者Mo CA评分呈正相关(r=0.362,P=0.004),而Hcy、Cys C与Mo CA评分均呈负相关(r=-0.410、-0.394,均P<0.01)。结论 HDL-C、Hcy、Cys C与CSVD患者认知障碍的发生关系密切,可为认知障碍的诊断与防治提供参考。

基于两样本孟德尔随机化方法分析低密度脂蛋白胆固醇与哮喘的因果关系

目的以单核苷酸多态性(single nucleotide polymorphism,SNP)为工具变量,基于孟德尔随机化(Mendelian randomization,MR)法探究低密度脂蛋白胆固醇(LDL-C)与哮喘的因果关系。方法根据全基因组关联研究(GWAS)的基因数据,借助MR-base平台,获得2020年3月10日至2023年3月10日样本量最大的LDL-C及哮喘的GWAS数据,筛选出与LDL-C相关的SNP(筛选条件设定为P<5×10-8),通过逆方差加权分析法(IVW)、加权中位数法(WME)、加权模型、简单模型和MR-Egger法分析LDL-C与哮喘风险的关系,同时绘制SNP相关的LDL-C与哮喘风险的森林图及散点图。结果筛选出的301个SNP均与哮喘不存在基因多效性(MR-Egger回归截距0.007)。所有的回归结果均显示,LDL-C为哮喘的危险因素,MR-Egger回归OR=1.609(95%CI 1.228~2.107)、WME OR=1.448(95%CI 1.266~1.656)、IVW OR=1.499(95%CI 1.348~1.667)、加权模型OR=1.462(95%CI 1.212~1.763)、简单模型OR=1.374(95%CI 1.024~1.846)。MR-Egger回归结果显示统计量Q=1095.819(P<0.001),提示SNP间存在异质性,故选择随机效应IVW模型。结论LDL-C与哮喘之间存在因果关系,LDL-C水平越高,哮喘发病风险越大。

NLR、LLR、ENR对短暂症状性脑梗死的预测价值

目的评估中性粒细胞/淋巴细胞比值(NLR)、低密度脂蛋白胆固醇/淋巴细胞比值(LLR)及嗜酸性粒细胞/中性粒细胞比值(ENR)预测短暂症状性脑梗死(TSI)的价值。方法选取保定市第一中心医院神经内一、二科2022年6月1日至2023年5月31日住院的201例以短暂性脑缺血(TIA)症状就诊的患者作为研究对象,依据颅脑DWI检查有无脑梗死病灶分为TSI组和TIA发作组。比较分析组间的资料,用Spearman相关分析探究各指标与TSI的关系,通过绘制受试者工作特征(ROC)曲线评价各指标对TSI的预测效能。结果符合纳入标准的患者共201例,其中TSI46例,TIA 155例。单因素分析显示,TSI组的淋巴细胞数、嗜酸性粒细胞数及ENR明显比TIA组低,NLR及LLR明显比TIA组高(P<0.05)。Spearman相关分析显示,淋巴细胞数、嗜酸性粒细胞数及ENR是TSI的保护因素,NLR及LLR是TSI的危险因素(P<0.05)。NLR、LLR及ENR对TSI的预测效能优于淋巴细胞数及嗜酸性粒细胞数,曲线下面积(AUC)分别为0.665、0.665及0.622。结论NLR、LLR及ENR检测费用低、方法简便,可作为预测TSI的新标志。

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。

基于脂组学方法分析不同危险因素的脑卒中患者预后的研究

目的探讨基于脂组学方法分析不同危险因素的脑卒中患者预后的研究。方法回顾性分析九江市第一人民医院2021年2月至2023年2月收治的120例缺血性脑卒中(AIS)患者的临床资料治疗3个月后将其按预后情况分为良好组(n=82)和不良组(n=38)。分析患者年龄、性别、吸烟史、饮酒史、高血压、高脂血症、糖尿病、脑卒中家族遗传史、总胆固醇(TC)、三酰甘油(TG)、糖化血红蛋白(HbA1c)、低密度脂蛋白胆固醇(LDL-C)水平对AIS患者预后的影响。结果全部纳入研究的120例AIS患者中,有38例患者出现预后不良,发生率为31.67%;有82例预后良好,发生率为68.33%。单因素分析结果提示,两组性别、吸烟史、饮酒史、高血压、高脂血症、糖尿病、脑卒中家族遗传史比较,差异无统计学意义(P>0.05);两组患者年龄、TC、TG、HbA1c以及LDL-C比较,差异有统计学意义(P<0.05)。多因素分析结果提示,年龄(β=0.266,OR=1.304,95%CI=1.136~1.498)、HbA1c(β=0.838,OR=2.312,95%CI=1.269~4.212)、LDL-C(β=1.662,OR=5.269,95%CI=2.178~12.745)是AIS患者预后不良的危险因素(P<0.05)。结论年龄、HbA1c、LDL-C是AIS患者预后不良的危险因素。可根据上述因素进行针对性干预,以期减少AIS患者预后不良的发生率。