Higher testosterone levels are associated with increased highdensity lipoprotein cholesterol in men with cardiovascular disease： results from the Massachusetts Male Aging Study

Aim： To study the relationship between circulating androgens （total testosterone [TT], free testosterone [IT] and dihydrotestosterone [DHT]） and high-density lipoprotein cholesterol （HDL-C） in men with and without cardiovascular disease （CVD）. Methods： Cross-sectional analyses included 1 661 baseline samples from the Massachusetts Male Aging Study （MMAS）, a population-based cohort of men ages 40-70 years. Serum hormones were measured by radioimmunoassay and HDL-C was determined following precipitation of the lower density lipoproteins. CVD was determined by self-report. Analyses were performed using multiple linear regression. Results： TT and HDL-C were positively correlated in the entire sample （r = 0.11, P = 0.0001）. After adjusting for confounders, we found this relationship was mostly limited to the 209 men with CVD. Among men with CVD, TT （P = 0.0004）, iT （P = 0.0172） and DHT （P = 0.0128） were all positively correlated with HDL-C, whereas in men without CVD only TT correlated with HDL-C （P = 0.0099）. Conclusion： Our results suggest that if androgens contribute to CVD in middle-aged men, the effect is not related to a suppressive effect of endogenous T on HDL-C. （Asian JAndrol 2008 Mar; 10： 193-200）

High-density Lipoprotein Cholesterol and In-hospital Mortality in Patients with Acute Aortic Dissection

The association between high-density lipoprotein cholesterol（HDL-C） and mortality in patients with acute aortic dissection（AAD） is unclear. From January 2007 to January 2014, a total of 928 consecutive AAD patients who were admitted within 48 h after the onset of symptoms were enrolled in the study. Patients were divided into two groups according to whether serum HDL-C level was below the normal lower limit or not. The Cox proportional hazard regression model was used to identify the predictive value of HDL-C for in-hospital mortality in patients with AAD. As compared with normal HDL-C group（n=585）, low HDL-C group（n=343） had lower levels of systolic blood pressure and hemoglobin and higher levels of leukocyte, alanine aminotransferase, blood glucose, blood urea nitrogen, creatinine and urea acid. Low HDL-C group had significantly higher in-hospital mortality than normal HDL-C group（21.6% vs. 12.6%, log-rank=10.869, P=0.001）. After adjustment for baseline variables including demographics and biologic data, the increased risk of in-hospital mortality in low HDL-C group was substantially attenuated and showed no significant difference（adjusted hazard ratio, 1.23; 95% confidence interval, 0.86–1.77; P=0.259）. Low HDL-C is strongly but not independently associated with in-hospital mortality in patients with AAD.

Research progress of monocyte/high density lipoprotein ratio in cardiovascular diseases

In recent years,monocyte to high density lipoprotein cholesterol ratio(MHR)has attracted wide attention as a new marker of inflammatory response.This indicator includes two aspects:inflammatory response and lipid accumulation,which are the two most basic characteristics of Atherosclerosis(AS).AS is closely related to the occurrence of Cardiovascular diseases(CVD).A large number of existing studies have confirmed that MHR is an inflammatory marker that can dynamically reflect the trend of inflammation,can reflect the chronic inflammatory response in blood vessels,and can evaluate the occurrence,development and prognosis of cardiovascular disease in a non-invasive manner.This article reviews recent studies on the role of monocytes and high-density lipoproteins in chronic inflammation of blood vessels,as well as the current status of research on MHR and cardiovascular disease in the light of recent literature.

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.

Relationship of Circulating High-Density Lipoprotein Cholesterol and Anemia

Circulating level of low HDLC （high-density lipoprotein cholesterol） represents a common critical risk factor for IHD （ischemic heart disease） and may further aggravate the condition in anemic subjects, as the presence of anemia itself is a threat to cardiovascular consequences. To investigate the relationship of circulating HDLC with anemia, first we determined the levels of total hemoglobin （Hb） in a total of 301 subjects （male, n = 158; female, n = 143） randomly, and then examined the circulating levels of HDLC in fasting condition. Age of the study subjects was 47.9 ~ 16.6 （mean ＋ SD） years. Both the male and female subjects were divided into three groups according to their levels of Hb. The relationship of circulating levels of HDLC with the levels of total Hb was statistically analyzed. In case of the male subjects, we found that the levels of HDLC differed significantly among the three groups with different levels of Hb （P = 0.0233） and decrease in the levels of HDLC correlated significantly with the gradual decrease of total Hb level （r = 0.2504; P = 0.0015）. In female subjects, we observed a similar trend of difference among the three groups （P = 0.0685）. However, decrease in the levels of HDLC correlated significantly with the gradual decrease of Hb level （r = 0,2199; P = 0.0083）. Altogether, this study demonstrates that decrease in the circulating HDLC is related to the gradual decrease of Hb level. This study also indicates that circulating level of HDLC may be influenced by the level of total Hb and reveals the cardiovascular risks in anemia as well.

A Possible Mechanism Linking Hyperglycemia and Reduced High-density Lipoprotein Cholesterol Levels in Diabetes

This study investigated the role of glucose in the biogenesis of high-density lipoprotein cholesterol(HDL-C).Mouse primary peritoneal macrophages were harvested and maintained in Dulbecco’s modified Eagle’s medium(DMEM) containing glucose of various concentrations.The cells were divided into 3 groups in terms of different glucose concentrations in the cultures:Control group(5.6 mmol/L glucose),high glucose concentration groups(16.7 mmol/L and 30 mmol/L glucose).ATP-binding cassette transporter A1(ABCA1) mRNA expression in the macrophages was detected by semi-quantitative RT-PCR 24,48 and 72 h after glucose treatment.The results showed that ABCA1 mRNA expression in the 16.7 mmol/L glucose group was not significantly different from that in the control group at all testing time points(P>0.05 for each).In the 30 mmol/L glucose group,macrophage ABCA1 mRNA expression was not changed significantly at 24 h(P=0.14),but was substantially decreased by 40.4% at 48 h(P=0.009) and by 48.1% at 72 h(P=0.015) as compared with that in the control group.It was concluded that ABCA1 is of vital importance for HDL-C biogenesis.High glucose may hamper HDL-C biogenesis by decreasing ABCA1 expression,which contributes to low HDL-C level in diabetes.

High-density lipoprotein endocytosis in endothelial cells

AIM: To describe the way stations of high-density lipoprotein(HDL) uptake and its lipid exchange in endothelial cells in vitro and in vivo. METHODS: A combination of fluorescence microscopy using novel fluorescent cholesterol surrogates and electron microscopy was used to analyze HDL endocytosis in great detail in primary human endothelial cells. Further, HDL uptake was quantified using radio-labeled HDL particles. To validate the in vitro findings mice were injected with fluorescently labeled HDL and particle uptake in the liver was analyzed using fluorescencemicroscopy. RESULTS: HDL uptake occurred via clathrin-coated pits, tubular endosomes and multivesicular bodies in human umbilical vein endothelial cells. During uptake and resecretion, HDL-derived cholesterol was exchanged at a faster rate than cholesteryl oleate, resembling the HDL particle pathway seen in hepatic cells. In addition, lysosomes were not involved in this process and thus HDL degradation was not detectable. In vivo, we found HDL mainly localized in mouse hepatic endothelial cells. HDL was not detected in parenchymal liver cells, indicating that lipid transfer from HDL to hepatocytes occurs primarily via scavenger receptor, class B, type Ⅰ mediated selective uptake without concomitant HDL endocytosis. CONCLUSION: HDL endocytosis occurs via clathrincoated pits, tubular endosomes and multivesicular bodies in human endothelial cells. Mouse endothelial cells showed a similar HDL uptake pattern in vivo indicating that the endothelium is one major site of HDL endocytosis and transcytosis.

High Density Lipoprotein Phospholipids as a Marker of Coronary Heart Disease of Shen-Yang Deficiency Syndrome

Objective: To seek a new biochemical index for diagnosis of coronary heart disease (CHD) of shen-Yang deficiency syndrom (CHD-SYD). Methods: Sixty-one patients with CHD were divided into 3 groups according to their TCM Syndrome type, 10 patients in the group without Xin-Qi deficiency (Group A), 25 in the group with Xin-Qi deficiency but without Shen-Yang deficiency (Group B) and 26 in the group both with Xin-Qi deficiency and Shen-Yang deficiency (Group C). Levels of 17-hydroxy-corticoste-roid in urine (urinary 17-OHCS) per 24 hrs, and serum level of high density lipoprotein cholesterol (HDL-C) and high density lipoprotein phospholipid (HDL-PL) in them were determined in synchrostep and compared with those in the control group of 23 healthy aged persons, urinary 17-OHCS per 24 hrs was taken as the diagnostic standard to screen a new index for diagnosis of Shen-Yang deficiency Syndrome, and preliminary appraisal to the index was made. Results: Serum HDL-PL in the CHD-SYD patients( Group C) was 616+157 mg/L, which was obviously lower than that in the patients of Group A and B. With low HDL-PL(<650 mg/L) used as the index to diagnose CHD-SYD, the sensitivity was 73%, the specificity 86% and the accuracy 80%. Conclusion: HDL-PL <650 mg/L could be adopted as an index for CHD-SYD diagnosis, which is simple and practical.

An Analysis of Health Factors Affecting Employees’ Absenteeism: Influences of HDL Cholesterol and Blood Sugar Levels

Background: Workers’ health condition is an important issue. It affects not only the well-being of workers but also the firms and society as a whole through medical costs and productivity losses due to absenteeism and presenteeism. Data and Methods: Data were obtained from 1136 employees at an operational site of a large corporation. The dataset contained both medical checkups and working record information. Health factors affecting long-term absence (over three days in three months) were analyzed. Logistic regression models and the procedure for selecting proper covariates based on likelihood test statistics and the Akaike information criterion were used. Results: Among health factors, high-density lipoprotein cholesterol (HDL-C) and blood sugar levels were important in the selected model. For HDL-C, the odds ratio (OR) based on one standard deviation difference was 0.75 with a 95% confidence interval (CI) of 0.59 - 0.95. For blood sugar, the OR was 1.20 with a 95% CI of 1.01 - 1.42. Improving HDL-C and blood sugar levels would reduce long-term absence by 25% and 20%, respectively. Conclusion: Controlling HDL-C and blood sugar levels is important to reduce long-term absenteeism. These factors can be improved by modifying eating habits. Since the operational site has its own company cafeterias, which most employees use, nutritional intervention is relatively easy with little or no cost. It may be worthwhile to implement nutritional intervention, especially for patients with low HDL-C or high blood sugar levels. Limitations: The results of this study were based on one operational site of a corporation. The employees were mainly operators working inside the building. The results may be different from other types of jobs and working conditions, such as fieldwork. Analyses of different types of jobs and working conditions are necessary.

Impact of metabolic syndrome components on clinical outcomes in hypertriglyceridemia-induced acute pancreatitis

BACKGROUND The incidence of hypertriglyceridemia(HTG)-induced acute pancreatitis(AP)is steadily increasing in China,becoming the second leading cause of AP.Clinical complications and outcomes associated with HTG-AP are generally more severe than those seen in AP caused by other etiologies.HTG-AP is closely linked to metabolic dysfunction and frequently coexists with metabolic syndrome or its components.However,the impact of metabolic syndrome components on HTGAP clinical outcomes remains unclear.AIM To investigate the impact of metabolic syndrome component burden on clinical outcomes in HTG-AP.METHODS In this retrospective study of 255 patients diagnosed with HTG-AP at the First Affiliated Hospital of Guangxi Medical University,we collected data on patient demographics,clinical scores,complications,and clinical outcomes.Subsequently,we analyzed the influence of the presence and number of individual metabolic syndrome components,including obesity,hyperglycemia,hypertension,and low high-density lipoprotein cholesterol(HDL-C),on the aforementioned parameters in HTG-AP patients.RESULTS This study found that metabolic syndrome components were associated with an increased risk of various complications in HTG-AP,with low HDL-C being the most significant risk factor for clinical outcomes.The risk of complications increased with the number of metabolic syndrome components.Adjusted for age and sex,patients with highcomponent metabolic syndrome had significantly higher risks of renal failure[odds ratio(OR)=3.02,95%CI:1.12-8.11)],SAP(OR=5.05,95%CI:2.04-12.49),and intensive care unit admission(OR=6.41,95%CI:2.42-16.97)compared to those without metabolic syndrome.CONCLUSION The coexistence of multiple metabolic syndrome components can synergistically worsen the clinical course of HTGAP,making it crucial to monitor these components for effective disease management.

Triglycerides and ratio of triglycerides to high-density lipoprotein cholesterol are better than liver enzymes to identify insulin resistance in urban middle-aged and older non-obese Chinese without diabetes

Background Insulin resistance （IR） plays an important pathophysiological role in the development of diabetes,dyslipidemia,hypertension,and cardiovascular disease.Moreover,IR can occur even in non-obese people without diabetes.However,direct detection of IR is complicated.In order to find a simple surrogate marker of IR early in nonobese people,we investigate the association of commonly-used biochemical markers （liver enzymes and lipid profiles） with IR in urban middle-aged and older non-obese Chinese without diabetes.Methods This cross-sectional study included 1 987 subjects （1 473 women）.Fasting blood samples were collected for measurement of glucose,insulin,liver enzymes,lipid profiles and creatinine.Subjects whose homeostasis model of assessment-IR （HOMA-IR） index values exceeded the 75th percentile （2.67 for women and 2.48 for men） of the population were considered to have IR.The area under the receiver operating characteristic curve （ROC） was used to compare the power of potential markers in identifying IR.Results Triglycerides （TG） and ratio of TG to high-density lipoprotein cholesterol （TG/HDL-C） discriminated IR better than other indexes for both sexes; areas under the receiver operating characteristic （ROC） curves （AUC） values were 0.770 （95％ confidence interval 0.733-0.807） and 0.772 （0.736-0.809）,respectively,for women and 0.754 （0.664-0.844）and 0.756 （0.672-0.840）,respectively,for men.To identify IR,the optimal cut-offs for TG and TG/HDL-C ratio were 1.315 mmol/L （sensitivity 74.3％,specificity 71.0％） and 0.873 （sensitivity 70.1％,specificity 73.4％）,respectively,for women,and 1.275 mmol/L （sensitivity 66.7％,specificity 74.4％） and 0.812 （sensitivity 75.8％,specificity 69.2％）,respectively,for men.Conclusion TG and TG/HDL-C ratio could be used to identify IR in urban middle-aged and older non-obese Chinese without diabetes.

糖尿病视网膜病变患者血清circFTO和miR-141-3p表达情况及其与病变分期的关系

目的:探讨血清circFTO、miR-141-3p水平变化与糖尿病视网膜病变患者不同疾病分期的关系。方法:选取2019-10/2022-11本院收治的198例2型糖尿病患者为研究对象,根据不同分期将患者分为非糖尿病视网膜病变(NDR)组70例、非增殖期糖尿病视网膜病变(NPDR)组66例、增殖期糖尿病视网膜病变(PDR)组62例;同期选取67例本院体检正常的志愿者作为对照组。采用实时荧光定量PCR(qRT-PCR)法检测血清circFTO和miR-141-3p水平;采用Pearson相关性分析检验糖尿病视网膜病变患者血清circFTO、miR-141-3p与各指标间的相关性;采用多因素Logistic回归分析探讨糖尿病视网膜病变的影响因素。结果:PDR组circFTO、收缩压(SBP)、舒张压(DBP)高于对照组、NDR组、NPDR组,miR-141-3p、高密度脂蛋白胆固醇(HDL-C)低于对照组、NDR组、NPDR组(P<0.05)。NDR组、NPDR组、PDR组空腹血糖(FPG)、糖化血红蛋白(HbA1c)高于对照组(均P<0.05)。PDR组病程高于NDR组和NPDR组(P<0.05)。糖尿病视网膜病变患者血清circFTO与SBP、DBP、FPG、HbA1c呈正相关,miR-141-3p与SBP、DBP、FPG、HbA1c呈负相关(均P<0.05)。circFTO是影响糖尿病视网膜病变的危险因素,miR-141-3p是影响糖尿病视网膜病变的保护因素(P<0.05)。结论:糖尿病视网膜病变患者血清circFTO显著升高,miR-141-3p显著降低,二者均与疾病分期密切相关,有望成为评估疾病进展的重要指标。

基于PI3K/AKT/mTOR信号通路探讨小陷胸汤改善高脂血症小鼠肝脏脂质代谢的分子机制

目的:探讨小陷胸汤调节PI3K/AKT/mTOR信号通路改善高脂血症小鼠肝脏脂质代谢的分子机制。方法:60只SPF级ApoE-/-小鼠,随机分为模型组,小陷胸汤低、中、高剂量组和辛伐他汀阳性药组,各12只,12只野生型C57BL/6J小鼠作为空白组。除空白组外,其余组给予8周高脂饮食造模,然后分别按照低、中、高相应剂量给药小陷胸汤及辛伐他汀,空白组和模型组给予同等剂量蒸馏水,周期60 d。给药结束后检测小鼠血清血脂水平,HE和油红O染色观察小鼠肝脏病理变化,通过RT-qPCR检测肝脏PI3K/AKT/mTOR信号通路关键基因的mRNA水平。结果:HE染色中,模型组小鼠肝脏有明显的脂肪变性,并有炎性细胞浸润,给药组和辛伐他汀阳性药组泡性脂变明显减少;油红O染色显示,模型组相比空白组橘色脂滴面积增多,给药后,脂质沉积改善明显并呈剂量依赖性。与空白组相比,模型组小鼠血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平显著升高(P<0.05),高密度脂蛋白胆固醇(HDL-C)水平显著降低(P<0.05);给药后,小鼠血清中TC、TG、LDL-C水平显著降低(P<0.05),HDL-C水平显著升高(P<0.05)。模型组PI3K、AKT、mTOR的mRNA水平较空白组显著升高(P<0.05);给药后,PI3K、AKT、mTOR的mRNA水平显著降低(P<0.05)。结论:小陷胸汤可能通过调控PI3K/AKT/mTOR信号通路有效改善高脂血症小鼠血脂异常和肝脏脂质代谢。

Could Low Hdl-Cholesterol Levels Be an Unvalued Predictor of Cancer Risk?: A Retrospective Case Study

Background: The relationship between serum lipid profile levels and cancer risk remained uncertain. Recently, it had been reported a significant inverse association between high-density lipoprotein cholesterol (HDL) and the risk of incident cancer that was independent of low-density lipoprotein cholesterol (LDL), age or sex. Objective: The aim of our study was to evaluate the behavior of HDL in cancer patients and in healthy population. Methods: We created a retrospectively search strategy in the laboratory information system (LIS). We filtered and searched those patients with CEA within 5 - 20 ng/ml and any value of HDL and corroborated the presence of cancer (Group 1 (G1)) or not (Group 2 (G2)). Moreover, we searched a control group (patients in outpatient oncology clinic) to observe the values of HDL. Comparisons and statistical logistic regression models were applied to link the levels of this biomarkers and cancer risk. Results: We examined 852 valid patients, median age 62 (50 - 73) years. Within the search strategy group, G2 showed highest levels of HDL (54 (43 - 67) mg/dl) and lowest CEA levels (6.7 (5.7 - 8.4) ng/ml) comparing with G1: HDL (47 (37 - 60) mg/dl) and the CEA (7.9 (6.2 - 10.9) ng/ml);p p r2: 0.092;p p = 0.001)] and CEA [OR: 1.115 (1.060 - 1.174), (p < 0.001)] and they were confirmed as independent predictors of cancer. Conclusion: Our findings confirmed the inverse association of HDL levels between healthy populations and were diagnosed with cancer. Moreover, in a random population, patients with cancer presented lower HDL values compared to those without cancer. Therefore, it could demonstrate the possible positive predictive value of low HDL related to cancer risk.

老年女性髋部脆性骨折患者骨转换特征及其与血清高密度脂蛋白胆固醇的相关性

目的探讨骨转换与老年女性髋部脆性骨折(fragile hip fracture,HF)风险及与高密度脂蛋白胆固醇(HDLc)的相关性。方法选取2021年1月至2022年12月年龄≥60岁女性住院骨质疏松症患者共661例,分为无骨折组(A组)266例和HF组(B组)395例。检测总胆固醇(Tch)、甘油三酯(TG)、HDLc、低密度脂蛋白胆固醇(LDLc)、骨钙素N段中分子片段(N-MID OC)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)、总蛋白(TP)、白蛋白(Alb)、钙(Ca)、磷(P)、镁(Mg)、尿素(Urea)、肌酐(Cr)、胱抑素C(Cys-C)、肾小球滤过率(eGFR)、骨形成率(MoMF)、骨吸收率(MoMR)及骨转化率(MoT)。结果(1)HF组TP[118(108,128)vs 124(114,131)]、Alb[38.4±3.7 vs 40.0±4.3]、HDLc[1.51(1.24,1.71)vs 1.54(1.37,1.73)]、Ca[2.21±0.12 vs 2.29±0.12]、P[1.03±0.16 vs 1.08±0.17]含量较无骨折组降低,年龄[76(68,83)vs 73(67,78)]、β-CTX[0.57(0.40,0.77)vs 0.34(0.19,0.56)]、MoMR[1.84(1.30,2.51)vs 1.09(0.61,1.83)]及MoT[2.16(1.56,2.85)vs 1.56(1.09,2.38)]较无骨折组增加,差异有统计学意义(P<0.05)。N-MID OC、MoMF、Urea、Cr、Cys-C、eGFR、Tch、TG、LDLc及Mg差异无统计学意义(P>0.05)。(2)老年女性HF与HDLc、TP、ALB、Ca、P、Mg呈负相关(r=-0.09、-0.26、-0.16、-0.28、-0.12、-0.03,P<0.05),与年龄、β-CTX、MoMR、MoT呈正相关(r=0.17、0.36、0.36、0.26,P<0.05),与N-MID OC、MoMF、Urea、Cr、Cys-C、eGFR、Tch、TG、LDLc无相关性(P>0.05)。(3)年龄、MoT、TP、Ca、P为老年女性HF的风险因素,OR分别为1.03(95%CI:1.01~1.06)、1.75(95%CI:1.44~2.12)、0.96(95%CI:0.92~0.99)、0.06(95%CI:0.01~0.37)、0.18(95%CI:0.06~0.6),P<0.05。(4)HDLc与骨转化间存在“U”型关系,P<0.01,其切点为1.692 mmol/L。结论高骨转换是老年女性HF的危险因素,其骨转化率与HDLc存在U型相关。

THR、MHR和NHR对冠状动脉狭窄程度和行PCI的预测价值

目的 探讨总胆固醇与高密度脂蛋白胆固醇比值(THR)、单核细胞与高密度脂蛋白胆固醇比值(MHR)和中性粒细胞与高密度脂蛋白胆固醇比值(NHR)对患者冠状动脉狭窄程度和行经皮冠状动脉介入(PCI)治疗的预测价值。方法 回顾性选取2021年6月至2023年6月在新疆医科大学第一附属医院行冠状动脉造影的患者,严格纳入排除标准筛选,共纳入6 281例患者,分为PCI组和non-PCI组,收集所有患者的临床资料、实验室检查结果及介入治疗资料。采用Pearson相关性分析评估THR、MHR和NHR与冠状动脉狭窄程度之间的关联。使用二元Logistic逐步回归和受试者工作特征(ROC)曲线评估THR、MHR和NHR单一指标和联合指标对冠心病患者行PCI治疗的影响因素和预测价值。结果 与Non-PCI组比较,PCI组年龄偏大,男性占比、患糖尿病占比、THR、MHR、NHR、Gensini评分高于Non-PCI组,既往支架植入比例少于Non-PCI组(P<0.05)。Pearson相关分析结果显示,THR(r=0.351,P<0.001)、MHR(r=0.192,P<0.001)和NHR(r=0.236,P<0.001)水平与冠状动脉狭窄程度的Gensini评分均存在显著正相关关系。多因素Logistic回归结果显示,年龄>50岁、男性、患糖尿病、THR、MHR、NHR是冠心病患者行PCI独立危险因素,既往支架植入史是冠心病患者行PCI的保护因素。ROC曲线结果显示,THR、MHR和NHR三者联合曲线下面积(AUC)最大(AUC=0.809,95%CI:0.798~0.820)。结论 THR、MHR和NHR与冠状动脉狭窄程度具有相关性,对评估冠心病行PCI治疗有较强的临床应用价值。

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。

脊柱退变住院患者血清尿酸/高密度脂蛋白比值与骨密度的相关性

目的探索脊柱退变住院患者血清尿酸/高密度脂蛋白比值与骨密度的相关性。方法共纳入803例脊柱退变的受试者,评估临床因素及实验室检查结果,测量骨密度,按照骨密度结果分为骨质疏松症组及非骨质疏松症组。采用多元Logistic回归分析血清尿酸/高密度脂蛋白比值(uric acid to high-density lipoprotein cholesterol ratio,UHR)与骨质疏松症的相关性。结果与非骨质疏松症组相比,骨质疏松症组的UHR更低(244.93±.102.51 vs 199.97±.91.96,P<0.001),多元Logistics回归分析提示,在校正了骨质疏松症的传统危险因素后,UHR最高的四分位患者发生骨质疏松症的可能性是UHR最低的四分位患者的0.402倍(P=0.018)。骨质疏松症的患病率在UHR四分位呈下降的趋势,骨密度在UHR四分位呈升高的趋势。UHR在骨量正常、骨量减少及骨质疏松症3组呈下降的趋势。结论低UHR是昆山地区脊柱退变住院患者发生骨质疏松症的危险因素。对于UHR较低的脊柱退变患者,应注意筛查骨质疏松症。

急性病毒性肝炎患者凝血四项、血脂指标水平及其预后评估价值分析

目的分析急性病毒性肝炎(AVH)患者凝血四项、血脂指标水平及其评估预后的价值。方法选取2020年1月1日至2022年1月31日收治的300例AVH作为研究组,300例体检健康人员作为对照组。比较2组一般资料、凝血四项[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、血脂指标[总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)]。研究组均行常规抗病毒、护肝治疗,比较研究组不同治疗效果患者治疗前后凝血四项、血脂指标,并分析治疗前凝血四项、血脂指标与治疗效果的相关性及预测治疗效果的价值。结果研究组外周血PT、APTT、TT长于对照组,FIB、TC、HDL-C、LDL-C水平低于对照组,TG水平高于对照组(P<0.01)。研究组治疗效果为无效患者治疗前、治疗后外周血PT、APTT、TT长于有效、显效患者,有效患者长于显效患者(P<0.05);FIB、TC、HDL-C、LDL-C水平低于有效、显效患者,有效患者低于显效患者,TG水平高于有效、显效患者,有效患者高于显效患者(P<0.05);研究组治疗后外周血PT、APTT、TT、TG水平与治疗效果呈负相关,FIB、TC、HDL-C、LDL-C与治疗效果呈正相关(P<0.05,P<0.01);治疗前凝血四项与血脂指标联合预测AVH患者治疗效果的曲线下面积为0.937(95%CI为0.903,0.962),预测敏感度、特异度分别为85.21%、88.61%,明显优于凝血四项、血脂指标单独预测(P<0.01)。结论AVH患者凝血四项、血脂指标存在明显异常,且治疗前凝血四项与血脂指标联合检测在预测治疗效果方面具有较高价值。

MHR、NLR与急性缺血性脑卒中静脉溶栓患者预后的关系

目的探究单核细胞与高密度脂蛋白胆固醇比值(MHR)、中性粒细胞与淋巴细胞比值(NLR)与急性缺血性脑卒中静脉溶栓患者预后的关系。方法回顾性分析2021年1月—2022年12月蚌埠第一人民医院收治的110例急性缺血性脑卒中患者的病历资料。收集患者的基线资料,根据患者90 d时电话随访结果分为预后良好组和预后不佳组。采用多因素逐步Logistic回归模型分析影响患者预后的高危因素;绘制受试者工作特征(ROC)曲线评估MHR、NLR对急性缺血性脑卒中静脉溶栓患者预后的预测效能。结果110例急性缺血性脑卒中患者预后良好76例(69.09%),预后不佳34例(30.91%)。预后不佳组患者的白细胞计数、美国国立卫生研究院卒中量表(NIHSS)评分、中性粒细胞计数、单核细胞计数、MHR、NLR高于预后良好组(P<0.05),高密度脂蛋白胆固醇、淋巴细胞计数低于预后良好组(P<0.05)。多因素逐步Logistic回归分析结果显示,白细胞计数[O^R=4.125(95%CI:1.409,12.068)]、NIHSS评分[O^R=4.860(95%CI:1.662,14.218)]、高密度脂蛋白胆固醇[O^R=0.234(95%CI:0.080,0.685)]、中性粒细胞计数[O^R=3.991(95%CI:1.364,11.676)]、单核细胞计数[O^R=3.529(95%CI:1.206,10.325)]、淋巴细胞计数[O^R=0.248(95%CI:0.085,0.724)]、MHR[O^R=3.445(95%CI:1.178,10.079)]、NLR[O^R=4.043(95%CI:1.382,11.829)]均为急性缺血性脑卒中患者预后不佳的影响因素(P<0.05)。ROC曲线分析结果显示,MHR、NLR单一及联合预测急性缺血性脑卒中患者预后的敏感性分别为82.35%(95%CI:0.648,0.926)、79.41%(95%CI:0.616,0.907)、85.29%(95%CI:0.682,0.944);特异性分别为76.32%(95%CI:0.649,0.850)、73.92%(95%CI:0.641,0.835)、88.16%(95%CI:0.782,0.941);曲线下面积分别为0.790(95%CI:0.712,0.869)、0.801(95%CI:0.732,0.891)、0.875(95%CI:0.810,0.940)。结论MHR、NLR水平与急性缺血性脑卒中患者的预后密切相关,且可用于预测患者的短期预后。