Correlation of Helicobacter pylori infection with high-density lipoprotein cholesterol levels and pulse wave conduction velocity

Background:Helicobacter pylori(HP)is associated with several gastrointestinal diseases,including peptic ulcer diseases and gastric cancer,and non-gastrointestinal diseases such as hypertension and Alzheimer's disease.However,the relationship between HP and lipid metabolism and atherosclerosis remains unclear.This study aims to investigate the association between H.pylori infection and high-density lipoprotein cholesterol levels and pulse wave conduction velocity.Methods:This is a report of a cross-sectional study that collected data from 2,827 participants.The data collected included results of life questionnaires,laboratory tests,13C-urea breath test(13C-UBT),and pulse wave conduction velocity test.Based on the results of the 13C-UBT test,the subjects were divided into two groups:the HP-uninfected group(HP−)and the HP-infected group(HP+).The study compared the differences in HDL-C levels and brachial-ankle pulse wave velocity(baPWV)between the two groups.One-way regression analysis was used to identify potential factors affecting HDL-C levels in the study population.Multiple regression equations were presented to analyze whether HP infection was an independent risk factor for abnormal HDL-C metabolism in the population.Results:Univariate analysis demonstrated that high-density lipoprotein cholesterol(HDL-C)levels were significantly lower in the HP+group compared to the HP−group,with a mean difference ofβ=−18.1 mg/dl(95%CI:−19.3 to−17.0,P<0.001).After adjusting for all variables,the HDL-C levels remained lower in the HP+group compared to the HP-group,with a mean difference ofβ=−17.4 mg/dl(95%CI:−18.2 to−16.7,P<0.001).These findings suggest that H.pylori infection is independently associated with abnormal HDL-C metabolism.Additionally,brachial-ankle pulse wave velocity(baPWV)was higher in the HP+group than in the HP−group on both sides.On the right side,the baPWV was 1,713.4±231.4 cm/s in the HP+group compared to 1,542.8±237.5 cm/s in the HP−group(t=−18.30,P<0.001).On the left side,the baPWV was 1,743.7±238.8 cm/s in the HP+group compared to 1,562.8±256.3 cm/s in the HP−group(t=−18.23,P<0.001).These results indicate a significant association between H.pylori infection and increased arterial stiffness,as measured by baPWV.Conclusion:Helicobacter pylori infection is associated with a decrease in high-density lipoprotein cholesterol levels and an increase in pulse wave conduction velocity.

Reduced serum high-density lipoprotein cholesterol levels and aberrantly expressed cholesterol metabolism genes in colorectal cancer

BACKGROUND Colorectal cancer(CRC)is a common malignant tumor of the gastrointestinal tract.Lipid metabolism,as an important part of material and energy circulation,is well known to play a crucial role in CRC.AIM To explore the relationship between serum lipids and CRC development and identify aberrantly expressed cholesterol metabolism genes in CRC.METHODS We retrospectively collected 843 patients who had confirmed CRC and received surgical resection from 2013 to 2015 at the Cancer Hospital of the Chinese Academy of Medical Sciences as our research subjects.The levels of serum total cholesterol(TC),triglycerides,low-density lipoprotein cholesterol(LDL-C),highdensity lipoprotein cholesterol(HDL-C),LDL-C/HDL-C and clinical features were collected and statistically analyzed by SPSS.Then,we used the data from Oncomine to screen the differentially expressed genes(DEGs)of the cholesterol metabolism pathway in CRC and used Gene Expression Profiling Interactive Analysis to confirm the candidate DEGs.PrognoScan was used to analyze the prognostic value of the DEGs,and Search Tool for the Retrieval of Interacting Genes was used to construct the protein-protein interaction network of DEGs.RESULTS The serum HDL-C level in CRC patients was significantly correlated with tumor size,and patients whose tumor size was more than 5 cm had a lower serum HDL-C level(1.18±0.41 mmol/L vs 1.25±0.35 mmol/L,P<0.01)than their counterparts.In addition,TC/HDL(4.19±1.33 vs 3.93±1.26,P<0.01)and LDL-C/HDL-C(2.83±1.10 vs 2.61±0.96,P<0.01)were higher in patients with larger tumors.The levels of HDL-C(P<0.05),TC/HDL-C(P<0.01)and LDL-C/HDL-C(P<0.05)varied in different stages of CRC patients,and the differences were significant.We screened 14 differentially expressed genes(DEGs)of the cholesterol metabolism pathway in CRC and confirmed that lipoprotein receptor-related protein 8(LRP8),PCSK9,low-density lipoprotein receptor(LDLR),MBTPS2 and FDXR are upregulated,while ABCA1 and OSBPL1A are downregulated in cancer tissue.Higher expression of LDLR(HR=3.12,95%CI:1.77-5.49,P<0.001),ABCA1(HR=1.66,95%CI:1.11-2.48,P=0.012)and OSBPL1A(HR=1.38,95%CI:1.01-1.89,P=0.041)all yielded significantly poorer DFS outcomes.Higher expression of FDXR(HR=0.7,95%CI:0.47-1.05,P=0.002)was correlated with longer DFS.LDLR,ABCA1,OSBPL1A and FDXR were involved in many important cellular function pathways.CONCLUSION Serum HDL-C levels are associated with tumor size and stage in CRC patients.LRP8,PCSK9,LDLR,MBTPS2 and FDXR are upregulated,while ABCA1 and OSBPL1A are downregulated in CRC.Among them,LDLR,ABCA1,OSBPL1A and FDXR were valuable prognostic factors of DFS and were involved in important cellular function pathways.

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.

Monocyte to high-density lipoprotein cholesterol ratio as a predictor of the activity of thyroid-associated ophthalmopathy

AIM:To evaluate the relationship between monocyte to high-density lipoprotein cholesterol ratio(MHR)and the disease activity of thyroid-associated ophthalmopathy(TAO).METHODS:A total of 87 patients were classified into two groups based on clinical activity score(CAS)scoring criteria:high CAS group(n=62,the CAS score was≥3);low CAS group(n=25,the CAS score was<3).In addition,a group of healthy people(n=114)were included to compared the MHR.Proptosis,MHR,average signal intensity ratio(SIR),average lacrimal gland(LG)-SIR,average extraocular muscles(EOM)area from 87 patients with TAO were calculated in magnetic resonance imaging(MRI),and compared between these two groups.Correlation testing was utilized to evaluate the association of parameters among the clinical variables.RESULTS:Patients in high CAS group had a higher proptosis(P=0.041)and MHR(P=0.048).Compared to the healthy group,the MHR in the TAO group was higher(P=0.001).Correlation testing declared that CAS score was strongly associated with proptosis and average SIR,and MHR was positively associated with CAS score,average SIR,and average LG-SIR.The area under the receiver operating characteristic curve(AUC)of MHR was 0.6755.CONCLUSION:MHR,a novel inflammatory biomarker,has a significant association with CAS score and MRI imaging(average SIR and LG-SIR)and it can be a new promising predictor during the active phase of TAO.

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.

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.

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.

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）

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.

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.

Apolipoprotein A1,the neglected relative of Apolipoprotein E and its potential role in Alzheimer’s disease

Lipoproteins are multi-molecule assemblies with the primary function of transportation and processing of lipophilic substances within aqueous bodily fluids(blood,cerebrospinal fluid).Nevertheless,they also exert other physiological functions such as immune regulation.In particular,neurons are both sensitive to uncontrolled responses of the immune system and highly dependent on a controlled and sufficient supply of lipids.For this reason,the role of certain lipoproteins and their protein-component(apolipoproteins,Apo’s)in neurological diseases is perceivable.ApoE,for example,is well-accepted as one of the major risk factors for sporadic Alzheimer’s disease with a protective allele variant(ε2)and a risk-causing allele variant(ε4).ApoA1,the major protein component of high-density lipoproteins,is responsible for transportation of excess cholesterol from peripheral tissues to the liver.The protein is synthesized in the liver and intestine but also can enter the brain via the choroid plexus and thereby might have an impact on brain lipid homeostasis.This review focuses on the role of ApoA1 in Alzheimer’s disease and discusses whether its role within this neurodegenerative disorder is specific or represents a general neuroprotective mechanism.

Coexistence of High Fibrinogen and Low High-density Lipoprotein Cholesterol Levels Predicts Recurrent Cerebral Venous Thrombosis

Background： Cerebral venous thrombosis （CVT） may lead to serious neurological disorders; however, little is known about the risk factors for recurrent CVT. Our aim was to determine the association between elevated fibrinogen and decreased high-density lipoprotein cholesterol （HDL-C） levels with recurrent CVT. Methods： This retrospective cohort study included participants if they had a first episode of objectively defined CVT and were admitted to Xuan Wu Hospital, Capital Medical University from August 2005 to September 2009. Demographic and clinical variables were collected, as well as laboratory parameters, inchiding plasma fibrinogen and HDL-C. Patients with CVT were tbllowed for recurrent symptomatic CVT. Follow-up was through the end of September 2010. Potential predictors of recurrence were analyzed using Cox survival analysis. Results： At tile end of the lbllow-up, 95 patients were eligible lbr the study. Twelve of 95 patients （12.6%） had recurred CVT. Tile median time of recurrence was 7 months （range： 1-39 months）. Eight of these 12 （66.7%） experienced rectirrence within the first 12 months alter their initial CVT. The recurrence rate of CVT was 2.76 per 100 patient-years. Multivariate Cox regression analysis demonstrated that the coexistence of high fibrinogen （〉4.00 g/L） and low HDL-C （〈1.08 mmol/L） levels at baseline was the only independent predictor for recurrent CVT （hazard ratio： 4.69; 95% confidence interval： 1.10-20,11; P 〈 0.05）. Of tile twelve patients with recurrent CVT in our study, 7 （58.3%） had high fibrinogen plus low HDL-C levels. All 7 of these patients took warfarin for 3-12 months, and 6 of 7 had rectirrent CVT after the discontinuation of anticoagulant treatment. Conclusions： Concomitant high fibrinogen and low HDL-C levels may be associated with recurrence of CVT. The ett＇ect of potential risk lhctors related to atherothrombosis on rectinent CVT should be closely monitored.

Predictive and Prognostic Value of High-density Lipoprotein Cholesterol in Young Male Patients with Acute Myocardial Infarction

Background： The level of high-density lipoprotein cholesterol （HDL-C） is an important risk indicator and used in risk factor counting and quantitative risk assessment; however, the effect of HDL-C in young male patients with acute myocardial infarction （AMI） is unclear. The aim of this study was to investigate the effect of HDL-C in young male patients. Methods： We recruited 267 consecutive young male patients （≤44 years） diagnosed with AMI. Other 247 participants free from coronary heart disease were enrolled as controls. HDL-C levels of AMI patients and controls were evaluated to analyze the predictive value on AMI. According to the cutoff point of 1.04 mmol/L HDL-C, patients of AMI were divided into two subgroups （normal HDL-C group and low HDL-C group） and were followed up for 2 years. Clinical end points included all major adverse coronary events （MACEs）： the main cause of death, nonfatal myocardial infarction, readmissions for acute coronary syndrome, arrhythmias, or revascularization. The prognostic value of HDL-C was evaluated using Cox regression according to MACE. Results： Patients of AMI had decreased proportion in normal HDL-C group compared to controls （47.2% vs. 57.9%; P = 0.017）. Logistic regression analysis showed that there was an inverse relationship between HDL-C and AMI in young males. In the low HDL-C subgroup of AMI patients （n = 141）, 34 （24.1%） patients experienced a MACE during the 2-year follow-up, compared with 15 （11.9%） patients in normal HDL-C subgroup （n = 126）. The Cox regression analysis showed that HDL-C was an independent predictor of a MACE during the follow-up period （hazard ratio = 0.354, P = 0.006）. Conclusion： HDL-C was an important parameter for predicting the risk and the clinical outcomes of AMI in young male patients.

Asialoglycoprotein receptor 1 gene expression in peripheral blood monocytes associates with serum total cholesterol and low-density lipoprotein cholesterol levels

To the Editor:Asialoglycoprotein receptor 1(ASGR1)is the major subunit of ASGR,it is predominantly expressed by liver parenchymal cells and relatively lower expression was found in peripheral blood monocytes.[1]A genetic study recently revealed that ASGR1 haploinsufficiency resulted from loss-of-function(LOF)variants was strongly associated with the pronounced reductions in serum total cholesterol(TC)and low-density lipoprotein cholesterol(LDL-C)levels,[2,3]suggesting that ASGR1 may play a key role in cholesterol metabolism.However,the function of ASGR1 remains largely unclear.This study was focused on the association of ASGR1 gene expression in monocytes and plasma cholesterol level.

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.

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.

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。

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。

单核细胞/高密度脂蛋白胆固醇比值与2型糖尿病肾脏疾病进展及预后的相关性研究

目的探讨单核细胞/高密度脂蛋白胆固醇比值(monocyte/high density lipoprotein cholesterol,MHR)与2型糖尿病肾脏疾病(diabetic kidney disease,DKD)进展及预后的关系。方法选取2017年1月1日至2022年12月31日在石河子大学第一附属医院肾病科确诊的269例2型DKD患者作为DKD组,同期在体检科选取269名健康体检者作为健康组,比较两组受试者MHR水平的差异。将269例DKD组患者按MHR中位数分为低水平MHR组和高水平MHR组,比较其一般资料和临床资料的差异,分析MHR水平与临床资料指标的相关性;比较两组患者终点事件的发生率,并比较不同预后DKD患者的基线肾功能及MHR水平;生存分析比较低水平MHR组和高水平MHR组患者肾脏累计生存率的差异;Cox回归分析探索DKD患者肾脏不良预后的独立危险因素;绘制受试者工作特征曲线(receiver operator characteristic curve,ROC),探索MHR对DKD不良预后的诊断效能。结果(1)与健康组相比,DKD组患者的MHR水平[0.4918(0.3788,0.6818)×10^(9)/mmol比0.2984(0.1867,0.4112)×10^(9)/mmol]更高(P<0.05);(2)高水平MHR组患者白细胞(white blood cell,WBC)[7.70(6.40,8.70)×10^(9)/L比6.50(5.40,8.00)×10^(9)/L]、中性粒细胞(neutrophil,Ne)[4.60(3.60,5.53)×10^(9)/L比3.99(3.18,5.19)×10^(9)/L]、单核细胞(monocyte,Mono)[0.69(0.60,0.70)×10^(9)/L比0.50(0.40,0.60)×10^(9)/L]、尿白蛋白肌酐比值(urinary albumin to creatinine ratio,UACR)[1214.59(373.48,3410.02)mg/g比1050.96(180.26,3341.06)mg/g]、24 h尿蛋白定量(24 hour urine protein,24 hUP)[3.21(1.42,5.51)g比2.66(0.58,4.56)g]、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)[2.72(2.06,3.40)mmol/L比2.23(1.63,2.80)mmol/L]、血肌酐(serum creatinine,Scr)[152.10(95.20,221.60)μmol/L比126.00(92.48,186.55)μmol/L]比低水平MHR组更高;高水平MHR组淋巴细胞(lymphocyte,Lym)[1.60(1.27,2.20)×10^(9)/L比1.82(1.30,2.40)×10^(9)/L]、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)[0.94(0.83,1.07)mmol/L比1.39(1.15,1.65)mmol/L]、估算肾小球滤过率(estimated glomerular filtration rate,eGFR)[39.69(25.19,65.10)mL·min^(-1)·(1.73 m^(2))^(-1)比47.12(28.86,73.60)mL·min^(-1)·(1.73 m^(2))^(-1)]比低水平MHR组更低,高水平MHR组肾脏累计生存时间[63(39,72)月比72(46,72)月]比低水平MHR组更短(P<0.05);(3)MHR与WBC、Ne、Mono、UACR、24 hUP、Scr、LDL-C呈正相关(P<0.05),与Lym、HDL-C、eGFR、肾脏累计生存时间呈负相关(P<0.05);(4)高水平MHR组患者终点事件发生率(52.59%)比低水平MHR组(38.06%)更高(P<0.05);(5)发生终点事件的DKD患者基线MHR[0.5492(0.4030,0.7235)×10^(9)/mmol比0.4255(0.3117,0.5134)×10^(9)/mmol]、UACR[2062.65(752.80,4234.80)mg/g比608.56(88.63,1912.44)mg/g]、24 hUP[3.79(2.54,5.53)g比1.58(0.39,4.85)g]、Scr[178.40(134.00,234.23)μmol/L比100.95(74.25,152.10)μmol/L]比未发生终点事件的DKD患者更高,eGFR[33.45(23.33,46.41)mL·min^(-1)·(1.73 m^(2))^(-1)比61.59(38.57,95.98)mL·min^(-1)·(1.73 m^(2))^(-1)]比未发生终点事件的DKD患者更低(P<0.05);(6)Cox回归分析结果提示MHR是DKD不良预后的独立危险因素;(7)ROC曲线结果显示MHR的曲线下面积为0.747,灵敏度为0.820,特异度为0.605。结论DKD患者的MHR水平较健康者高,MHR是DKD患者肾功能进展的独立危险因素,MHR对DKD患者不良预后有一定的诊断价值,但特异度不高。

单核细胞计数/高密度脂蛋白胆固醇及促甲状腺激素对绝经期女性急性冠脉综合征患者预测价值及与冠状动脉病变相关性研究

背景既往研究发现单核细胞计数、高密度脂蛋白胆固醇(HDL-C)、促甲状腺激素(TSH)与急性冠脉综合征(ACS)相关,然而单核细胞计数/高密度脂蛋白胆固醇(MHR)与ACS发病的相关性研究较少,绝经期女性MHR、TSH与ACS发病是否存在关联仍不明确。目的探讨MHR、TSH对绝经期女性ACS患者发病的预测价值,并研究上述指标与患者冠状动脉狭窄程度的相关性。方法选择2020—2021年在苏北人民医院心血管内科住院诊治并行冠状动脉造影的325例绝经期女性作为研究对象。通过电子病历系统收集患者一般资料,研究对象入院后采集静脉血检测单核细胞计数、总胆固醇(TC)、三酰甘油(TG)、HDL-C、低密度脂蛋白胆固醇(LDL-C)、TSH等。以双平面Simpson法测量左心室射血分数(LVEF),通过冠状动脉造影术观察冠状动脉病变情况。采用Gensini评分标准统一衡量冠状动脉病变情况。符合ACS诊断标准的患者为ACS组(n=184),非ACS者为对照组(n=141)。同时依据Gensini评分三分位数将ACS组进行分组:≤36.5分为低危亚组(n=59),36.6~66.5分为中危亚组(n=64),>66.5分为高危亚组(n=61)。采用单因素及多因素Logistic回归分析探究ACS的影响因素。绘制受试者工作特征(ROC)曲线评估TSH、MHR及联合检测对ACS的诊断价值并计算ROC曲线下面积(AUC)。采用Spearman秩相关分析探究TSH、MHR及联合检测指标与Gensini积分的相关性。结果ACS组与对照组患者基线资料结果示,ACS组BMI、吸烟比例、高血压、糖尿病、LDL-C、单核细胞计数、TSH、MHR高于对照组,LVEF、HDL-C低于对照组(P<0.05)。多因素Logistic回归分析结果示,吸烟、高血压、BMI≥24.0 kg/m^(2)、LDL-C≥3.30 mmol/L、TSH≥2.1m U/L、MHR≥0.25是绝经期女性发生ACS的危险因素,HDL-C≥1.2 mmol/L为保护因素(P<0.05)。ROC曲线结果显示,MHR、TSH及联合预测指标诊断绝经期女性ACS的AUC分别为0.777(95%CI=0.725~0.830,P<0.001)、0.747(95%CI=0.694~0.800,P<0.001)、0.810(95%CI=0.764~0.857,P<0.001)。中危亚组、高危亚组MHR、TSH均高于低危亚组,高危亚组MHR、TSH高于中危亚组(P<0.05)。Spearman秩相关分析结果示,ACS组患者MHR(r_(s)=0.497,P<0.01)、TSH(r_(s)=0.498,P<0.01)及联合预测指标与Gensini评分均呈正相关(r_(s)=0.600,P<0.001)。结论TSH及MHR升高是绝经期女性发生ACS的独立危险因素,两指标及联合对病情预测具有较高的灵敏度和特异度,并与患者冠状动脉病变程度相关,对绝经期女性ACS的早期识别及风险评估具有一定的临床应用价值。