【摘要】 目的 探讨成都市成华区中老年人群血脂水平、分布特点及其与胰岛素抵抗指数（HOMA-IR）的关系。 方法 2007年5月在此区中老年（50~79岁）人群中随机抽取672人进行心血管危险因素研究调查，对其血脂水平及HOMA-IR进行统计分析。 结果 人群当中①女性各血脂项目的水平均比男性高，其中总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）的差异有统计学意义（Plt;0.05）；②三酰甘油（TG）升高的比例较高，其中男性为30.0%，女性为27.6%；大部分人群HDL-C、低密度脂蛋白胆固醇（LDL-C）水平处于合适范围，HDL-C降低的比例为6.0%，LDL-C升高的比例为7.3%；③随着TG水平的升高、HDL-C 水平的降低，HOMA-IR呈升高趋势；LDL-C水平的升高，HOMA-IR呈升高趋势，仅在女性人群中差异有统计学意义（Plt;0.05），在男性人群中差异无统计学意义；④TG与HOMA-IR呈正相关，相关系数为0.185（P=0.000）；HDL-C与HOMA-IR呈负相关，相关系数为-0.145（P=0.000）。LDL-C与HOMA-IR呈正相关，相关系数为0.099（P=0.010）。 结论 TG增高是成都市成华区中老年人群的显著特点，女性HDL-C比男性高；血脂紊乱与胰岛素抵抗相关。【Abstract】 Objective To investigate the relationship between blood lipids level and homeostasis model assessment-insulin resistance (HOMA-IR) in elder people in Chengdu. Methods In May 2007, 672 people aged from 50 to 79 years in Chengdu were recruited by random sampling methods for the survey of cardiovascular risk factors. The blood lipids level and HOMA-IR were statistically analyzed. Results ① The serum total cholesterol (TC) and high density lipoprotein chole sterol (HDL-C) were obviously higher in women than those in men (Plt;0.05). ② Triacylglycerol (TG) increased in 30.0% of men and 27.6% of women; HDL-C and low density lipoprotein cholesterin (LDL-C) in most of the involved people were appropriate. ③ HOMA-IR increased as the TG level increased and HDL-C decreased; HOMA-IR increased as the LDL-C level increased, which was significant in the females (Plt;0.05). ④ HDL-C was positively correlated with HOMA-IR (r=-0.145, P=0.000); LDL-C was positively correlated with HOMA-IR (r=0.099, P=0.010). Conclusion The increase of hypertriglyceridemia was the most frequent type of the dislipidemia in the elder people in Chengdu; HDL-C level is higher in women than in men. Dyslipidemia is correlated with insulin resistance.
ObjectiveTo investigate the role of apelin, glycosylated hemoglobin (HbA1c), cholesterol (TC), triglyceride (TG), High density lipoprotein cholesterol (HDLC), low density lipoprotein cholesterol (LDLC) in the development and progress of diabetic retinopathy (DR). MethodsThe serum concentration of apelin, HbA1c, TC, TG, HDLC and LDLC were measured in 30 normal control subjects and 90 patients with type 2 diabetic mellitus, including 30 cases without DR (NDR), 30 with non-proliferative DR (NPDR), 30 with proliferative DR (PDR). These data were analyzed by SPSS for windows 13.0. ResultsThe serum concentration of apelin, HbA1c, TC, HDLC, LDLC were significantly higher in NDR, NPDR, PDR group than those in control group (F=403.06, 5.45, 4.27, 201.56, 4.90;P < 0.05). The serum concentration of TG has no significantly difference (F=2.19, P > 0.05). The serum concentration of apelin, HbA1c, TC, LDLC were significantly higher in NDR, NPDR, PDR group than those in control group (t=0.30, 0.58, 0.79;P < 0.05), the serum concentration of HDLC were significantly lower than those in control group(t=0.79, P < 0.01). There were significantly positive correlation between the progression of DR and the serum concentration of apelin, HbA1c, TC, LDLC(r=0.962, 0.562, 0.935;P < 0.05). There were significantly negative correlation between the progression of DR and the serum concentration of HDLC(r=-0.753, P < 0.01). There were correlation between apelin and HbA1c, LDLC and HDLC(r=0.956, 0.741, -0.691;P < 0.01). ConclusionOur data demonstrated that serum apelin levels increased significantly in patients with diabetic retinopathy, and are closely related to blood sugar, blood lipid metabolic abnormalities.
Objective This study aimed to explore the relationship between serum lipid and lipoprotein levels and occurrence of breast cancer, and relationship between serum lipid and lipoprotein levels and clinicopathological characteristics of breast cancer patients. Methods Clinical data of 788 patients with breast cancer and 395 patients with benign breast disease were retrospectively collected, who received treatment in The First Affiliated Hospital of Chongqing Medical University from January 2014 to March 2016, and to explore the relationship between levels of total cholesterol (TC)/triglyceride (TG)/high density lipoprotein cholesterol (HDL-c)/low density lipoprotein cholesterol (LDL-c) and occurrence of breast cancer/ clinicopathological characteristics of breast cancer patients. Results ① Influencing factors that affected the occurrence of breast cancer: multifactor logistic analysis showed that, height (OR=0.950, P=0.006), body mass index (OR=1.062, P=0.041), and serum LDL-c level (OR=1.349, P=0.016) were independent influencing factors for occurrence of breast cancer, people had high body mass index and higher level of serum LDL-c had high risk of breast cancer, but people had high height had low risk of breast cancer. ②Association analysis of serum lipid and lipoprotein levels and clinicopathological characteristics of breast cancer patients: the serum TC level was correlated with expression of progesteronereceptors (PR) and lymph node metastasis status (P<0.05), the serum TC levels of patients with negative-expression of PR and lymph node metastasis were slightly higher than that of patients with positive-expression of PR and non-lymph node metastasis; the serum TG level was associated with body mass index (P<0.05), that the serum TG level of patients with body mass index≥25 kg/m2was slightly higher than that of patients with body mass index<25 kg/m2; the serum HDL-c level was correlated with the body mass index and diameter of the tumor (P<0.05), the serum HDL-c level of the patients with body mass index≥25 kg/m2 was slightly lower than that of patients with body mass index<25 kg/m2, the serum HDL-c level of patients with the tumor diameter≤2 cm was slightly higher than that of patients with the tumor diameter >2 cm; the serum LDL-c level was correlated with body mass index, expression of estrogenreceptors (ER) and PR, and molecular typing ( P<0.05), the serum LDL-c level was slightly higher in patients with body mass index≥25 kg/m2, negative expression of ER and PR, and non Luminal type patients, comparing with patients with body mass index<25 kg/m2, positive expression of ER and PR, and Luminal type patients. Conclusions High level of serum LDL-c is strongly associated with occurrence of breast cancer, and levels of serum lipid and lipoprotein are associated with expression of hormone receptor, molecular type of breast cancer, and status of lymph node, but it needs further randomized controlled studies to confirm.
Objective To assess the efficacy and safety of Xuezhikang capsule (XZK) for hyperlipidemia. Methods MEDIINE，EMBASE, Cochrane Central Register of Controlled Trials(CCTR), Cochrane Metabolic and Endocrine Disorders Group data bank, and Chinese Biomedical Database(CBM), China Hospital Knowledge Database(CHKD) were searched，and the published/unpublished information was handsearched (updated to Dec., 2005) to identify randomized controlled trials (RCTs) or quasi-RCT of XZK versus statins or other lipid lowering drugs in treating hyperlipidemia patients. The quality evaluation, data extraction and analysis were conducted by the method recommended in Cochrane Reviewer’s Handbook 4.2.2. Data were analyzed using Review Manager (Version 4.2). Results Eleven trials (conducted in China) were identified, including 1 073 patients with hyperlipidemia met the inclusion criteria. All the included RCTs were graded as B or C. ① The effect of XZK in reducing TC: There were no significant differences between XZK and statins ( WMD 0.06, 95%CI-0.09 to 0.20 and RR1.02, 95%CI 0.93 to 1.12), XZK and fibrates (WMD 0.05, 95%CI -0.22 to 0.31) and XZK and probucol(WMD 0.42, 95%CI -0.01 to 0.85). XZK was superior to hexanicit (WMD 0.96, 95%CI 0.73 to 1.18). ② The effect of XZK in reducing TG: XZK had the same effect as statins (WMD 0.02, 95%CI -0.10 to 0.14 and RR 1.17, 95%CI 0.92 to 1.49) and hexanicit (WMD 0.28, 95%CI -0.17 to 0.73 ).Meanwhile, XZK was superior to probucol (WMD 0.71, 95%CI 0.22 to 1.20), but it was not as good as fibrates (WMD -0.81, 95%CI -1.40 to -0.23). ③ The effect of XZK in increasing HDL-C：XZK had the same effect as that of statins (WMD -0.03, 95%CI -0.10 to 0.04 and RR 1.03, 95% CI 0.80 to 1.33). The effect of XZK was better than that of hexanicit (WMD 0.15, 95%CI 0.01 to 0.29). XZK had the same effect of fibrates (WMD 0.03, 95%CI -0.08 to 0.15) and probucol (WMD 0.04, 95%CI -0.16 to 0.24). ④ The effect of XZK in reducing LDL-C：The effects of XZK and statins were the same (WMD -0.23, 95%CI -0.61 to 0.15 and RR 1.15, 95%CI 0.75 to 1.77). The effect of XZK was better than that of hexanicit (WMD 0.53, 95%CI 0.16 to 0.90). Meanwhile, XZK had the same effect as those of fibrates (WMD 0.19, 95%CI -0.12 to 0.50) and probucol (WMD 0.35, 95%CI -0.03 to 0.73). ⑤ The adverse reactions of XZK were mainly the gastrointestinal tract reaction, while liver function abnormality and myalgia were scarcely found. Conclusion Xuezhikang capsule have the same effects as those of statins in reducing the levels of TC, TG, LDL-C and raising HDL-C in patients with hyperlipidemia. No obvious adverse reactions are found during the short-term treatment. But further confirmation with clinical randomized controlled trials of high quality, large sample and long-term follow-up is needed.
Objective To analyze the prevalence and influencing factors of dyslipidemia among permanent residents in Longquanyi district of Chengdu for prevention and control of dyslipidemia. Methods Permanent residents in Longquanyi district were selected as research objects by convenient sampling method between November 2021 and February 2022. The dyslipidemia rate in the population was analyzed, and the influencing factors of dyslipidemia were analyzed by univariate and multivariate logistic regression. Results A total of 11 408 permanent residents were included. Among them, 3650 people had dyslipidemia, with a prevalence rate of 32.00% (3650/11408). The prevalence rates of high total cholesterol, high triglyceride, high low-density lipoprotein cholesterol, and low high-density lipoprotein cholesterol were 19.30% (2 202/11 408), 13.38% (1 526/11 408), 5.05% (576/11 408) and 0.73% (83/11 408), respectively. Multivariate logistic regression analysis showed that female, age≥30 years old, drinking, overweight / obesity, hypertension, diabetes and hyperuricemia were independent risk factors of dyslipidemia among permanent residents (P<0.05). Conclusions The prevalence of dyslipidemia in Longquanyi district is high, mainly with high total cholesterol and high triglyceride. Gender, age, drinking, body mass index, and the levels of blood pressure, blood glucose and blood uric acid are the factors affecting the incidence of dyslipidemia among permanent residents. Early intervention for high-risk groups with dyslipidemia should be adopted to effectively reduce the risk and burden of dyslipidemia.
目的 探讨川崎病（Kawasaki disease，KD）患儿血脂代谢与冠状动脉病变之间的关系。 方法 纳入2007年1月-2009年10月住院治疗的82例KD患儿，检测治疗前后血总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）、极低密度脂蛋白（VLDL-C）、载脂蛋白A1（ApoA1）及载脂蛋白B100（ApoB100）水平。选取50例健康儿童作为对照。KD患儿在治疗前行超声心动图检查，根据超声心动图显示将KD组再分为冠状动脉病变组（CAL组，n=31）和非冠状动脉病变组（NCAL，n=51）。 结果 治疗前，KD患儿TC、ApoA1、HDLC降低，TG、LDL-C升高，与正常儿童相比有统计学意义（Plt;0.05）。KD患儿CAL组较NCAL组变化更明显，有统计学意义（Plt;0.05）。VLDL-C和ApoB100水平KD患儿与正常儿童比较、NCAL组与CAL组比较变化均不明显（Pgt;0.05）。治疗后与治疗前相比，NCAL组TC、TG、HDL-C、LDL-C、ApoA1恢复正常（Plt;0.05）），而CAL组仅TC、LDL-C、ApoA1恢复正常（Plt;0.05）。 结论 KD患儿存在血脂代谢紊乱，TC、TG、HDL-C、LDL-C、ApoA1与冠状动脉的损害有关，应早期进行干预。
ObjectiveTo investigate the relationship between thyroid stimulating hormone (TSH) and the blood lipid level in patients with subclinical hypothyroidism (SCH). MethodsWe carried out a retrospective analysis on the clinical data of 264 patients with their first diagnosis of subclinical hypothyroidism without treatment from 2010 January to 2014 January. A total of 288 healthy controls were chosen from communities. The patients were groups based on TSH≥10.0 mU/L and 3.6 mU/L≤ TSH< 10.0 mU/L. We investigated the relationship between TSH and the level of blood lipids by analyzing liver and renal function, blood lipids, thyroid function, and thyroid peroxidase antibody (TPO-Ab) in the patients. ResultsTriglyceride (TG) and high density lipoprotein cholesterol levels were not significantly different among the three groups (P>0.05). Total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) levels of the group with TSH≥10 mU/L were respectively (5.93±1.12) and (3.82±1.11) mmol/L, which were significantly higher than those in the controls[(4.43±1.12) and (2.66±0.43) mmol/L] (P<0.05). TC, TG and LDL-C levels of the group with 3.6 mU/L≤ TSH< 10.0 mU/L were higher than the controls, but the differences were not significant (P>0.05). After thyroid hormone replacement therapy within 12 weeks, TG, LDL-C, and TC levels of TPO-Ab positive patients with subclinical hypothyroidism (n=112) were respectively (4.62±1.03), (2.97±0.52), and (1.17±0.62) mmol/L, which were significantly lower than those levels before treatment[(5.43±1.18), (3.62±0.58), and (2.03±0.71) mmol/L] (P<0.05). ConclusionThe disorder of lipid metabolism exists in patients with subclinical hypothyroidism. Especially, the level of TSH greater than or equal to 10 mU/L is a high risk factor for dyslipidemia. In TPO-Ab positive patients, therapy of thyroid hormone replacement can effectively improve the blood lipid abnormalities in patients with subclinical hypothyroidism, and it may be an effective measure to improve the disorder of lipid metabolism economically and effectively.
Objective To investigate the correlation between cervical Modic change (MC) and blood lipid and glucose levels. Methods Patients hospitalized with neck and shoulder pain in the Affiliated Hospital of North Sichuan Medical College between January 2015 and January 2021 were selected and divided into MC group and non-MC group according to whether the signal changes of cervical vertebral endplate occurred on MRI. The general data (age, gender, smoking history, drinking history), blood lipid indicators (high-density lipoprotein, low-density lipoprotein, lipoprotein a, total cholesterol, triglyceride) and blood glucose indicators (glycosylated hemoglobin, fasting blood glucose) were compared between the two groups. Multivariate logistic regression analysis was used to explore the correlation between MC and various indicators. Results A total of 160 patients were included, including 48 patients in MC group and 112 patients in non-MC group. The age [(61.46±12.10) vs. (56.22±10.65) years], total cholesterol [(5.06±1.17) vs. (4.44±1.31) mmol/L], triglyceride [(1.61±0.64) vs. (1.38±0.58) mmol/L], glycosylated hemoglobin (6.78%±1.27% vs. 5.79%±0.85%), and fasting blood glucose [(7.84±1.51) vs. (6.93±1.47) mmol/L] of the patients in MC group were significantly higher than those in non-MC group (P<0.05). There was no significant difference in gender, smoking ratio, drinking ratio, high-density lipoprotein, low-density lipoprotein or lipoprotein a between the two groups (P>0.05). Logistic regression analysisshowed that age [odds ratio (OR)=1.064, 95% confidence interval (CI) (1.022, 1.109), P=0.003], total cholesterol [OR=1.788, 95%CI (1.187, 2.694), P=0.005], triglyceride [OR=2.624, 95%CI (1.257, 5.479), P=0.010] and glycosylated hemoglobin [OR=4.942, 95%CI (2.446, 9.987), P<0.001] were risk factors of cervical MC. Conclusions Age, total cholesterol, triglyceride and glycosylated hemoglobin are risk factors of cervical MC. Elderly patients with hyperlipidemia and hyperglycemia should be alert to the occurrence of cervical MC. Controlling the levels of blood lipid and glucose may reduce the risk of cervical MC.
Objective To investigate the long-term dynamic changes of liver function and glucose-lipid metabolism in human immunodeficiency virus (HIV)-infected patients with metabolic dysfunction-associated fatty liver disease (MAFLD) after antiretroviral therapy (ART). Methods HIV-infected patients who visited Public Health Clinical Center of Chengdu between October 1st, 2012 and June 30th, 2013 were recruited and divided into two groups according to whether they had MAFLD or not. All of them were treated with the first-line regimen of tenofovir + lamivudine + efavirenz for 156 weeks, and the anthropometric indices, liver function, and levels of glucose, lipids and uric acid were measured at baseline and at each follow-up time point. In addition, the long-term dynamic characteristics of liver function and glucose and lipid metabolism parameters of the two groups were compared during the 156 weeks of ART treatment. Results A total of 61 male HIV-infected patients were enrolled. The prevalence of MAFLD in them was 31.1% (19/61) at baseline and increased by 4.9 percentage points per year after ART. Before the start of follow-up (week 0), the levels of alanine aminotransferase (ALT) [(46.23±27.09) vs. (28.00±17.43) U/L, P=0.002] and γ-glutamyl transpeptidase (GGT) [(41.46±9.89) vs. (24.02±10.72) U/L, P<0.001] were higher in the MAFLD group than those in the non-MAFLD group, while the between-group differences in the levels of aspartate aminotransferase (AST) [(33.33±15.61) vs. (28.98±12.43) U/L, P=0.248] and alkaline phosphatase [(85.30±21.27) vs. (83.41±24.47) U/L, P=0.773] were not statistically significant. During the 156-week follow-up period, the 4 items of liver function gradually increased in the MAFLD group, especially from week 120 onwards, 3 of which (ALT, AST and GGT) were significantly higher than those in the non-MAFLD group (P<0.05). In addition, the levels of fasting blood glucose, triglyceride, total cholesterol, and low-density lipoprotein were also significantly higher in the MAFLD group than those in the non-MAFLD group at some time points during the 156-week follow-up period (P<0.05). Conclusions Compared with HIV-infected patients without MAFLD, HIV-infected patients with MAFLD are more likely to develop impaired liver function and disorders of glucose and lipid metabolism during long-term tenofovir + lamivudine + efavirenz regimen ART treatment. Therefore, close clinical monitoring of liver function and glucose and lipid metabolism related parameters is required for such patients.