中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
CHINESE JOURNAL OF LABORATORY MEDICINE
2012年
4期
354-358
,共5页
陈力平%林杰%孔维菊%袁俊菲%肖立
陳力平%林傑%孔維菊%袁俊菲%肖立
진력평%림걸%공유국%원준비%초립
胆固醇,LDL%甘油三酯类%高脂血症%自动分析
膽固醇,LDL%甘油三酯類%高脂血癥%自動分析
담고순,LDL%감유삼지류%고지혈증%자동분석
Cholesterol,LDL%Triglycerides%Hyperlipidemias%Autoanalysis
目的 调查血脂正常健康人群和高血脂人群小而密低密度脂蛋白胆固醇(sdLDL-C)的分布,分析sdLDL-C与其他血脂组分的相关性.方法 1012名18～ 93岁血脂正常受试者(男503名,女509名)按性别(男性、女性)和年龄(18～ 29岁、30 ～69岁和≥70岁)共分6组；433例23～90岁血脂增高受试者按空腹甘油三酯(TG)、低密度脂蛋白胆固醇( LDL-C)水平分为:高TG组(165例)、高LDL-C组(129例)和联合增高组(139例).用Olympus AU2700自动分析仪测定血清sdLDL-C、TG、LDL-C、TC、HDL-C、ApoAI和ApoB.采用方差分析及Kruskal-Wallis H检验进行统计学分析.结果 血脂正常受试者sdLDL-C近似正态分布,且存在性别和年龄差异:18 ～ 29岁组男性sdLDL-C[ (0.55 ±0.21) mmol/L]高于女性[(0.47±0 22) mmol/L,t=2.212,P=0.028];30 ～69岁组男性sdLDL-C(0.66±0.28) mmol/L[高于女性[(0.62±0.25) mmol/L,t=2.121,P=0.034]；≥70岁组男性sdLDL-C[ (0.54±0.21) mmol/L]与女性[(0.54±0.22) mmo]/L[差异无统计学意义(t=0.022,P=0.982).血脂增高受试者sdLDL-C[( 1.25±0.44) mmol/L明显高于血脂正常受试者[ (0.60 ±0.26) mmol/L,t =29.306,P＜0.01].联合增高组的sdLDL-C最高[(1.52±0.49)mmol/L,F =525.66,P＜0.01]；高TG组的sdLDL-C/LDL-C比值最大(0.47±0.12,F=287.93,P＜0.01)；高LDL-C组的非sdLDL-C(LDL-C减去sdLDL-C)最高[(2.71±0.52) mmol/L,F =336.32,P＜0.01].sdLDL-C与TC、TG、LDL-C、ApoB、BMI呈正相关(rs=0.66、0.68、0.65、0.79、0.27),与HDL-C和ApoAI呈负相关(rs=-0.42、-0.37,P均＜0.01).偏相关分析:sdLDL-C与TG、LDL-C、TC偏相关系数为0 42、0.28、0.15,P均＜0.01.结论 LDL-C和TG是影响sdLDL-C水平的重要因素,但TG的影响更大.sdLDL-C是评价小而密低密度脂蛋白(sdLDL)水平、判断脂质代谢整体状况的适宜且良好的指标.有必要对不同地区人群sdLDL-C分布进行调查,建立正常人群sdLDL-C参考区间,这对发挥sdLDL在临床诊疗、健康评估中的应有作用十分必要.
目的 調查血脂正常健康人群和高血脂人群小而密低密度脂蛋白膽固醇(sdLDL-C)的分佈,分析sdLDL-C與其他血脂組分的相關性.方法 1012名18～ 93歲血脂正常受試者(男503名,女509名)按性彆(男性、女性)和年齡(18～ 29歲、30 ～69歲和≥70歲)共分6組；433例23～90歲血脂增高受試者按空腹甘油三酯(TG)、低密度脂蛋白膽固醇( LDL-C)水平分為:高TG組(165例)、高LDL-C組(129例)和聯閤增高組(139例).用Olympus AU2700自動分析儀測定血清sdLDL-C、TG、LDL-C、TC、HDL-C、ApoAI和ApoB.採用方差分析及Kruskal-Wallis H檢驗進行統計學分析.結果 血脂正常受試者sdLDL-C近似正態分佈,且存在性彆和年齡差異:18 ～ 29歲組男性sdLDL-C[ (0.55 ±0.21) mmol/L]高于女性[(0.47±0 22) mmol/L,t=2.212,P=0.028];30 ～69歲組男性sdLDL-C(0.66±0.28) mmol/L[高于女性[(0.62±0.25) mmol/L,t=2.121,P=0.034]；≥70歲組男性sdLDL-C[ (0.54±0.21) mmol/L]與女性[(0.54±0.22) mmo]/L[差異無統計學意義(t=0.022,P=0.982).血脂增高受試者sdLDL-C[( 1.25±0.44) mmol/L明顯高于血脂正常受試者[ (0.60 ±0.26) mmol/L,t =29.306,P＜0.01].聯閤增高組的sdLDL-C最高[(1.52±0.49)mmol/L,F =525.66,P＜0.01]；高TG組的sdLDL-C/LDL-C比值最大(0.47±0.12,F=287.93,P＜0.01)；高LDL-C組的非sdLDL-C(LDL-C減去sdLDL-C)最高[(2.71±0.52) mmol/L,F =336.32,P＜0.01].sdLDL-C與TC、TG、LDL-C、ApoB、BMI呈正相關(rs=0.66、0.68、0.65、0.79、0.27),與HDL-C和ApoAI呈負相關(rs=-0.42、-0.37,P均＜0.01).偏相關分析:sdLDL-C與TG、LDL-C、TC偏相關繫數為0 42、0.28、0.15,P均＜0.01.結論 LDL-C和TG是影響sdLDL-C水平的重要因素,但TG的影響更大.sdLDL-C是評價小而密低密度脂蛋白(sdLDL)水平、判斷脂質代謝整體狀況的適宜且良好的指標.有必要對不同地區人群sdLDL-C分佈進行調查,建立正常人群sdLDL-C參攷區間,這對髮揮sdLDL在臨床診療、健康評估中的應有作用十分必要.
목적 조사혈지정상건강인군화고혈지인군소이밀저밀도지단백담고순(sdLDL-C)적분포,분석sdLDL-C여기타혈지조분적상관성.방법 1012명18～ 93세혈지정상수시자(남503명,녀509명)안성별(남성、녀성)화년령(18～ 29세、30 ～69세화≥70세)공분6조；433례23～90세혈지증고수시자안공복감유삼지(TG)、저밀도지단백담고순( LDL-C)수평분위:고TG조(165례)、고LDL-C조(129례)화연합증고조(139례).용Olympus AU2700자동분석의측정혈청sdLDL-C、TG、LDL-C、TC、HDL-C、ApoAI화ApoB.채용방차분석급Kruskal-Wallis H검험진행통계학분석.결과 혈지정상수시자sdLDL-C근사정태분포,차존재성별화년령차이:18 ～ 29세조남성sdLDL-C[ (0.55 ±0.21) mmol/L]고우녀성[(0.47±0 22) mmol/L,t=2.212,P=0.028];30 ～69세조남성sdLDL-C(0.66±0.28) mmol/L[고우녀성[(0.62±0.25) mmol/L,t=2.121,P=0.034]；≥70세조남성sdLDL-C[ (0.54±0.21) mmol/L]여녀성[(0.54±0.22) mmo]/L[차이무통계학의의(t=0.022,P=0.982).혈지증고수시자sdLDL-C[( 1.25±0.44) mmol/L명현고우혈지정상수시자[ (0.60 ±0.26) mmol/L,t =29.306,P＜0.01].연합증고조적sdLDL-C최고[(1.52±0.49)mmol/L,F =525.66,P＜0.01]；고TG조적sdLDL-C/LDL-C비치최대(0.47±0.12,F=287.93,P＜0.01)；고LDL-C조적비sdLDL-C(LDL-C감거sdLDL-C)최고[(2.71±0.52) mmol/L,F =336.32,P＜0.01].sdLDL-C여TC、TG、LDL-C、ApoB、BMI정정상관(rs=0.66、0.68、0.65、0.79、0.27),여HDL-C화ApoAI정부상관(rs=-0.42、-0.37,P균＜0.01).편상관분석:sdLDL-C여TG、LDL-C、TC편상관계수위0 42、0.28、0.15,P균＜0.01.결론 LDL-C화TG시영향sdLDL-C수평적중요인소,단TG적영향경대.sdLDL-C시평개소이밀저밀도지단백(sdLDL)수평、판단지질대사정체상황적괄의차량호적지표.유필요대불동지구인군sdLDL-C분포진행조사,건립정상인군sdLDL-C삼고구간,저대발휘sdLDL재림상진료、건강평고중적응유작용십분필요.
Objective To investigate the distribution characteristics of serum small dense low density lipoprotein-cholesterol (sdLDL-C) levels in healthy normolipidemia and hyperlipidemia and analyze the correlation between sdLDL-C and other serum lipids.Methods Totally 1012 normolipidemic subjects (18 93 years old,503 male,509 females) were grouped according to gender and age (18 -29,30 -69 and ≥70 years old).And 433 hyperlipidemic subjects (23 -90 years) were divided into the following 3 groups based on fasting triglyceride (TG) and low density lipoprotein-cholesterol (LDL-C)levels:hypertriglyceridemia (n =165 ),high-LDL-C ( n =129) and combined hyperlipidemia ( n =139 ).The sdLDL-C and other serum lipids were measured by Olympus AU2700 automatic analyzer.Analysis of Variance and Kruskal-Wallis H test was used for statistical analysis.Results The distribution of the sdLDL-C levels in normolipidemic subjects was near normal distribution.The sdLDL-C levels had differences in gender and age.In the 18 -29 and 30 -69 years old group,the mean values of sdLDL-C were significantly higher in males than in females [ (0.55 -0.21 ) mmol/L vs (0.47 ±0.22) mmol/L,t =2.212,P =0.028 and (0.66±0.28) mmol/L vs (0.62±0.25) mmol/L,t =2.121,P=0.034].In the ≥70 years old group,the difference of sdLDL-C levels in gender was not statistically significant [ male ( 0.54 ± 0.21 )mmol/L vs female (0.54 ± 0.22 ) mmol/L,t =0.022,P =0.982] ; the mean value was ( 0.54 ± 0.22 ) mmol/L The hyperlipidemic subjects had conspicuous higher levels of sdLDL-C compared with normolipidemia [ ( 1.25 ±0.44) mmol/L vs (0.60 ±0.26) mmol/L,t =29.306,P ＜0.001 ].Among all of groups,the combined hyperlipidemia group had the highest sdLDL-C level [ ( 1.52 ± 0.49) mmol/L,F =525.66,P ＜0.001 ] ; the hypertriglyceridemia group had the highest sdLDL-C/LDL -C level (0.47 ±0.12,F =287.93,P ＜0.001 ) and the high-LDL-C group had the highest level of non-sdLDL-C [LDL-C subtract sdLDL-C,(2.71 ± 0.52) mmol/L.F =336.32,P ＜ 0.001 ].The sdLDL-C showed a good positive correlation with TC,TG,LDL-C,ApoB and BMI ( rs =0.66,0.68,0.65,0.79 and 0.27,P ＜ 0.001 ),and negative correlation with HDL-C and ApoA1 ( rt =- 0.42 and - 0.37,P ＜ 0.001 ).Based on partial correlative analysis,sdLDL-C showed a different correlation with TG,LDL-C and TC ( r =0.42,0.28 and 0.15,P ＜ 0.001 ).Conclusions LDL-C and TG are the important factors influencing the sdLDL-C levels.However,TG has greater effect than LDL-C.The sdLDL-C is an appropriate and good index to evaluate the small dense low density lipoprotein (sdLDL) mass and the overall situation of lipid metabolism.In order to make full use of sdLDL in the clinical treatment and health assessment,it is necessary to establish sdLDL-C reference intervals through the survey of distribution of sdLDL-C levels in different geographic areas.
