家族性高脂血症家系血浆载脂蛋白B与代谢综合征的相关性研究  

Apolipoprotein B is associated with metabolic syndrome in Chinese pedigrees with familial hyperlipidemia

作　　者：裴卫东[1] 孙余华[1] 柔卫军[2] 祖秋[3] 李瑶[1] 张朝阳[1] 戴军[1] 贾玉和[1] 陆宗良[1] 吴锡桂[1] 刘力生[1] 惠汝太 

机构地区：[1]中国医学科学院中国协和医科大学阜外心血管病医院心血管病研究所,北京100037 [2]北京铁路局太原铁路分局卫生医保管理中心 [3]北京军区总医院内分泌科

出　　处：《中华医学杂志》2005年第5期313-317,共5页National Medical Journal of China

基　　金：国家自然科学基金资助项目(30200105);北京市自然科学基金资助项目 ( 7022027 );北京市科技新星计划基金资助项目(2003A59)

摘　　要：目的对不同类型家族性高脂血症及血脂正常对照家系代谢综合征(MS)的患病率及其相关因素进行探讨.方法共搜集了70个家系,其中年龄大于20岁的家系成员共560人:分别为家族性混合型高脂血症(FCHL)家系43个共379人;家族性高甘油三酯血症(FHTG)家系3个共30人;家族性高胆固醇血症(FH)家系16个共102人;血脂正常对照家系8个共49人.MS诊断标准参考美国国家胆固醇宣教计划(NCEP-ATPⅢ),并结合中国人群资料,以体重指数替代腰围作为诊断标准之一.采用多元Logistic回归分析不同家系中MS的相关因素.结果 60.7%的FCHL患者及71.4%的FHTG患者符合MS的诊断标准,这两种类型高脂血症家系MS的患病率最高.MS在不同家系成员(包括高脂血症受累者和未受累者)中的患病率分别为:FCHL为36.7%,FHTG为33.3%,FH为17.6%,血脂正常对照家系为16.3%.FCHL与血脂正常对照家系MS患病率的危险度优势比(OR值)和95%可信区间为2.97 (1.29～7.07).调整年龄、载脂蛋白A1及低密度脂蛋白胆固醇,多元Logistic回归分析显示血浆载脂蛋白B与MS相关,不同家系OR值如下:FCHL家系为1.05 (1.03～1.07);FHTG家系为1.26 (1.03～1.55);FH家系为1.07 (1.01～1.12);而血脂正常对照家系却未显示有意义的相关(P> 0.05).血浆载脂蛋白A1与MS相关关系如下:FCHL 家系OR值为0.95 (0.94～0.97),FH家系OR值为0.94 (0.90～0.99),而FHTG家系及血脂正常对照家系却未显示有意义的相关(P> 0.05).结论载脂蛋白B是FCHL、FHTG以及FH家系中MS的相关因子.Objective To investigate the prevalence of metabolic syndrome (MS) as well as the potential predictors in families with familial combined hyperlipidemia (FCHL), familial hypertriglyceridemia (FHTG), familial hypercholesterolemia (FH) and normolipidemic families in China Methods The prevalence of MS was identified among 70 different families with 560 individuals aged ≥ 20, including 43 FCHL families with 379 individuals, 3 FHTG families with 30 individuals, 16 FH families with 102 individuals and 8 normolipidemic families with 49 individuals Diagnosis of MS was based on the modified criteria of National Cholesterol Education Program, US, substituting body mass index for waist circumference Multivariate logistic regression was used to analyze the association between MS and different pedigrees Results MS was identified in 60 7% of the FCHL patients and 71 4% of the FHTG patients The prevalence of MS in the family members was 36 7% for the FCHL families, 33 3% for the FHTG families, 17 6% for the FH families, and 16 3% for the normolipidemic families, with an odds ratio ( OR ) of 2 97 (95% CI 1 29 to 7 07) in the FCHL families compared with in the normolipidemic families Multivariate logistic regression showed an association between apolipoprotein (apo) B and MS with an OR of 1 05 (1 03 to 1 07) in the FCHL families, an OR of 1 26 (1 03 to 1 55) in the FHTG families, and an OR of 1 07 (1 01 to 1 12) in the FH families, independent of variables such as age, gender, apoA1, and LDL cholesterol, but showed no association in the normolipidemic families ( P >0 05) Similarly, apo A1 provided an OR of 0 95 (0 94 to 0 97) in the FCHL families and an OR of 0 94 (0 90 to 0 99) in the FH families, but neither in the FHTG families nor in the normolipidemic families (both P >0 05) Conclusion Apo B may be regarded as a relevant factor in the assessment of MS in FCHL, FHTG and FH families in Chinese However, this finding needs to be verified b

关 键 词：家系 正常 MS 血脂 家族性 高脂血症 对照 多元 搜集 结论 

分 类 号：R589.2[医药卫生—内分泌]