代谢综合征患者餐后血脂与颈动脉内膜中层厚度关系的探讨  

Postprandial lipoprotein and carotid artery intima-media thickness in patients with metabolic syndrome

作　　者：仝珊[1] 黄淑田[1] 

机构地区：[1]山西医科大学第二医院心内科

出　　处：《中国心血管病研究》2006年第12期914-917,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的探讨代谢综合征(MS)患者餐后血脂代谢情况及其与颈动脉内中膜厚度(IMT)的相关性。方法选择40名健康人为对照组,60例MS患者为MS组。MS组以空腹甘油三酯为标准(≥1.7mmol/L)分为两个亚组:空腹甘油三酯正常组(MS1)与空腹高甘油三酯组(MS2)。禁食12h后,分别接受高脂肪饮食,于空腹、餐后2、4、6h测定血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)。使用彩超仪检测各组颈动脉IMT。结果餐后血清TG水平显著升高,浓度峰值是4h,TC、LDL-C、HDL-C无明显改变(P>0.05)。MS1组、MS2组餐后TG峰值浓度明显高于对照组(P<0.05)。MS组颈动脉IMT明显增厚,MS1、MS2颈动脉IMT与对照组相比,差异有统计学意义(P<0.05),但MS1与MS2之间差异无统计学意义(P>0.05)。直线相关分析示,年龄、体重指数、腰臀围比、TG0h、TG4h和收缩压均与颈动脉IMT呈显著正相关(r1=0.1513,r2=0.2111,r3=0.2312,r4=0.3441,r5=0.3765,r6=0.1839,P<0.05),且颈动脉IMT与TG4h的相关系数最大。结论MS患者脂肪餐后TG水平异常升高是其血脂代谢异常的重要内容之一,且餐后脂代谢异常常发生在空腹血脂异常之前,易引起动脉粥样硬化,故应常规检测MS患者的餐后血脂和颈动脉IMT。Objective The present study is to evaluate lipoprotein changes after a fat meal, and the relationship between the level of postprandial lipoprotein and the carotid artery intima-media thickness （CAIMT） in patients with metabolic syndrome. Methods 40 subjects of metabolic syndrome were divided into two groups： the postprandial hyperltriglyceridemia group （MS1）, hyperitriglyccridcmia group （MS2）. The test of fat loading was carried out in the three groups, TG2h ,TG4h were taken as the index of response of TG after test of fat loading. On the same time total cholesterol （TC）, hign density lipoprotein （HDL-C）, lower density lipoprotein （LDL-C）, body mass index （BMI）, SBP, DBP were measured. The CAIMT was measured using echography. 25 normal subjects served as controls. Results Postprandial TG levels is obviously higher than fasting levels （P〈0.05）. The TG level reached its peak value at 4 h. The levels of TC,LDL-C and HDL-C had no significantly changes（P〉0.05 ）. The TG-peak of MS1 and MS2 were both significantly higher than that of the control group（P〈 0.05）. The absolute value of CAIMT in both of the MS1 and MS2 were significantly higher than that of the control group （P〈 0.05）, no significantly different was found between the MS1 and MS2 （P〉0.05）. CAIMT were positively related to the age, BMI, WHR, TG0h, TG4h and SBP （r1 =0.1513：2=0.2111,r3=0.2312：4=0.3441,r5=0.3765,r6=0.1839,P〈0.05）. Conclusion The TG re moval rate is delayed for metabolic syndrome group, this is very important in disorder of lipids metabolization for metabolic syndrome. Postprandial lipemia leads to cause atherosclerosis. The carotid artery intima-media thickness and postprandial lipoprotein of the patients with metabolic syndrome should be routinely measured.

关 键 词：代谢 脂蛋白类 颈动脉 血管内膜 血管中膜 动脉硬化 

分 类 号：R543.5[医药卫生—心血管疾病]