血清三酰甘油水平与小而密低密度脂蛋白胆固醇的关系  

The relationship of serum triglyceride and small dense low-density lipoprotein cholesterol

作　　者：张正清[1] 王连升[1] 庄兴[1] 张琦[1] 范虞琪[2] 陈福祥[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院检验科,上海200011 [2]上海交通大学医学院附属第九人民医院心内科,上海200011

出　　处：《检验医学》2011年第12期802-805,共4页Laboratory Medicine

基　　金：上海市卫生局青年基金资助项目(2010Y013)

摘　　要：目的探讨健康人群和血脂代谢异常者小而密低密度脂蛋白胆固醇(sdLDL-C)水平分布及血清三酰甘油(TG)水平对sdLDL-C水平的影响。方法将693例血脂代谢异常者分为A组(542例,TG<1.70 mmol/L)和B组(151例,TG≥1.70 mmol/L),同时选取健康对照者181名。采用肝素-镁沉淀法检测血清sdLDL-C水平,同时检测空腹血糖、血脂[包括总胆固醇(TC)、TG、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]及载脂蛋白A1(apo A1)、载脂蛋白B(apo B)。分析各组各指标间的差异及血清TG水平对sdLDL-C的影响。结果 B组TC、aopB水平高于健康对照组和A组(P<0.05),HDL-C水平明显低于健康对照组和A组(P<0.05)。健康对照组sdLDL-C水平呈偏态分布,以第95百分位数(0.62 mmol/L)作为正常参考阈值。血脂异常组sdLDL-C水平为0.46(0.34～0.64)mmol/L,明显高于健康对照组[0.22(0.16～0.38)mmol/L](P<0.001)。多元逐步回归分析表明,对sdLDL-C水平有显著影响的因素为TG和LDL-C。17.6%的A组患者血清sdLDL-C水平高于正常参考阈值(P<0.05)。受试者工作特征(ROC)曲线分析表明,TG识别sdLDL-C水平升高的Cut-off值为1.36 mmol/L。结论血清sdLDL-C水平受TG的影响最大,判断sdLDL-C水平是否升高的TG的界值应适当调低。Objective To investigate the distribution of small dense low-density lipoprotein cholesterol（sdLDL-C） in healthy subjects and dyslipidemia patients,and evaluate the influence of serum triglyceride（TG） on sdLDL-C.Methods The 693 dyslipidemia patients were classified into Group A（542 cases,TG 1.70 mmol/L） and Group B（151 cases,TG ≥ 1.70 mmol/L）,and 181 healthy subjects were enrolled as controls.The serum sdLDL-C level was determined by heparin-Mg precipitation method.The levels of total cholesterol（TC）,TG,high-density lipoprotein cholesterol（HDL-C）,low-density lipoprotein cholesterol（LDL-C）,apolipoprotein A1（apo A1）,apolipoprotein B（apo B） and fast plasma glucose were determined.The difference among the groups and the influence of serum TG on sdLDL-C were analyzed.Results The TC and apo B levels in Group B were significantly higher than those in healthy control group and Group A（P0.05）,while HDL-C was obviously lower than those in healthy control group and Group A（P0.05）.The level of sdLDL-C in healthy control group was skewed distribution,and the 95th percentile was 0.62 mmol/L as the normal reference level.The serum sdLDL-C in the dyslipidemia patients[0.46（0.34-0.64）mmol/L] was significantly higher than that in the healthy control group [0.22（0.16-0.38）mmol/L]（P0.001）.The multi-variety regression analysis showed that the TG and LDL-C were the major factors for the level of serum sdLDL-C.The 17.6% patients in Group A had higher sdLDL-C than the normal reference level 0.62 mmol/L.The receiver operating characteristic（ROC） curve analysis showed that the optimal Cut-off value of TG was 1.36 mmol/L to identify the patients with higher sdLDL-C.Conclusions The serum sdLDL-C is mostly affected by TG.The borderline values of TG should be set lower to identify the subjects with higher sdLDL-C.

关 键 词：小而密低密度脂蛋白 三酰甘油 血脂代谢异常 

分 类 号：Q513[生物学—生物化学]