甘油三酯和高密度脂蛋白胆固醇与炎症的关系  

Relations between fasting serum lipids and high-sensitivity C-reactive protein level in Chengdu residents

作　　者：舒燕[1] 何森[1] 陈晓平[1] 吕政兵[1] 杨芮[1] 刘凯[1] 崔凯军[1] 黄德嘉[1] 

机构地区：[1]四川大学华西医院心血管内科,成都610041

出　　处：《中华心血管病杂志》2012年第2期125-130,共6页Chinese Journal of Cardiology

基　　金：＂十一五＂科技支撑项目（2006BAI01A01）

摘　　要：目的 研究甘油三酯（TG）和高密度脂蛋白胆固醇（ HDL-C）与炎症之间的关系.方法 按照随机抽样的方法抽取样本,在排除影响血脂及炎症水平的相关因素后,共有580例,平均年龄（62.3 ±6.6）岁；男性占58.7％.资料中包含TG,HDL-C和高敏C反应蛋白（hsCRP）,该人群最终被纳入分析.结果 在整个人群中,TG与hsCRP呈正相关,HDL-C与hsCRP呈负相关；且在BMI＜ 24kg/m2的人群中,相关性更强（r分别为0.236及-0.140,P均＜0.001）.在BMI＜ 24 kg/m2的人群中,高TG患者和低HDL-C患者的hsCRP浓度较高,差异有统计学意义；且随着血脂异常程度的增加,hsCRP浓度及异常率也逐渐升高（趋势P均＜0.01）.Logistic分析提示,在BMI＜ 24 kg/m2的人群中,TG和HDL-C异常与hsCRP异常独立相关,即使在调整性别、年龄、TC、LDL-C、FPG、收缩压、舒张压、高血压病史、糖尿病病史、吸烟史及饮酒史等后,以TG及HDL-C均正常为对照,存在1个血脂成分异常（高TG或低HDL-C）或2个血脂成分异常时（高TG且低HDL-C）,hsCRP异常的OR值分别为1.970（P =0.105）和9.098（P =0.031）.而在BMI≥24 kg/m2的人群中,上述关系不存在,但心血管疾病危险因素的聚集状态更明显.结论 整个人群中,TG与hsCRP呈正相关,HDL-C与hsCRP呈负相关,且在BMI＜ 24 kg/m2的人群中,相关性更强.在BMI＜ 24 kg/m2的人群中,TG和HDL-C异常与炎症异常独立相关.在BMI≥24 kg/m2的人群中,上述关系不存在,但心血管疾病危险因素的聚集状态更明显.Objective To explore the associations between fasting serum lipids and high-sensitivity C-reactive protein （ hsCRP）.Methods Serum triglyceride （ TG）,high-density lipoprotein cholesterol （HDL-C） and hsCRP were measured in residents of Chengdu,China.Subjects with potential factors which might influence lipids and hsCRP were excluded,580 subjects [ mean age （ 62.3 ± 6.6 ） years ; male：58.7% ] were finally recruited by random sampling methods.Results There was a weak positive relationship between TG and hsCRP （ r =0.108,P =0.01 ） and a weak negative relationship between HDLC and hsCRP （r =- 0.197,P 〈 0.001 ）,this was also true in the sub-group with BMI 〈 24 kg/m2 （ r =0.236,-0.140 respectively,all P 〈0.001 ）.In subjects with BMI 〈24 kg/m2,the hsCRP concentration was significantly higher in subjects with higher TG or lower HDL-C （ all P 〈 0.05 ）.hsCRP increased in proportion with the degree of dyslipidemia.After adjusting for gender,age,TC,LDL-C,fasting blood glucose,systolic blood pressure,diastolic blood pressure,history of hypertension and diabetes,smoking and alcohol drinking,logistic regression analysis showed that the odds ratio for increased hsCRP was 1.970 in subjects with either increased TG or lower HDL-C （P =0.105） and 9.098 in subjects with both higher TG or lower HDL-C levels （P =0.031 ）.However,the observed relationship between TG,HDL-C and hsCRP in subjects with BMI 〈 24 kg/m2 could not be observed in subjects with subjects with BMI 〉 24 kg/m2despite significant more cardiovascular risk factors in these subjects.Conclusions A weak positive correlation between TG and hsCRP as well as a weak negative correlation between HDL-C and hsCRP was evidenced in the whole cohort suggesting dyslipidemia might be related to enhanced inflammatory status.However,this relationship is not observed in subjects with BMI 〉 24 kg/m2 despite existence of more cardiovascular risk factors in these subjects.

关 键 词：甘油三酯类 脂蛋白类 HDL C反应蛋白质 

分 类 号：R541.4[医药卫生—心血管疾病]