不同糖化血红蛋白人群的血脂及脂蛋白的价值  

The value of blood lipids and lipoproteins in people with different glycosylated hemoglobin

作　　者：庄兴[1] ZHUANG Xing(Department of Clinical Laboratory,Shanghai Ninth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

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,200011

出　　处：《国际检验医学杂志》2021年第S01期79-83,共5页International Journal of Laboratory Medicine

摘　　要：目的探讨不同糖化血红蛋白含量人群中血脂及脂蛋白的变化情况,有助于临床对表面健康人群的血脂管理。方法检测302例表面健康人群的葡萄糖(GLU)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、小而密低密度脂蛋白胆固醇(sdLDL-C)、载脂蛋白A1(apoA1)、载脂蛋白B(apoB)、游离脂肪酸(NEFA)、脂蛋白a[Lp(a)]、脂蛋白相关脂酶A2(Lp-PLA2)、对氧磷1(PON-1)、RLP、糖化血红蛋白(HbA1c)。分别根据HbA1c、Lp-PLA2分组统计,并做ROC。结果与不同的糖化血红蛋白含量呈显著相关性的项目有HDL-C、apoA1和TG/HDL-C;呈现一定相关是apoA1/apoB和sdLDL-C/LDL-C;进一步在HbA1c 5.7%~6.4%的人群做血脂及脂蛋白分析,具有显著相关性的项目有TC、LDL-C、sdLDL-C、apoB、Lp-PLA2、RLP、apoA1/apoB、non-HDL-C;TG、sdLDL-C/LDL-C和TG/HDL-C呈现一定相关性;并在这组中将Lp-PLA2分成4组,以状态变量最高做ROC曲线下面积,AUC在0.7以上的项目,且依次递减,分别为:non-HDL-C、LDL-C、apoB、sdLDL-C、TC、RLP。结论血脂及脂蛋白中不同指标的联合应用有助于临床对不同糖化血红蛋白含量的表面健康人群在心血管,尤其在动脉粥样硬化疾病等方面的诊断和监测。Objective To explore the changes of blood lipids and lipoproteins in different glycosylated hemoglobin content population,which is helpful to the management of blood lipid in the healthy people.Methods GlU,TC,TG,HDL-C,LDL-C,sdLDL-C,apoA1,apoB,NEFA,Lp(a),Lp-PLA2,PON-1,RLP and HbA1c were detected in 302 apparently healthy people.According to HbA1c,Lp-PLA2 group statistics,and do ROC.Results HDL-C,apoA1 and TG/HDL-C were significantly correlated with the content of hba1c.There is a correlation between apoA1/apoB and sdLDL-C/LDL-C.Lipids and lipoproteins were analyzed in 5.7%-6.4%of HbA1c population.The items with significant correlation were TC,LDL-C,sdLDL-C,apoB,Lp-PLA2,RLP,apoA1/apoB and non-HDL-C,TG,sdLDL-C/LDL-C and TG/HDL-C were correlated.Lp-PLA2 was divided into four groups at 5.7%~6.4%HbA1c.The highest state variable was the area under the ROC curve,with AUC above 0.7 and decreasing successively,as non-HDL-C,LDL-C,APOB,sdLDL-C,TC and RLP.Conclusion The combined application of different indexes in blood lipid and lipoprotein is helpful for clinical diagnosis of cardiovascular diseases in apparently healthy people with different levels of glycosylated hemoglobin,especially in the diagnosis and monitoring of atherosclerotic cardiovascular disease.

关 键 词：糖化血红蛋白 小而密低密度脂蛋白胆固醇 脂蛋白相关磷脂酶A2 非高密度脂蛋白胆固醇 心血管疾病 动脉粥样硬化性心血管疾病 

分 类 号：R54[医药卫生—心血管疾病]