血浆中脂质代谢分子与颈动脉粥样硬化斑块、传统心血管危险因素及膳食因素的关系  

Relationship between lipid metabolism molecules in plasma and carotid atheroscle-rotic plaques,traditional cardiovascular risk factors,and dietary factors

作　　者：和静 房中则[3] 杨颖[4] 刘静[5] 马文瑶 霍勇[4] 高炜[6] 武阳丰 谢高强[1,2,7,8] HE Jing;FANG Zhongze;YANG Ying;LIU Jing;MA Wenyao;HUO Yong;GAO Wei;WU Yangfeng;XIE Gaoqiang(Peking University First Hospital,Beijing 100034,China;Clinical Research Institute,Institute of Advanced Clinical Medicine,Peking University,Beijing 100191,China;College of Public Health,Tianjin Medical University,Tianjin 300070,China;Department of Cardiology,Peking University First Hospital,Beijing 100034,China;Center of Clinical and Epidemiology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;Department of Cardiology,Peking University Third Hospital,Beijing 100191,China;Key Laboratory of Epidemiology of Major Diseases(Peking University),Beijing 100191,China;State Key Laboratory of Vascular Homeostasis and Remodeling(Peking University),Beijing 100191,China)

机构地区：[1]北京大学第一医院,北京100034 [2]北京大学临床医学高等研究院临床研究所,北京100191 [3]天津医科大学公共卫生学院,天津300070 [4]北京大学第一医院心内科,北京100034 [5]首都医科大学附属北京安贞医院临床与流行病研究中心,北京100029 [6]北京大学第三医院心内科,北京100191 [7]重大疾病流行病学教育部重点实验室(北京大学),北京100191 [8]血管稳态与重构全国重点实验室(北京大学),北京100191

出　　处：《北京大学学报（医学版）》2024年第4期722-728,共7页Journal of Peking University:Health Sciences

基　　金：国家自然科学基金(30872168、81473044)。

摘　　要：目的:探索血浆中脂质代谢分子与颈动脉粥样硬化斑块、传统心血管危险因素的关系及可能的膳食相关因素。方法:从参加2012年“亚临床动脉粥样硬化队列10年随访研究”的北京市石景山区1 312名社区人群中,按照入排标准(年龄<70岁、无临床心血管病及其他疾病等)筛选出85名有2个以上颈动脉软斑块或混合斑块者,以及相匹配的89名无斑块对照者;然后从中各随机抽取10名分别作为病例组和对照组。颈动脉斑块采用GE Vivid i超声仪(8L探头)确定。采用高效液相色谱-质谱联用法对脂质代谢分子进行检测,检测指标包括113种脂质代谢分子。传统心血管危险因素使用统一的标准问卷进行采集,膳食相关因素采用膳食使用频率和重量问卷进行采集。采用Wilcoxin秩和检验分析病例组和对照组脂质代谢分子的差异,在对照组中,采用Spearman相关法描述有统计学意义的脂质代谢分子与传统心血管危险因素、膳食因素的相关关系。结果:在113种脂质代谢分子中检测出的53种脂质分子中,C24:0鞘磷脂,C22:0、C24:0神经酰胺,C18:0磷脂酰乙醇胺,C18:2 (Cis)磷脂酰胆碱,C18:0磷脂酰胆碱等在颈动脉粥样硬化斑块病例组显著高于无斑块对照组。对照组相关分析发现,C24:0鞘磷脂与低密度脂蛋白胆固醇呈显著正相关(r=0.636,P<0.05),C18:2 (Cis)磷脂酰胆碱与收缩压呈显著正相关(r=0.733,P<0.05),C18:0磷脂酰乙醇胺与高敏C反应蛋白呈显著正相关(r=0.782,P<0.01),C22:0、C24:0神经酰胺及C18:0磷脂酰乙醇胺与蔬菜摄入量呈显著负相关(r=-0.679,P<0.05;r=-0.711,P<0.05;r=-0.808,P<0.01),C24:0神经酰胺与豆类食品摄入量呈显著负相关(r=-0.736,P<0.05)。结论:血浆C24:0鞘磷脂、C22:0和C24:0神经酰胺、C18:0磷脂酰乙醇胺、C18:2和C18:0磷脂酰胆碱等脂质代谢分子升高可能是人类动脉粥样硬化斑块的新危险因素,这些分子可能与血脂、血压或炎症水平及�Objective:To explore the relationship between lipid metabolism molecules in plasma and carotid atherosclerotic plaques,traditional cardiovascular risk factors and possible dietary related factors.Methods:Firstly,among 1312 community people from those who participated in a 10-year follow-up study of subclinical atherosclerosis cohort in Shijingshan District,Beijing,85 individuals with 2 or more carotid soft plaques or mixed plaques and 89 healthy individuals without plaques were selected according to the inclusive and the exclusive criteria(<70 years,not having clinical cardiovascular disease and other diseases,etc.).Secondly,10 cases and 10 controls were randomly selected in the above 85 and 89 individuals respectively.Carotid plaques were detected using GE Vivid i Ultrasound Machine with 8L detector.Lipid metabolism molecules were detected by high performance liquid chromatography-mass spectrometry.The detection indexes included 113 lipid metabolism molecules.Traditional cardiovascular risk factors were collected by unified standard questionnaires,and dietary related factors were collected by main dietary frequency and weight scale.The difference of lipid metabolism molecules between the case group and the control group was analyzed by Wilcoxin rank test.In the control group,the Spearman correlation method was used to analyze the correlation between statistically significant lipid metabolism molecules and traditional cardiovascular risk factors and dietary factors.Results:Among the 113 lipid metabolism molecules,53 lipid metabolism molecules were detected.C24:0 sphingomyelin(SM),C22:0/C24:0 ceramide molecules,C18:0 phosphoethanolamine(PE)molecules,and C18:0/C18:2(Cis)phosphatidylcholine(PC)were significantly higher in the carotid atherosclerotic plaque group than in the control group.The correlation analysis showed that C24:0 SM was significantly positively correlated with low density lipoprotein cholesterol(LDL-C,r=0.636,P<0.05),C18:2(Cis)PC(DLPC)was significantly positively correlated with systolic pressure(r=

关 键 词：脂质代谢分子 动脉粥样硬化 相关分析 危险因素 

分 类 号：R543.4[医药卫生—心血管疾病]