Patients undergoing coronary artery bypass grafting (CABG) belong to the very high-risk group of atherosclerotic cardiovascular disease. Although CABG gets advantages in relieving symptoms and improving long-term outcomes, a significant risk of cardiovascular adverse events after surgery still exists and standardized secondary prevention is needed. Lipid management plays a critical role as a secondary preventive strategy in CABG. However, lipid management of CABG patients in real clinical setting is inadequate, including lack of standardized lipid-lowering strategy, low goal attainment rate, as well as poor long-term medication adherence. In recent years, a series of clinical trials have provided a lot of groundbreaking new evidence for lipid management in patients with cardiovascular diseases which offers new strategies together with objectives of lipid-lowering and comprehensive management for patients undergoing CABG. This article reviews the strategy and research progress of lipid management after CABG, aiming to provide objective reference for clinical treatment.
Objective To study the relation between the pathogenesis of gallstone and blood lipid and protein.Methods Then indexes of blood lipid and protein in 204 cases of gallstone patients were measured and analysed by statistical software SPSS. Results There was a significant difference between the gallstone group and control in the value of proalbumin, total cholesterol, high density lipoprotein and carrier protein B (Ｐ＜0.01), the value of total protein, triglyceride, low density lipoprotein cholesterol, very low density lipoprotein cholesterol and carrier protein A1 were higher than those in the control (Ｐ＜0.05). Conclusion The indexes mentioned above may play an important role in the gallstone formation.
【摘要】 目的 探討老年糖尿病患者血清胱抑素C與血脂及高敏C反應蛋白的關系。 方法 2008年5月-2009年10月糖尿病患者共141例，其中糖尿病合并癥組68例，單純糖尿病組73例；另選取對照組51例。對入選者的血清胱抑素C、血脂及高敏C反應蛋白進行分析。 結果 老年男女糖尿病合并癥組血清胱抑素C、高敏C反應蛋白、總膽固醇、甘油三酯及低密度脂蛋白膽固醇最高、高密度脂蛋白膽固醇最低，與對照組比較有統計學意義（Plt;0.05）、與單純糖尿病組比較，無統計學意義（Pgt;0.05）。老年男女單純糖尿病組高敏C反應蛋白、總膽固醇、甘油三酯高于對照組，組間比較，有統計學意義（Plt;0.05）。老年男女單純糖尿病組血清胱抑素C與對照組比較，無統率學意義（Pgt;0.05）。老年女性單純糖尿病組低密度脂蛋白膽固醇與對照組比較，有統計學意義（Plt;0.05）。老年男性糖尿病二組與對照組血清胱抑素C低于老年女性糖尿病二組與對照組，組間比較，無統計學意義（Pgt;0.05）。老年男性糖尿病患者血清胱抑素C與高敏C反應蛋白及血脂不相關。老年女性糖尿病合并癥組血清胱抑素C與空腹血糖正相關；單純糖尿病組血清胱抑素C與高密度脂蛋白膽固醇負相關、與低密度脂蛋白膽固醇正相關、與高敏C反應蛋白不相關。 結論 老年糖尿病患者高脂、高糖及低度炎癥狀態下，血清胱抑素C水平較高。血脂對血清胱抑素C的影響可能存在性別差異。隨著動脈粥樣硬化的加重，血清胱抑素C有升高趨勢。【Abstract】 Objective To investigate the relationship between serum cystatin C concentration and lipid, hs-C reactive protein in the elderly with diabetes. Methods A total of 192 senile people form May 2008 to October 2009 were investigated. There were 141 patients with diabetes, in whom 68 were with cardiovascular and cor, cerebrovascular diseases, 73 were with diabetes only.There were 51 control subjects. The data of serum cystatin C, hs-CRP, TC, TG, HDL-C and LDL-C were analyzed. Results Serum cystatin C of elderly men was lower than that in elderly women, but no signifcant correlation between them was found (Pgt;0.05). Serum cystatin C, hs-CRP, TC, TG and LDL-C was higher, and HDL-C was lower in male and female diabetes subjects with cardiovascular and cor, cerebrovascullar diseases, than that in control subjects (Plt;0.05). Serum hs-CRP, TC and TG were higher in the elderly with diabetes only, than that in control subjects (Plt;0.05). LDL-C was higher in senile women with diabetes only, than that in female control subjects (Plt;0.05). Serum cystatin C with LDL-C in elderly women with diabetes only, with FPG in female diabetes subjects with cardiovascular and cor, cerebrovascular diseases had position correlation (Plt;0.05). No correlation were observed between serum cystatin C and hs-CRP in male and female diabetes subjects, and lipid in male diabetes subjects. Conclusions We speculate that high serum lipid, high glucose and low level of inflammation may result in increasing of serum cystatin C in senily people with diabetes. The influence of serum lipid on serum cystatin C may be different in male and female senile people.Along with atherosclerotic aggravating, the level of serum cystatin C was increasing.
Objective To investigate the correlation between cervical Modic change (MC) and blood lipid and glucose levels. Methods Patients hospitalized with neck and shoulder pain in the Affiliated Hospital of North Sichuan Medical College between January 2015 and January 2021 were selected and divided into MC group and non-MC group according to whether the signal changes of cervical vertebral endplate occurred on MRI. The general data (age, gender, smoking history, drinking history), blood lipid indicators (high-density lipoprotein, low-density lipoprotein, lipoprotein a, total cholesterol, triglyceride) and blood glucose indicators (glycosylated hemoglobin, fasting blood glucose) were compared between the two groups. Multivariate logistic regression analysis was used to explore the correlation between MC and various indicators. Results A total of 160 patients were included, including 48 patients in MC group and 112 patients in non-MC group. The age [(61.46±12.10) vs. (56.22±10.65) years], total cholesterol [(5.06±1.17) vs. (4.44±1.31) mmol/L], triglyceride [(1.61±0.64) vs. (1.38±0.58) mmol/L], glycosylated hemoglobin (6.78%±1.27% vs. 5.79%±0.85%), and fasting blood glucose [(7.84±1.51) vs. (6.93±1.47) mmol/L] of the patients in MC group were significantly higher than those in non-MC group (P<0.05). There was no significant difference in gender, smoking ratio, drinking ratio, high-density lipoprotein, low-density lipoprotein or lipoprotein a between the two groups (P>0.05). Logistic regression analysisshowed that age [odds ratio (OR)=1.064, 95% confidence interval (CI) (1.022, 1.109), P=0.003], total cholesterol [OR=1.788, 95%CI (1.187, 2.694), P=0.005], triglyceride [OR=2.624, 95%CI (1.257, 5.479), P=0.010] and glycosylated hemoglobin [OR=4.942, 95%CI (2.446, 9.987), P<0.001] were risk factors of cervical MC. Conclusions Age, total cholesterol, triglyceride and glycosylated hemoglobin are risk factors of cervical MC. Elderly patients with hyperlipidemia and hyperglycemia should be alert to the occurrence of cervical MC. Controlling the levels of blood lipid and glucose may reduce the risk of cervical MC.
Objective To observe the serum lipid level of patients with branch retinal vein occlusion (BRVO). Methods A total of 71 BRVO patients (BRVO group) were enrolled in this study. The patients included 31 males and 40 females, with an average age of (52.75plusmn;10.2) years. All the patients were examined for visual acuity, slit lamp ophthalmoscopy combine with preset lens, fundus color photography and fundus fluorescein angiography (FFA) examination. Seventy-two age and sex matched normal subjects were enrolled in this study as control group. The subjects included 32 males and 40 females, with an average age of (53.10plusmn;9.5) years. The BRVO and control group were divided into four subgroup which including age with ＜40 years, 40-49 years, 50-59 years and ge;60 years. The plasma cholesterol and triglyceride level of BRVO group, control group, and age subgroups of BRVO and control group were comparatively analyzed. Results The average plasma cholesterol levels were (4.529plusmn;0.100) and (4.274plusmn;0.106) mmol/L in BRVO and control group, respectively. There was no difference between two groups (t=-1.738，P＞0.05). The average triglyceride levels were (1.500plusmn;0.129) and (1.319plusmn;0.095) mmol/L in BRVO and control group, respectively. There was no difference between two groups (t=-1.135，P＞0.05). There was no difference of average plasma cholesterol (t=-1.755, 1.850, -1.892, -0.507) and triglyceride (t=0.846, -0.074, -1.288, -1.887) level in age subgroups of BRVO and control subgroup (P＞0.05). Conclusion There is no significant difference of serum lipid level between BRVO patients and controls.
Objective To investigated the influence of the CYP2C9 polymorphism on lipid profile and blood concentration in epileptic children with VPA. Methods This study collected the information of healthy children and epilepsy children who were treated with VPA in the First Affiliated Hospital of Putian University during June, 2018 to March, 2021. The serum lipids of 184 cases were collected and compared between epilepsy group before and after treatment with VPA with the control group. The polymorphism of CYP2C9 gene in children with epilepsy was detected, and lipid and VPA concentration were compared after classification. Results There was no significant difference in lipid between the control group and the epilepsy group before treatment (P>0.05); The TC, HDL, LDL, TC/HDL, LDL/HDL were statistically different in VPA treatment group from the control group (P<0.05), and there were statistical differences in TG, LDL, TC/HDL, LDL/HDL between the trial group before the initiation and VPA treatment (P<0.05); There is no correlation between VPA blood concentration and lipid (P>0.05). VPA concentration, TC, HDL, LDL, TC/HDL and LDL/HDL in CYP2C9 wild-type were statistically different from heterozygous mutant. Conculsions CYP2C9 polymorphism and long-term use of VPA caused the changes in serum lipid levels in epilepsy children.
The present study was designed to elucidate the role of apoE polymorphism in the lithogenesis of cholecystolithiasis and to explore the hereditary pathogenesis of the disease. Polymerase Chain Reaction (PRC) was used as researching apoE phenotypes and allele frequencies in patients with gallstones (n=87) and in controls (n=50), and the fasting serum lipids of subjects were also measured. The characteristics of lipid variants were analysed among the patients with different apoE phenotypes. The results showed that the levels of TG (1.43mmol/L), VLDL-C(0.68mmol/L) in E2/3 patients were greatly higher than those in E2/3 controls (1.06mmol/L, Ｐ＜0.05 and 0.48mmol/L, Ｐ＜0.05), and LDL-C (1.41mmol/L) was markably lower in E2/3 patients than that in controls (2.04mmol/L, Ｐ＜0.05). The levels of serum lipids decreased significantly in E3/3 patients with HDL-C (0.89mmol/L), HDL2-C (0.49mmol/L), HDL3-C (0.39mmol/L), and compared with those in E3/3 controls (1.28mmol/L Ｐ＜0.05, 0.73mmol/L Ｐ＜0.001 and 0.55mmol/L Ｐ＜0.001). In E3/4 patients there were only slight changes of VLDL-C, LDL-C level. The results suggest that the average level of serum lipids in the same apoE phenotype patients with gallstones is higher than that in controls, and the different apoE phenotypes patients with gallstones have different characteristics of dyslipidemia. ε2 allele is probably one of the dangerous factor in the lithogenesis of cholecystolithiasis.
【摘要】 目的 探討成都市成華區中老年人群血脂水平、分布特點及其與胰島素抵抗指數（HOMA-IR）的關系。 方法 2007年5月在此區中老年（50~79歲）人群中隨機抽取672人進行心血管危險因素研究調查，對其血脂水平及HOMA-IR進行統計分析。 結果 人群當中①女性各血脂項目的水平均比男性高，其中總膽固醇（TC）、高密度脂蛋白膽固醇（HDL-C）的差異有統計學意義（Plt;0.05）；②三酰甘油（TG）升高的比例較高，其中男性為30.0%，女性為27.6%；大部分人群HDL-C、低密度脂蛋白膽固醇（LDL-C）水平處于合適范圍，HDL-C降低的比例為6.0%，LDL-C升高的比例為7.3%；③隨著TG水平的升高、HDL-C 水平的降低，HOMA-IR呈升高趨勢；LDL-C水平的升高，HOMA-IR呈升高趨勢，僅在女性人群中差異有統計學意義（Plt;0.05），在男性人群中差異無統計學意義；④TG與HOMA-IR呈正相關，相關系數為0.185（P=0.000）；HDL-C與HOMA-IR呈負相關，相關系數為-0.145（P=0.000）。LDL-C與HOMA-IR呈正相關，相關系數為0.099（P=0.010）。 結論 TG增高是成都市成華區中老年人群的顯著特點，女性HDL-C比男性高；血脂紊亂與胰島素抵抗相關。【Abstract】 Objective To investigate the relationship between blood lipids level and homeostasis model assessment-insulin resistance (HOMA-IR) in elder people in Chengdu. Methods In May 2007, 672 people aged from 50 to 79 years in Chengdu were recruited by random sampling methods for the survey of cardiovascular risk factors. The blood lipids level and HOMA-IR were statistically analyzed. Results ① The serum total cholesterol (TC) and high density lipoprotein chole sterol (HDL-C) were obviously higher in women than those in men (Plt;0.05). ② Triacylglycerol (TG) increased in 30.0% of men and 27.6% of women; HDL-C and low density lipoprotein cholesterin (LDL-C) in most of the involved people were appropriate. ③ HOMA-IR increased as the TG level increased and HDL-C decreased; HOMA-IR increased as the LDL-C level increased, which was significant in the females (Plt;0.05). ④ HDL-C was positively correlated with HOMA-IR (r=-0.145, P=0.000); LDL-C was positively correlated with HOMA-IR (r=0.099, P=0.010). Conclusion The increase of hypertriglyceridemia was the most frequent type of the dislipidemia in the elder people in Chengdu; HDL-C level is higher in women than in men. Dyslipidemia is correlated with insulin resistance.
Objective To assess the efficacy and safety of Xuezhikang capsule (XZK) for hyperlipidemia. Methods MEDIINE，EMBASE, Cochrane Central Register of Controlled Trials(CCTR), Cochrane Metabolic and Endocrine Disorders Group data bank, and Chinese Biomedical Database(CBM), China Hospital Knowledge Database(CHKD) were searched，and the published/unpublished information was handsearched (updated to Dec., 2005) to identify randomized controlled trials (RCTs) or quasi-RCT of XZK versus statins or other lipid lowering drugs in treating hyperlipidemia patients. The quality evaluation, data extraction and analysis were conducted by the method recommended in Cochrane Reviewer’s Handbook 4.2.2. Data were analyzed using Review Manager (Version 4.2). Results Eleven trials (conducted in China) were identified, including 1 073 patients with hyperlipidemia met the inclusion criteria. All the included RCTs were graded as B or C. ① The effect of XZK in reducing TC: There were no significant differences between XZK and statins ( WMD 0.06, 95%CI-0.09 to 0.20 and RR1.02, 95%CI 0.93 to 1.12), XZK and fibrates (WMD 0.05, 95%CI -0.22 to 0.31) and XZK and probucol(WMD 0.42, 95%CI -0.01 to 0.85). XZK was superior to hexanicit (WMD 0.96, 95%CI 0.73 to 1.18). ② The effect of XZK in reducing TG: XZK had the same effect as statins (WMD 0.02, 95%CI -0.10 to 0.14 and RR 1.17, 95%CI 0.92 to 1.49) and hexanicit (WMD 0.28, 95%CI -0.17 to 0.73 ).Meanwhile, XZK was superior to probucol (WMD 0.71, 95%CI 0.22 to 1.20), but it was not as good as fibrates (WMD -0.81, 95%CI -1.40 to -0.23). ③ The effect of XZK in increasing HDL-C：XZK had the same effect as that of statins (WMD -0.03, 95%CI -0.10 to 0.04 and RR 1.03, 95% CI 0.80 to 1.33). The effect of XZK was better than that of hexanicit (WMD 0.15, 95%CI 0.01 to 0.29). XZK had the same effect of fibrates (WMD 0.03, 95%CI -0.08 to 0.15) and probucol (WMD 0.04, 95%CI -0.16 to 0.24). ④ The effect of XZK in reducing LDL-C：The effects of XZK and statins were the same (WMD -0.23, 95%CI -0.61 to 0.15 and RR 1.15, 95%CI 0.75 to 1.77). The effect of XZK was better than that of hexanicit (WMD 0.53, 95%CI 0.16 to 0.90). Meanwhile, XZK had the same effect as those of fibrates (WMD 0.19, 95%CI -0.12 to 0.50) and probucol (WMD 0.35, 95%CI -0.03 to 0.73). ⑤ The adverse reactions of XZK were mainly the gastrointestinal tract reaction, while liver function abnormality and myalgia were scarcely found. Conclusion Xuezhikang capsule have the same effects as those of statins in reducing the levels of TC, TG, LDL-C and raising HDL-C in patients with hyperlipidemia. No obvious adverse reactions are found during the short-term treatment. But further confirmation with clinical randomized controlled trials of high quality, large sample and long-term follow-up is needed.