小而密低密度脂蛋白与颈动脉 粥样硬化程度的相关性

Relationship between serum levels of small dense low-density lipoprotien cholesterol and the degree of carotid atherosclerosis

摘要:

目的 研究血清小而密低密度脂蛋白胆固醇（sdLDL-C）、低密度脂蛋白/ 高密度脂蛋白胆固 醇比值（LDL/HDL-C）及小而密低密度脂蛋白/ 高密度脂蛋白胆固醇比值（sdLDL/HDL-C）与颈动脉粥 样硬化程度的关系。方法 选取2018 年9 月—2019 年2 月在哈尔滨医科大学附属第四医院神经内科就诊 的227 例患者，根据彩超结果分为增厚组114 例和狭窄组113 例。另取同期该院100 例健康体检者作为对照 组。分别检测sdLDL-C 及其他血脂指标，计算各胆固醇比值，并分析各指标与颈动脉粥样硬化程度的关系。 结果 3 组血清sdLDL-C、HDL-C、载脂蛋白A、载脂蛋白B、LDL/HDL-C 及sdLDL/HDL-C 比较，差 异有统计学意义（P <0.05）。Logistic 回归分析显示，HDL-C[Ol ^ R=0.673（95% CI ：0.642，0.870），P =0.043] 是颈动脉粥样硬化的保护因素，sdLDL-C[Ol ^ R=4.790（95% CI ：1.816，12.632），P =0.002] 是颈动脉粥样硬化 的危险因素。Spearman 相关性分析显示，sdLDL-C 水平与总胆固醇、甘油三酯、LDL-C、LDL/HDL-C 及 sdLDL/HDL-C 呈正相关（r s =0.628、0.560、0.637、0.716 0.903，均P =0.000），与HDL-C 呈负相关（r s =-0.299， P =0.003）。结论 血清sdLDL-C 是颈动脉粥样硬化的重要危险因素，可用于评估颈动脉粥样硬化程度。

Abstract:

Objective To investigate the relationship between levels of small dense low-density lipoprotein (sdLDL-C), LDL-C/HDL-C ratio, sdLDL-C/HDL-C ratio and the degree of carotid atherosclerosis. Methods 227 patients in the Department of Neurology of the Fourth Affiliated Hospital of Harbin Medical University from September 2018 to February 2019 were recruited. According to the result of color Doppler ultrasonic detection, the patients were divided into the carotid intima-media thickening group (114 cases) and the carotid stenosis group (113 cases). 100 healthy people were randomly selected as the control group from the physical examination center during the same period. sdLDL-C and other lipid indexes were detected, the cholesterol ratio was calculated, and the relationship between the indexes and the degree of carotid atherosclerosis was analyzed. Results The values of serum sdLDL-C, HDL-C, APOA, APOB, LDL-C/HDL-C and sdLDL-C/HDL-C were significantly different in the control group, carotid intima-media thickening group and carotid stenosis group (P < 0.05). Logistic regression analysis showed HDL-C [Ol ^ R = 0.673 (95% CI: 0.642, 0.870), P = 0.0430] was the protective factor for carotid atherosclerosis, while sdLDL-C [Ol ^ R = 4.790 (95% CI: 1.816, 12.632), P = 0.0015] was a risk factor. Spearman correlation analysis showed that level of sdLDL-C was positively correlated with that of TC, TG, LDL-C, LDL-C/ HDL-C, and sdLDL-C/HDL-C (r s = 0.628, 0.56, 0.637, 0.716, 0.903, P < 0.05), but negatively correlated with that of HDL-C (r s = -0.299, P = 0.003). Conclusions sdLDL-C is an important risk factor for carotid atherosclerosis and can be used to evaluate the degree of carotid atherosclerosis.