LDL-C和non-HDL-C对家族性高三酰甘油血症和家族性混合型高脂血症的鉴别诊断价值的比较

发布时间：2018-03-07 15:08

本文选题：低密度脂蛋白胆固醇(LDL-C)　切入点：非高密度脂蛋白胆固醇(non-HDL-C)　出处：《西安交通大学学报(医学版)》2017年03期 　论文类型：期刊论文

【摘要】：目的比较低密度脂蛋白胆固醇(LDL-C)和非高密度脂蛋白胆固醇(non-HDL-C)在家族性高三酰甘油血症(FHTG)和家族性混合型高脂血症(FCHL)鉴别诊断中的应用价值。方法选取9个FHTG家系共94人、24个FCHL家系共94人,根据血脂异常情况将2个家系再分为受累组和未受累组;另设10个对照家系(共57人)。比较各家系血清三酰甘油(TAG)、总胆固醇(TC)、HDL-C、LDL-C、non-HDL-C等血脂指标水平;FHTG家系和FCHL家系按TAG水平分层后,分析non-HDL-C和LDL-C的相关性;最后用受试者工作特征曲线(ROC曲线)分析比较nonHDL-C和LDL-C用于FHTG家系和FCHL家系鉴别诊断的cut-off值。结果 FHTG家系受累组TAG、TC、nonHDL-C水平均高于未受累组和对照组(P0.01或P0.05);FCHL家系受累组TAG、TC、HDL-C、LDL-C、nonHDL-C水平均高于未受累组和对照组(P0.01或P0.05);FHTG家系受累组TAG水平显著高于FCHL家系受累组(P0.01),而TC、HDL-C、LDL-C、non-HDL-C水平低于FCHL家系(P0.01或P0.05)。FHTG家系和FCHL家系内non-HDL-C和LDL-C均呈正相关,但随TAG水平升高其相关性均呈下降趋势;LDL-C和non-HDL-C用于FHTG家系和FCHL家系鉴别诊断的最佳cut-off值分别为3.575、4.525mmol/L。结论除常规血脂指标外,non-HDL-C可能是鉴别诊断FHTG家系和FCHL家系的新指标;其鉴别诊断价值可能优于LDL-C。
[Abstract]:Objective to compare the value of low density lipoprotein cholesterol (LDL-C) and non-high density lipoprotein cholesterol (non-HDL-C) in the differential diagnosis of familial hypertriglyceridemia and familial mixed hyperlipidemia. Methods Nine FHTG families were selected. A total of 94 people, 24 FCHL families, 94 people, According to the dyslipidemia, two families were divided into two groups: the affected group and the non-affected group, and the other 10 families (57 persons in total) were divided into two groups. The serum levels of serum triacylglycerol (TAGG), total cholesterol (TC), LDL-C (non-HDL-C) and other blood lipid indexes were compared between the FHTG family and the FCHL family according to the TAG level. The correlation between non-HDL-C and LDL-C was analyzed. Finally, the cut-off values of nonHDL-C and LDL-C in differential diagnosis of FHTG and FCHL families were analyzed and compared by using the operating characteristic curve (ROC curve). Results the levels of TCnonHDL-C in the FHTG family were higher than those in the unaffected group and the control group (P0.01 or P0.05FCHL). The level of TAG in the TCC group was higher than that in the unaffected group and the control group (P0.01 or P0.05FHTG), but the level of non-HDL-C and LDL-C in the FCHL family was significantly higher than that in the FCHL family group (P0.01 or P0.05. FHTG pedigree). The level of LDL-CnonHDL-C was significantly lower than that in the FCHL pedigree (P0.01 or P0.05FHTG pedigree), and the non-HDL-C and LDL-C levels in the FCHL pedigree were significantly lower than those in the FCHL pedigree (P0.01 or P0.05FHTG pedigree). However, with the increase of TAG level, the correlation between LDL-C and non-HDL-C was decreased. The best cut-off value of LDL-C and non-HDL-C for differential diagnosis of FHTG and FCHL families were 3.575 ~ 4.525 mmol / L, respectively. Conclusion in addition to routine blood lipid index, non-HDL-C may be a new index for differential diagnosis of FHTG and FCHL families. Its differential diagnostic value may be superior to that of LDL-C.
【作者单位】：兰州大学第一临床医学院;兰州大学第一医院医学检验中心;甘肃省人民医院检验中心;兰州大学第二医院儿童心理行为科;
【基金】：国家“十五”重大科技专项(No.2002BA711A08-17) 教育部科技基础平台建设(No.505015) 甘肃省自然科学研究基金(No.1308RJZA218,1302FKDA034) 甘肃省卫生行业科研计划管理项目(No.GW GL2014-48)~~
【分类号】：R589.2

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