上海交通大学学报(医学版) ›› 2022, Vol. 42 ›› Issue (4): 482-489.doi: 10.3969/j.issn.1674-8115.2022.04.010

• 论著 · 临床研究 • 上一篇    下一篇

基于垂直密度梯度离心全自动血脂谱检测法的家族性高三酰甘油血症家系血脂亚组分分析

何志洁1(), 何津春1,2(), 张燕培1, 王耀东1, 王占科3   

  1. 1.兰州大学第一临床医学院,兰州 730013
    2.兰州大学第一医院检验科,兰州 730013
    3.宁波美康盛德医学检验所,宁波 315105
  • 收稿日期:2021-12-27 接受日期:2022-04-10 出版日期:2022-04-28 发布日期:2022-04-28
  • 通讯作者: 何津春 E-mail:hezhj16@lzu.edu.cn;jinchunhe@163.com
  • 作者简介:何志洁(1995—),女,硕士生;电子信箱:hezhj16@lzu.edu.cn
  • 基金资助:
    国家“十五”重大科技专项(2002BA711A08-17);甘肃省自然科学基金(1308RJZA218);甘肃省中医药管理局科研课题(GZK-2017-50);甘肃省戒毒管理局横向委托课题(2014-02);甘肃省功能基因组与分子诊断重点实验室开放课题(2016-001)

Analysis of lipoprotein subclasses of family with familial hypertriglyceridemia based on VAP method

HE Zhijie1(), HE Jinchun1,2(), ZHANG Yanpei1, WANG Yaodong1, WANG Zhanke3   

  1. 1.First School of Clinical Medicine, Lanzhou University, Lanzhou 730013, China
    2.Clinical Laboratory, First Hospital of Lanzhou University, Lanzhou 730013, China
    3.Ningbo Meikang Shengde Medical Laboratory, Ningbo 315105, China
  • Received:2021-12-27 Accepted:2022-04-10 Online:2022-04-28 Published:2022-04-28
  • Contact: HE Jinchun E-mail:hezhj16@lzu.edu.cn;jinchunhe@163.com
  • Supported by:
    National Science and Technology Major Project of the Ministry of Science and Technology of China during the“10th Five-Year Plan”(2002BA711A08-17);Natural Science Foundation of Gansu Province(1308RJZA218);Research Project of Gansu Provincial Administration of Traditional Chinese Medicine(GZK2017-50);Horizontally Commissioned Project of Gansu Drug Rehabilitation Administration(2014-02);Open Project of Gansu Provincial Key Laboratory of Functional Genomics and Molecular Diagnosis(2016-001)

摘要:

目的·分析家族性高三酰甘油血症(familial hypertriglyceridemia,FHTG)家系成员血脂亚组分的特征。方法·收集兰州大学第一医院1个符合FHTG家系诊断标准的FHTG家系,纳入该家系13位成员,根据家系成员三酰甘油(triacylglycerol,TAG)水平是否升高(≥2.26 mmol/L)分为高TAG组(n=7)和对照组(n=6)。通过面对面的调查,收集家系成员的年龄、性别、身高、体质量、体质量指数(body mass index,BMI)、腰围、生活习惯及病史等一般资料,并根据调查结果绘制家系系谱图。家系成员空腹8~12 h后,采集外周静脉血样本进行生化项目检测,并采用垂直密度梯度离心全自动血脂谱检测法(vertical auto profile,VAP)测定研究对象血清血脂亚组分,主要包括TAG、总胆固醇、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、低密度脂蛋白[low-density lipoprotein,LDL]、极低密度脂蛋白(very-low-density lipoprotein,VLDL)、极低密度脂蛋白3(very-low-density lipoprotein 3,VLDL3)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、高密度脂蛋白2(high-density lipoprotein 2,HDL2)、高密度脂蛋白3(high-density lipoprotein 3,HDL3)、中间密度脂蛋白、脂蛋白残粒、脂蛋白a、非高密度脂蛋白;VAP基于LDL最大时间值分析LDL密度模式。用垂直脂蛋白图谱法(vertical lipoprotein profile,VLP)检测研究对象血清低密度脂蛋白颗粒(low-density lipoprotein particle,LDL-P)。采用独立样本t检验比较对照组和高TAG组血脂亚组分水平的差异。结果·FHTG家系高TAG组的身高、体质量、BMI和腰围显著高于对照组(P=0.022,P=0.000,P=0.001,P=0.000)。2组间性别差异有统计学意义(P=0.029),年龄差异无统计学意义(P=0.561)。高TAG组TAG、VLDL、VLDL3、LDL-P水平均高于对照组(P=0.003,P=0.033,P=0.020,P=0.043),HDL-C、HDL2、HDL3水平均低于对照组(P=0.000,P=0.001,P=0.001)。高TAG组LDL密度模式均为小而密,而对照组LDL密度模式为混合或大而疏。其他指标之间的差异没有统计学意义。结论·除临床常用的TAG、HDL-C外,VLDL、VLDL3、LDL-P、小而密LDL、HDL2、HDL3有望成为FHTG诊断和治疗的指标。

关键词: 家族性高三酰甘油血症, 垂直密度梯度离心全自动血脂谱检测法, 血脂亚组分, 三酰甘油, 心血管疾病

Abstract:

Objective·To analyze the characteristics of lipoprotein subclasses of family members with familial hypertriglyceridemia (FHTG).

Methods·A FHTG family with 13 members meeting the diagnostic criteria of the FHTG family was collected at the First Hospital of Lanzhou University. They were divided into the high triacylglycerol (TAG) group (7 persons) and the control group (6 persons) according to whether the level of TAG of the family members increased (≥2.26 mmol/L). Through the face-to-face investigation, age, gender, height, weight, body mass index (BMI), waist circumference, living habits and medical history and other general information of each member were collected. Based on the survey results, a family tree was drawn. After 8?12 h in abrosia, peripheral venous blood samples of the family members were collected for biochemical testing. The vertical auto profile (VAP) was used to determine the serum lipoprotein subclasses of the study subjects, including TAG, total cholesterol, low-density lipoprotein cholesterol (LDL-C), low-density lipoprotein (LDL), very low-density lipoprotein (VLDL), very low-density lipoprotein 3 (VLDL3), high-density lipoprotein cholesterol (HDL-C), high-density lipoprotein 2 (HDL2), high-density lipoprotein 3 (HDL3), intermediate-density lipoprotein, remnant-like lipoprotein particle, lipoprotein a and non-high-density lipoprotein. The LDL pattern was obtained by VAP method based on the analysis of LDL max time value. The vertical lipoprotein profile (VLP) was used to determine the serum low-density lipoprotein particle (LDL-P) of the study subjects. The levels of lipoprotein subclasses between the control group and the high TAG group were compared by independent sample t test.

Results·Compared with the control group, the high TAG group in FHTG pedigree had remarkably higher levels of height, weight, BMI and waist circumference (P=0.022, P=0.000, P=0.001, P=0.000). There was statistical significance in gender difference between the two groups (P=0.029), but there was no significant difference in age (P=0.561). Compared with the control group, the high TAG group had remarkably higher levels of TAG, VLDL, VLDL3 and LDL-P (P=0.003, P=0.033, P=0.020, P=0.043), and remarkably lower level of HDL-C, HDL2 and HDL3 (P=0.000, P=0.001, P=0.001). The LDL pattern in the high TAG group was small and dense, while the LDL pattern in the normal control group was mixed or large and sparse. There were no significant differences between other indicators.

Conclusions·In addition to the TAG and HDL-C commonly used in clinical practice, VLDL, VLDL3, LDL-P, small and dense LDL, HDL2 and HDL3 are expected to become the indicators for FHTG diagnosis and treatment.

Key words: familial hypertriglyceridemia (FHTG), vertical auto profile (VAP), lipoprotein subclasses, triacylglycerol (TAG), cardiovascular disease

中图分类号: