上海交通大学学报（医学版）

上海交通大学学报（医学版） >

2022 , Vol. 42 >Issue 4: 482 - 489

DOI: https://doi.org/10.3969/j.issn.1674-8115.2022.04.010

论著 · 临床研究

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 ,
  • 何津春 ,
  • 张燕培 ,
  • 王耀东 ,
  • 王占科
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  • 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
何志洁（1995—），女，硕士生；电子信箱：hezhj16@lzu.edu.cn。
何津春，电子信箱：jinchunhe@163.com。

收稿日期: 2021-12-27

  录用日期: 2022-04-10

  网络出版日期: 2022-04-28

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)

收起

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

  • Zhijie HE ,
  • Jinchun HE ,
  • Yanpei ZHANG ,
  • Yaodong WANG ,
  • Zhanke WANG
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  • 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
HE Jinchun, E-mail: jinchunhe@163.com.

Received date: 2021-12-27

  Accepted date: 2022-04-10

  Online published: 2022-04-28

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)

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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

本文引用格式

何志洁 , 何津春 , 张燕培 , 王耀东 , 王占科 . 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[J]. 上海交通大学学报（医学版）, 2022 , 42(4) : 482 -489 . DOI: 10.3969/j.issn.1674-8115.2022.04.010

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

参考文献

1 LAHOZ C, MOSTAZA J M. Familial hypertriglyceridemia/polygenic hypertrigliceridemia[J]. Clin Investig Arterioscler, 2021, 33(Suppl 2): 37-42.
2 CARRASQUILLA G D, CHRISTIANSEN M R, KILPEL?INEN T O. The genetic basis of hypertriglyceridemia[J]. Curr Atheroscler Rep, 2021, 23(8): 39.
3 CRUZ-BAUTISTA I, HUERTA-CHAGOYA A, MORENO-MACíAS H, et al. Familial hypertriglyceridemia: an entity with distinguishable features from other causes of hypertriglyceridemia[J]. Lipids Health Dis, 2021, 20(1): 14.
4 诸骏仁, 高润霖, 赵水平, 等. 中国成人血脂异常防治指南(2016年修订版)[J]. 中国循环杂志, 2016, 31(10): 937-953.
4 ZHU J R, GAO R L, ZHAO S P, et al. The guidelines for prevention and treatment of dyslipidemia in Chinese adults (revised edition 2016)[J]. Chin J Cardiol, 2016, 44(10): 833-853.
5 KULKARNI K R. Cholesterol profile measurement by vertical auto profile method[J]. Clin Lab Med, 2006, 26(4): 787-802.
6 刘维娟, 周珊珊, 何津春, 等. 家族性高三酰甘油血症诊断标准及鉴别诊断[J]. 医学综述, 2014, 20(17): 3089-3091.
6 LIU W J, ZHOU S S, HE J C, et al. Diagnostic criteria and differential diagnosis of familial hypertriglyceridemia[J]. Med Recapitulate, 2014, 20(17): 3089-3091.
7 梁纯子, 朱满, 涂建成. VAP检测血浆脂蛋白亚组分的新进展及应用分析[J]. 检验医学, 2019, 34(1): 76-81.
7 LIANG C Z, ZHU M, TU J C, Research progress of VAP in determining plasma lipoprotein subfractions[J]. Lab Med, 2019, 34(1): 76-81.
8 PAN L, YANG Z H, WU Y, et al. The prevalence, awareness, treatment and control of dyslipidemia among adults in China[J]. Atherosclerosis, 2016, 248: 2-9.
9 张娜, 张海燕, 郭晓红, 等. 中国近十年急性胰腺炎病因变化特点的Meta分析[J]. 中华消化病与影像杂志(电子版), 2016, 6(2): 71-75.
9 ZHANG N, ZHANG H Y, GUO X H, et al. Changes of etiology in acute pancreatitis in recent 10 years in China: Meta-analysis[J]. Chin J Digest Med Imageol (Electronic Edition), 2016, 6(2): 71-75.
10 OLESEN S S, HARAKOW A, KROGH K, et al. Hypertriglyceridemia is often under recognized as an aetiologic risk factor for acute pancreatitis: a population-based cohort study[J]. Pancreatology, 2021, 21(2): 334-341.
11 SHAIK A, ROSENSON R S. Genetics of triglyceride-rich lipoproteins guide identification of pharmacotherapy for cardiovascular risk reduction[J]. Cardiovasc Drugs Ther, 2021, 35(3): 677-690.
12 中华医学会心血管病学分会循证医学评论专家组, 中国老年学学会心脑血管病专业委员会. 甘油三酯增高的血脂异常防治中国专家共识[J]. 中华心血管病杂志, 2011, 39(9): 793-796.
12 Expert Group of Evidence-based Medicine Review of Cardiovascular Credit Association of Chinese Medical Association, Professional Committee of Cardiovascular and Cerebrovascular Diseases of Chinese Gerontology Society. Consensus of Chinese experts on the prevention and treatment of dyslipidemia caused by elevated triglycerides[J]. Chin J Cardiol, 2011, 39(9): 793-796.
13 FARUKHI Z, MORA S. Is it time to abandon fasting for routine lipid testing? [J]. Clevel Clin J Med, 2017, 84(12): 919-922.
14 JUSTESEN J M, ALLIN K H, SANDHOLT C H, et al. Interactions of lipid genetic risk scores with estimates of metabolic health in a Danish population[J]. Circ Cardiovasc Genet, 2015, 8(3): 465-472.
15 REINER ?. Triglyceride-rich lipoproteins and novel targets for anti-atherosclerotic therapy[J]. Korean Circ J, 2018, 48(12): 1097-1119.
16 LANGLOIS M R, CHAPMAN M J, COBBAERT C, et al. Quantifying atherogenic lipoproteins: current and future challenges in the era of personalized medicine and very low concentrations of LDL cholesterol. A consensus statement from EAS and EFLM[J]. Clin Chem, 2018, 64(7): 1006-1033.
17 HALLéN J, SREEHARAN N. Development of triglyceride-lowering drugs to address residual cardiovascular risk: strategic and clinical considerations[J]. Eur Heart J Cardiovasc Pharmacother, 2018, 4(4): 237-242.
18 NORDESTGAARD B G. Triglyceride-rich lipoproteins and atherosclerotic cardiovascular disease: new insights from epidemiology, genetics, and biology[J]. Circ Res, 2016, 118(4): 547-563.
19 ALLAIRE J, VORS C, COUTURE P, et al. LDL particle number and size and cardiovascular risk: anything new under the sun? [J]. Curr Opin Lipidol, 2017, 28(3): 261-266.
20 MARTIN S S, KHOKHAR A A, MAY H T, et al. HDL cholesterol subclasses, myocardial infarction, and mortality in secondary prevention: the Lipoprotein Investigators Collaborative[J]. Eur Heart J, 2015, 36(1): 22-30.
21 ZHAO M, GUO Z H, JIA G W, et al. Influencing factors of coronary artery Stenosis in patients with stable coronary heart disease and a correlation analysis[J]. Am J Transl Res, 2021, 13(8): 9522-9529.
22 SINGH A, PUHAN R, PRADHAN A, et al. Small dense low-density lipoprotein for risk prediction of acute coronary syndrome[J]. Cardiol Res, 2021, 12(4): 251-257.
23 YU Y, WANG L, ZHU X, et al. Sodium ozagrel and atorvastatin for type 2 diabetes patients with lacunar cerebral infarction[J]. World J Diabetes, 2021, 12(12): 2096-2106.
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