中国冶金工业医学杂志

老年肥胖者脂蛋白、载脂蛋白的水平变化及他汀的干预分析

作者：田改生1 王璐2

分类号：R 543.5

出版年,卷(期):页码：2019,36(6):623-625

摘要：

摘要：目的观察老年肥胖者脂蛋白（a）［Lp（a）］、载脂蛋白A1（ApoA1）、载脂蛋白B（ApoB）和血脂（TG、TC、HDL-C、LDL-C）水平变化，以及应用他汀类药物半年及以上的肥胖者Lp（a）、载脂蛋白、血脂的变化和对颈动脉内膜中层厚度（CIMT）的影响。方法入选老年肥胖者127例，分两组，治疗组63例，非治疗组64例。另选健康者20例为对照组。记录入选者身高、体重，检测TG、TC、HDL-C、LDL-C、ApoA1、ApoB、Lp（a）和CIMT，计算体质指数（BMI）、ApoA1/ApoB，评定颈动脉斑块积分。组间对比各指标的差异，分析BMI及CIMT与各因素的相关性。结果（1）老年肥胖者TG、TC、LDL-C、ApoB、Lp（a）、CIMT高于对照组；HDL-C、ApoA1/ApoB低于对照组。（2）治疗组CIMT、TG、TC、ApoB、LDL-C低于非治疗组；治疗组HDL-C、ApoA1/ApoB高于非治疗组。（3）BMI与CIMT、TG、TC、LDL-C、ApoB、Lp（a）正相关，与HDL-C、ApoA1、ApoA1/ApoB负相关。CIMT与BMI、TC、LDL-C、ApoB、Lp（a）正相关；与HDL-C、ApoA1/ApoB负相关。结论老年肥胖者脂蛋白、载脂蛋白及血脂增高；他汀类药物可降低肥胖者血脂、载脂蛋白，升高HDL-C、延缓CIMT进展。

Abstract：Objective To observe the change of lipoprotein（a）（Lp（a））, apolipoprotein A1（ApoA1）, apolipoprotein B（ApoB））and Triglycerides （TG）, Totle cholesterol （TC）, high density lipoprotein cholesterol（HDL-C）, low density lipoprotein cholesterol（LDL-C）of elderly obese , as well as the change of the obesity’s Lp（a）, apolipoproteins, blood lipid levels and investigate the influences on their Carotid intima-media thickness（CIMT）after used statins for six months or longer. Methods 127 obesities were selected and divided into treatment group of 63 cases and non-treatment group of 64 cases. 20 healthy volunteers were randomly selected as control group. The parameters of height, weight, TG, TC, HDL-C, LDL-C, ApoA1, ApoB, Lp（a） and CIMT, calculate body mass index（BMI）, ApoA1/ ApoB and plaque score. Differences of groups were compared. The correlation about BMI and CIMT with various factors were analyzed. Results （1）TG, TC, LDL-C, ApoB, Lp（a）, CIMT in elder obese were higher than that in the control group，HDL-C, ApoA1/ApoB is lower than that in the control group. （2）CIMT, TG, TC, ApoB, LDL-C in treatment group were lower and HDL-C, ApoA1/ApoB were higher than that in non-treatment group. （3）BMI was positively correlated with CIMT, TG, TC, LDL-C, ApoB, Lp（a）and was negative correlation with HDL-C, ApoA1, ApoA1/ApoB. CIMT were positively correlated with BMI, TC, LDL-C, ApoB, Lp（a）and negatively correlated with HDL-C, ApoA1/ApoB. Conclusion Lipoprotein, apolipoprotein and blood lipids are increased in elderly obese people; statins can reduce blood lipids, apolipoproteins, increase HDL-C, and delay the progression of CIMT in obese.

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参考文献：

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