Tacikowski Tadeusz, Dzieniszewski Jan, Nowicka Grazyna, Ciok Janusz
Clinic of Metabolic Diseases and Gastroenterology, National Institute of Food and Nutrition, Warsaw, Poland.
Med Sci Monit. 2002 Oct;8(10):CR697-701.
The purpose of our study was to compare lipid profile assessed by ultracentrifugation in various types of hyperlipoproteinemia (HLP) in correlation with obesity and hepatic steatosis diagnosed in the ultrasonic examination of the abdominal cavity.
MATERIAL/METHODS: We studied 64 patients (38 women and 26 men with a mean age of 53.5 years) with various types of HLP, divided into two groups: 1) hypercholesterolemia, 2) mixed hyperlipoproteinemia. Lipid profile by ultracentrifugation was performed simultaneously with ultrasonic examination.
Among 33 patients with hypercholesterolaemia, 7 had hepatic steatosis (21.2%), with a mean serum TG concentration significantly higher than in those patients without steatosis. Of the mixed HLP patients, 16 had hepatic steatosis (51.5%), with a mean serum TG level over twice the concentration found in patients without steatosis. We found significantly higher levels of total cholesterol and triglycerides in patients with steatosis than in those without. In the HDL fraction, the cholesterol concentration was lower (38.4 mg/dl) in cases of steatosis than in cases without (48.0 mg/dl).
Patients with steatosis showed features characteristic of insulin resistance syndrome, i.e. higher BMI values, higher mean serum TG, and low HDL cholesterol concentrations. In patients with hypercholesterolemia and hepatic steatosis, increased serum triglycerides are associated with increased TG concentration in the VLDL fraction. Mixed HLP patients with hepatic steatosis have higher TG and cholesterol in the VLDL fraction, and in these cases a significant rise in total TG is observed.
我们研究的目的是比较通过超速离心法评估的各种类型高脂蛋白血症（HLP）患者的血脂谱，并将其与通过腹腔超声检查诊断出的肥胖和肝脂肪变性进行相关性分析。
材料/方法：我们研究了64例各种类型HLP患者（38名女性和26名男性，平均年龄53.5岁），分为两组：1）高胆固醇血症，2）混合型高脂蛋白血症。超速离心法测定血脂谱的同时进行超声检查。
在33例高胆固醇血症患者中，7例有肝脂肪变性（21.2%），其血清甘油三酯（TG）平均浓度显著高于无肝脂肪变性的患者。在混合型HLP患者中，16例有肝脂肪变性（51.5%），其血清TG平均水平是无肝脂肪变性患者的两倍多。我们发现有肝脂肪变性的患者总胆固醇和甘油三酯水平明显高于无肝脂肪变性的患者。在高密度脂蛋白（HDL）组分中，有肝脂肪变性的患者胆固醇浓度（38.4mg/dl）低于无肝脂肪变性的患者（48.0mg/dl）。
有肝脂肪变性的患者表现出胰岛素抵抗综合征的特征，即较高的体重指数（BMI）值、较高的血清TG平均水平和较低的HDL胆固醇浓度。在高胆固醇血症合并肝脂肪变性的患者中，血清甘油三酯升高与极低密度脂蛋白（VLDL）组分中TG浓度升高有关。合并肝脂肪变性的混合型HLP患者VLDL组分中的TG和胆固醇含量更高，在这些情况下，总TG显著升高。
