Noel M A, Smith T K, Ettinger W H
Department of Internal Medicine, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
J Am Geriatr Soc. 1991 May;39(5):455-61. doi: 10.1111/j.1532-5415.1991.tb02489.x.
This research project was undertaken to determine the clinical characteristics, lipoprotein abnormalities, and outcomes of older hospitalized patients who develop hypocholesterolemia.
The project had two parts: (1) a retrospective, case-control study of 50 hospitalized patients greater than or equal to 65 years old whose serum cholesterol was normal on admission (greater than or equal to 160 mg/dL) and fell to less than or equal to 120 mg/dL during hospitalization; (2) a laboratory study of lipoproteins in 17 hospitalized patients greater than or equal to 65 years old whose cholesterol was normal on admission but fell to less than or equal to 120 mg/dL during hospitalization.
Case-control Study--Nine percent of patients greater than or equal to 65 years old developed hypocholesterolemia while in the hospital, and these patients were more likely than controls to have undergone surgery and to have nothing by mouth for 5 days or longer. Cases had a longer length of stay, more complications, and were slightly more likely to die in the hospital than controls. LABORATORY STUDY--Hypocholesterolemic patients had low concentrations of all lipoproteins (VLDL, LDL, HDL), and the LDL and HDL were enriched in triglyceride and depleted of cholesterol ester.
Acquired hypocholesterolemia is a common finding in hospitalized older patients and is associated with poor outcomes. Patients who became hypocholesterolemic in the hospital had both a low concentration of lipoprotein particles and abnormalities in lipoprotein particle composition.
开展本研究项目以确定发生低胆固醇血症的老年住院患者的临床特征、脂蛋白异常情况及预后。
该项目分为两部分：（1）一项回顾性病例对照研究，研究对象为50名年龄大于或等于65岁的住院患者，这些患者入院时血清胆固醇正常（大于或等于160mg/dL），但在住院期间降至小于或等于120mg/dL；（2）一项针对17名年龄大于或等于65岁的住院患者的脂蛋白实验室研究，这些患者入院时胆固醇正常，但在住院期间降至小于或等于120mg/dL。
病例对照研究——年龄大于或等于65岁的患者中有9%在住院期间发生了低胆固醇血症，与对照组相比，这些患者更有可能接受过手术，且禁食5天或更长时间。病例组的住院时间更长，并发症更多，且在医院死亡的可能性略高于对照组。实验室研究——低胆固醇血症患者的所有脂蛋白（极低密度脂蛋白、低密度脂蛋白、高密度脂蛋白）浓度均较低，且低密度脂蛋白和高密度脂蛋白富含甘油三酯，胆固醇酯含量减少。
获得性低胆固醇血症在老年住院患者中很常见，且与不良预后相关。在医院发生低胆固醇血症的患者不仅脂蛋白颗粒浓度低，而且脂蛋白颗粒组成也异常。
