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死后评估胆固醇、甘油三酯和载脂蛋白水平。

Postmortem evaluation of cholesterol, triglyceride, and apolipoprotein levels.

机构信息

CURML, University Center of Legal Medicine, Lausanne University Hospital, Chemin de la Vulliette 4, 1000, Lausanne, Switzerland.

Department of Legal Medicine, University of Genova, Via de Toni 12, Genoa, Italy.

出版信息

Int J Legal Med. 2017 Nov;131(6):1777-1782. doi: 10.1007/s00414-017-1669-4. Epub 2017 Aug 18.

Abstract

Cholesterol and triglyceride levels have been analyzed in the forensic setting and their values correlated with atherosclerotic lesions found at autopsy and histology. Nevertheless, the results of these investigations have provided diverging information on postmortem molecule stability and postmortem measurement reliability. The aim of this study was to determine triglycerides, total cholesterol, low-density and high-density lipoprotein cholesterol, apolipoprotein B, and apolipoprotein A-I in antemortem and postmortem serum samples in a series of cases (N = 10, including cardiac and noncardiac deaths) that underwent forensic investigations and had both samples available, measure the same molecules in postmortem serum from femoral blood and pericardial and pleural fluids (N = 39, including cardiac and noncardiac deaths), and evaluate whether different levels of these molecules could be observed in cases characterized by different degrees of coronary artery atherosclerosis (N = 39, including cardiac and noncardiac deaths). Preliminary results indicated that total cholesterol and low-density and high-density lipoprotein cholesterol levels in postmortem serum samples tended to be lower than those in antemortem specimens, whereas triglyceride levels in postmortem serum samples tended to be higher than those in antemortem samples. No relationship could be found between postmortem serum and pericardial fluid levels or between postmortem serum and pleural fluid levels of all tested biomarkers. Lastly, cases characterized by severe coronary artery atherosclerosis revealed higher postmortem serum levels of total cholesterol and apolipoprotein B. Globally considered, these data confirm that femoral blood postmortem serum levels of cholesterol and apolipoproteins may be considered suitable to estimate their antemortem values in forensic cases characterized by coronary artery atherosclerosis.

摘要

在法医学环境中分析了胆固醇和甘油三酯水平,并将其与尸检和组织学发现的动脉粥样硬化病变相关联。然而,这些研究的结果提供了关于死后分子稳定性和死后测量可靠性的相互矛盾的信息。本研究的目的是确定一系列进行法医调查并有两份样本的案例(N=10,包括心源性和非心源性死亡)的生前和死后血清样本中的甘油三酯、总胆固醇、低密度和高密度脂蛋白胆固醇、载脂蛋白 B 和载脂蛋白 A-I,测量死后从股动脉血、心包和胸腔积液中获得的相同分子(N=39,包括心源性和非心源性死亡),并评估这些分子的不同水平是否可以观察到不同程度的冠状动脉粥样硬化的病例(N=39,包括心源性和非心源性死亡)。初步结果表明,死后血清样本中的总胆固醇、低密度和高密度脂蛋白胆固醇水平往往低于生前样本,而死后血清样本中的甘油三酯水平往往高于生前样本。死后血清与心包液或死后血清与胸腔液之间的所有测试生物标志物水平之间均未发现关系。最后,冠状动脉粥样硬化严重的病例显示出更高的死后血清总胆固醇和载脂蛋白 B 水平。总体而言,这些数据证实,股动脉死后血清中的胆固醇和载脂蛋白水平可用于估计法医学中冠状动脉粥样硬化病例的生前值。

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