Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China.
MOH Key Laboratory of Geriatrics, Beijing Hospital, National Center of Gerontology, Beijing 100730, China.
Clin Biochem. 2021 Aug;94:42-47. doi: 10.1016/j.clinbiochem.2021.04.017. Epub 2021 Apr 21.
Abnormal lipid metabolism manifests as hypercholesterolemia in patients with obstructive jaundice due to lipoprotein X (LpX). Our aim was to explore the clinical laboratory characteristics of patients with obstructive jaundice accompanied by dyslipidemia in a large number of samples.
A total of 665 patients with obstructive jaundice were included and categorized into two groups (with/without dyslipidemia) based on the ratio of the sum of HDL-c and LDL-c to total cholesterol [(HDL-c + LDL-c)/TC] with a cut-off value of 0.695. Laboratory liver, kidney, and blood lipid parameters were determined. Cholesterol composition assessment was performed by ultracentrifugation and high-performance liquid chromatography (UC-HPLC), and serum protein profiles were analyzed by capillary electrophoresis.
Liver function in patients with obstructive jaundice accompanied by dyslipidemia was more aggravated than that in patients with simple obstructive jaundice (P < 0.05). The (HDL-c + LDL-c)/TC ratio was negatively correlated with bilirubin levels (P < 0.05). In addition, the difference in ApoB/LDL-c ratios was statistically significant between the obstructive jaundice accompanied by dyslipidemia group and healthy control group (P < 0.05). The LDL-c concentration determined by the UC-HPLC method was more than five times that determined by the enzymatic method (P < 0.05). Bisalbuminemia was found in 43 of 60 patients with obstructive jaundice accompanied by hypercholesterolemia.
In patients with obstructive jaundice, the decreased (HDL-c + LDL-c)/TC ratio may be a novel marker to identify dyslipidemia secondary to LpX. The decreased ratio was associated with poor liver function and indicated disease progression.
阻塞性黄疸患者由于脂蛋白 X (LpX) 导致脂代谢异常,表现为高胆固醇血症。我们的目的是在大量样本中探讨伴有血脂异常的阻塞性黄疸患者的临床实验室特征。
共纳入 665 例阻塞性黄疸患者,根据高密度脂蛋白胆固醇(HDL-c)与低密度脂蛋白胆固醇(LDL-c)之和与总胆固醇的比值[(HDL-c+LDL-c)/TC]是否大于 0.695 将患者分为两组(血脂异常组和无血脂异常组)。检测患者的肝功能、肾功能和血脂参数,采用超速离心联合高效液相色谱(UC-HPLC)方法评估胆固醇组成,应用毛细管电泳分析血清蛋白图谱。
伴有血脂异常的阻塞性黄疸患者的肝功能较单纯阻塞性黄疸患者更严重(P<0.05)。(HDL-c+LDL-c)/TC 比值与胆红素水平呈负相关(P<0.05)。此外,血脂异常组与健康对照组的 ApoB/LDL-c 比值差异有统计学意义(P<0.05)。UC-HPLC 法测定的 LDL-c 浓度是酶法的 5 倍以上(P<0.05)。在 60 例伴有高胆固醇血症的阻塞性黄疸患者中,发现了 43 例双白蛋白血症。
在阻塞性黄疸患者中,降低的(HDL-c+LDL-c)/TC 比值可能是识别 LpX 引起的血脂异常的新标志物。比值降低与肝功能较差相关,提示疾病进展。