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肝豆状核变性患者的血脂异常模式及相关因素:一项临床分析

Dyslipidemia patterns and associated factors in Wilson's disease patients: a clinical analysis.

作者信息

Wu Rong, Luo Xingguang, Wang Xiao-Ping

机构信息

Department of Neurology, Tongren Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, United States.

出版信息

Front Neurol. 2024 Nov 20;15:1411236. doi: 10.3389/fneur.2024.1411236. eCollection 2024.

Abstract

OBJECTIVE

This study aims to analyze the lipid metabolism patterns and identify risk factors for dyslipidemia in Wilson's Disease (WD), offering novel insights into diagnosis and treatment strategies for unexplained dyslipidemia.

METHODS

Data from Wilson's disease patients hospitalized at the First People's Hospital of Shanghai from December 2008 to February 2015 were collected. Patients were categorized into normal lipid (46 cases) and dyslipidemia (42 cases) groups based on lipid levels. Group analyzes were conducted using t-tests, chi-square analysis, and rank sum tests. Spearman correlation, multiple linear regression, or Logistic regression were employed to identify relevant influencing factors.

RESULTS

  1. The incidence of abnormal blood lipids in a series of Wilson's disease patients was 47.73% (25.12 ± 1.29 years old), and the incidence of control healthy group was 27.40%, with proportions of hypercholesterolemia, hypertriglyceridemia, and low-density lipoprotein cholesterol being 14.77, 30.68, and 29.63%, respectively; 2. Significant differences were observed between the dyslipidemia and normal WD groups in AST/ALT ratio, liver parenchymal echo, liver surface, spleen area, and ultrasound total score.3. Low-and high-density lipoprotein cholesterols (LDL-c and HDL-c) showed no significant correlation with these indicators. Triglyceride (TG) exhibited moderately negative correlation with AST/ALT, liver parenchymal echo, spleen area, and ultrasound score. Total cholesterol (TC) displayed low negative correlation with these factors.

CONCLUSION

  1. Dyslipidemia incidence in Wilson's disease patients may exceed that of the normal population, especially in adolescents with unexplained abnormal lipid metabolism; 2. Patients with mild to moderate liver damage are predisposed to elevated triglycerides and total cholesterol, reflecting liver damage impact on lipid metabolism; 3. Glucose metabolism is not implicated in WD-related dyslipidemia; 4. No significant correlation was found between abnormal lipid metabolism and blood concentration of trace elements in WD patients.
摘要

目的

本研究旨在分析肝豆状核变性(WD)患者的脂质代谢模式,并确定血脂异常的危险因素,为不明原因血脂异常的诊断和治疗策略提供新的见解。

方法

收集2008年12月至2015年2月在上海市第一人民医院住院的肝豆状核变性患者的数据。根据血脂水平将患者分为血脂正常组(46例)和血脂异常组(42例)。采用t检验、卡方分析和秩和检验进行组间分析。采用Spearman相关性分析、多元线性回归或Logistic回归来确定相关影响因素。

结果

  1. 一系列肝豆状核变性患者血脂异常发生率为47.73%(年龄25.12±1.29岁),健康对照组发生率为27.40%,高胆固醇血症、高甘油三酯血症和低密度脂蛋白胆固醇的比例分别为14.77%、30.68%和29.63%;2. 血脂异常组与肝豆状核变性正常组在AST/ALT比值、肝实质回声、肝表面、脾面积和超声总分方面存在显著差异。3. 低密度和高密度脂蛋白胆固醇(LDL-c和HDL-c)与这些指标无显著相关性。甘油三酯(TG)与AST/ALT、肝实质回声、脾面积和超声评分呈中度负相关。总胆固醇(TC)与这些因素呈低度负相关。

结论

  1. 肝豆状核变性患者血脂异常发生率可能超过正常人群,尤其是脂质代谢异常原因不明的青少年;2. 轻度至中度肝损伤患者易出现甘油三酯和总胆固醇升高,反映肝损伤对脂质代谢的影响;3. 糖代谢与肝豆状核变性相关的血脂异常无关;4. 肝豆状核变性患者脂质代谢异常与微量元素血浓度之间未发现显著相关性。

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Cell Metab. 2024 Jul 2;36(7):1439-1455. doi: 10.1016/j.cmet.2024.05.003. Epub 2024 May 31.
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The Function of ATPase Copper Transporter ATP7B in Intestine.ATP 酶铜转运蛋白 ATP7B 在肠道中的功能
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