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戒酒前后酒精性肝病女性患者的高密度脂蛋白亚组分、含载脂蛋白A-I的脂蛋白、脂蛋白(a)及胆固醇酯转运蛋白活性

High density lipoprotein subfractions, apolipoprotein A-I containing lipoproteins, lipoprotein (a), and cholesterol ester transfer protein activity in alcoholic women before and after ethanol withdrawal.

作者信息

Välimäki M, Kahri J, Laitinen K, Lahdenperä S, Kuusi T, Ehnholm C, Jauhiainen M, Bard J M, Fruchart J C, Taskinen M R

机构信息

Third Department of Medicine, University of Helsinki, Finland.

出版信息

Eur J Clin Invest. 1993 Jul;23(7):406-17. doi: 10.1111/j.1365-2362.1993.tb00783.x.

Abstract

We studied 11 female alcoholics before and after ethanol withdrawal of 2 weeks and 10 healthy normolipidaemic, nonalcoholic women of similar age. In alcoholic women the HDL2 mass was increased by 63% (P < 0.01) on admission and normalized (P < 0.01) during abstention. The concentrations of HDL3 cholesterol and its mass remained unchanged throughout the study. Consistently with the fall of HDL2 gradient gel electrophoresis analyses also demonstrated decrease of the cholesterol concentration of HDL2b and HDL2a (P < 0.05) during alcohol withdrawal. On admission the apo A-II concentration was increased by 48% (P < 0.01) and it was normalized (P < 0.001) during abstention. Among apo A-I containing lipoproteins the most prominent change occurred in Lp A-I:A-II, which fell by 32% (P < 0.01) during 1 week's alcohol withdrawal. During abstention the lipoprotein (a) concentration increased in 10 out of 11 women. In patients cholesteryl ester transfer (CETP) activity increased by 35% (P < 0.01) during 1 week of ethanol withdrawal. On admission postheparin plasma lipoprotein (LPL) and hepatic lipase activities were increased by 25% (P = NS); during 1 week's abstention they both returned to the control level (P < 0.05- < 0.01). In conclusion, chronic alcoholic women display multiple changes of lipoprotein metabolism which are rapidly reversed during abstinence. In contrast to alcoholic men, studied previously by us using the same study design and methods, there was no significant elevation of HDL3 cholesterol and apo A-I. The data suggest that alcohol interferes with several regulatory steps of HDL metabolism which are partly gender dependent.

摘要

我们对11名女性酗酒者在戒酒2周前后进行了研究,并选取了10名年龄相仿、血脂正常的健康非酗酒女性作为对照。酗酒女性入院时HDL2质量增加了63%(P<0.01),戒酒期间恢复正常(P<0.01)。整个研究过程中,HDL3胆固醇浓度及其质量保持不变。与HDL2下降一致,梯度凝胶电泳分析也显示戒酒期间HDL2b和HDL2a的胆固醇浓度降低(P<0.05)。入院时载脂蛋白A-II浓度增加了48%(P<0.01),戒酒期间恢复正常(P<0.001)。在含载脂蛋白A-I的脂蛋白中,最显著的变化发生在Lp A-I:A-II,在戒酒1周期间下降了32%(P<0.01)。戒酒期间,11名女性中有10名的脂蛋白(a)浓度升高。患者在戒酒1周期间胆固醇酯转移蛋白(CETP)活性增加了35%(P<0.01)。入院时,肝素后血浆脂蛋白脂肪酶(LPL)和肝脂肪酶活性增加了25%(P=无显著性差异);戒酒1周期间,二者均恢复至对照水平(P<0.05-<0.01)。总之,慢性酗酒女性表现出脂蛋白代谢的多种变化,这些变化在戒酒期间迅速逆转。与我们之前使用相同研究设计和方法研究的酗酒男性不同,HDL3胆固醇和载脂蛋白A-I没有显著升高。数据表明,酒精干扰了HDL代谢的几个调节步骤,部分存在性别依赖性。

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