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[预防性体检期间原发性高脂蛋白血症的诊断]

[Diagnosis of primary hyperlipoproteinemia during a preventive examination].

作者信息

Raslová K, Mongiellová V, Hucková M

机构信息

Výskumný ústav medicínskej informatiky, oddelenie klinickej biochémie FN, Bratislava.

出版信息

Cas Lek Cesk. 1993 Mar 8;132(5):137-41.

PMID:8472293
Abstract

The study analyses the occurrence and etiology of hyperlipoproteinemia (HLP) in healthy middle-aged probands who participated in a preventive examination. Frequency of HLP was 35%. After a 2-month low-cholesterol-diet, a control biochemical examination was done. The concentration of serum triglycerides decreased significantly (3.02 +/- 1.47, 2.02 +/- 1.14, p < 0.05, respectively). The occurrence of type IV HLP decreased from 51.6% to 24.4% (p < 0.003). For the analysis of etiology of HLP we divided the hyperlipemic probands on the basis of presence of normolipemy (I. group), or HLP (II. group) in the control, and compared the lipid levels between them. We found out that the cholesterol levels in the II. group were significantly higher than in the I. group already before the diet-period (7.0 +/- 0.87 mmol/l, 5.85 +/- 0.81 respectively, p < 0.001), although the both groups did not differ in the triglyceride levels. Genetic examination in families revealed familial combined HLP in 24.4%, primary hypercholesterolemia in 12%, familial hypertriglyceridemia in 2% polygenic hypertriglyceridemia in 18%. We found out not only very high incidence of HLP in a sample of Slovak population but also that the most cases have the genetic background. The most frequent type of HLP was type IV. Since the triglyceride levels give poor information about the coronary risk, we recommend to examine the HDL-cholesterol already in the screening preventive programs.

摘要

该研究分析了参加预防性体检的健康中年受试者中高脂蛋白血症(HLP)的发生情况及病因。HLP的发生率为35%。经过2个月的低胆固醇饮食后,进行了对照生化检查。血清甘油三酯浓度显著降低(分别为3.02±1.47、2.02±1.14,p<0.05)。IV型HLP的发生率从51.6%降至24.4%(p<0.003)。为分析HLP的病因,我们根据对照组中血脂正常(I组)或HLP(II组)的情况对高脂血症受试者进行分组,并比较两组之间的血脂水平。我们发现,在饮食期前,II组的胆固醇水平就显著高于I组(分别为7.0±0.87 mmol/l、5.85±0.81,p<0.001),尽管两组的甘油三酯水平无差异。对家族进行的基因检测显示,家族性混合性HLP占24.4%,原发性高胆固醇血症占12%,家族性高甘油三酯血症占2%,多基因性高甘油三酯血症占18%。我们发现,在斯洛伐克人群样本中,HLP的发生率不仅很高,而且大多数病例具有遗传背景。最常见的HLP类型为IV型。由于甘油三酯水平对于冠状动脉风险的信息提供不足,我们建议在筛查预防性项目中就检测高密度脂蛋白胆固醇。

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