Miida T, Sasaki H, Sato K, Makino Y, Ona S, Yanuki K, Inano K, Nakamura Y, Okada M
Department of Laboratory Medicine, Niigata University School of Medicine.
Rinsho Byori. 1996 Sep;44(9):860-4.
To clarify whether the effect of the postural change on lipid levels can be corrected after the adjustment of albumin levels, and if so, whether there is within-day variation in corrected lipid levels, we measured total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), and albumin levels before and after 60 min of the supine posture in 6 volunteers. We also measured the same variables before and after meals and at midnight in 30 inpatients with diabetes mellitus. We found that TC levels decreased by -7.7 +/- 2.7% (p < 0.005), and HDL-C by -5.8 +/- 5.3% (p < 0.05) after 60 min of the supine posture. The decreases disappeared after the adjustment of albumin to the baseline levels (TC; -0.2 +/- 1.0%, HDL-C; -1.7 +/- 4.2%, not significant). The within-day variation decreased from 10.9 +/- 4.9% to 5.8 +/- 2.2% in TC, and from 13.8 +/- 4.7% to 9.5 +/- 3.9% in HDL-C after the albumin adjustment. Corrected TC levels were, however, significantly lower after breakfast through at midnight than those before breakfast. This study indicates that the postural changes in lipid levels can be corrected after the adjustment of albumin levels, and that there is within-day variation in corrected TC levels. These findings suggest that the timing of sampling should be standardized for TC measurement in the management of diabetes mellitus with hypercholesterolemia.
为了阐明体位变化对血脂水平的影响在白蛋白水平调整后是否可以得到纠正，以及如果可以纠正，校正后的血脂水平是否存在日内变化，我们测量了6名志愿者在仰卧姿势60分钟前后的总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）和白蛋白水平。我们还测量了30名糖尿病住院患者在饭前、饭后和午夜前后的相同变量。我们发现，仰卧姿势60分钟后，TC水平下降了-7.7±2.7%（p<0.005），HDL-C下降了-5.8±5.3%（p<0.05）。在将白蛋白调整至基线水平后，下降消失（TC；-0.2±1.0%，HDL-C；-1.7±4.2%，无统计学意义）。白蛋白调整后，TC的日内变化从10.9±4.9%降至5.8±2.2%，HDL-C的日内变化从13.8±4.7%降至9.5±3.9%。然而，校正后的TC水平在早餐后至午夜期间显著低于早餐前。本研究表明，白蛋白水平调整后血脂水平的体位变化可以得到纠正，并且校正后的TC水平存在日内变化。这些发现表明，在高胆固醇血症糖尿病管理中进行TC测量时，采样时间应标准化。
