男性冠心病患者血清载脂蛋白AI及胰岛素及C－肽关系.docVIP

男性冠心病患者血清载脂蛋白AI及胰岛素及C－肽关系 　【关键词】 冠心病；载脂蛋白AI；胰岛素；C－肽 　　［摘要］ 目的：研究冠心病（CHD）男性患者血清载脂蛋白AI（apo AI)与胰岛素（Ins)及C肽（CP）的关系。方法：征集95例男性非糖尿病年龄在60岁下的冠心病患者和92例冠心病先证者，61例非心脏病患者，分别采集血样检测高密度脂蛋白胆固醇（HDLC），apo AI,胰岛素及C肽，葡萄糖等。所有患者的年龄、体重指数和吸烟习惯的差异不具有显著性意义。结果：高血糖（OR 2.3，95% CI 1.6~4.8），胰岛素（OR 2.1，95% CI 1.3~3.6），CP（OR4.1，95%CI 2.2~7.5)和低HDLC（OR 2.0，95%CI 1.1~3.5)或apo AI(OR 3.9,95% CI 2.1~7.1)等都与冠心病强相关。结论：联合检测apo AI,Ins,CP等将有助于非糖尿病患者冠心病危险性的预测作用。 　　［关键词］ 冠心病；载脂蛋白AI；胰岛素；C－肽 　　Correlationship Between Serum Apolipoprotein AI,Insulin and Cpeptide in Patients with Coronary Heart Diseases 　　Abstract：Objective To study the correlation of serum apolipoprotein AI,insulin and Cpeptide in male patients with coronary heart diseases(CHD).Methods 95male nondiabetic patients were recruited.Fasting blod samples of all subjects were collected,and high density lipoprotein cholesterol (HDLC),apolipoprotein AI,insulin,Cpeptide,glucose,ect were measuered.All subjects were matched by age,body mass index,and smoking habits.Results High serum levels of glucose(OR 2.3,95% CI 1.6~4.8),insulin(OR 2.1,95% CI 1.3~3.6),and Cpeptide(OR 4.1,95% CI 2.2~7.5)as well as low serum levels of HDL cholesterol (OR 2.0,95%CI 1.1~3.5)or apolipoprotein AI(OR 3.9,95%CI 2.1~7.1)had significant association with CHD.Conclusion The combined measurement of apolipoprotein AI,insulin and Cpeptide may improve identification of nondiabetic patients at increased risk for CHD. 　　Key words：Coronary heart disease;Apolipoprotein AI;Insulin;Cpeptide 　　大量临床和流行病学研究证实高密度脂蛋白胆固醇(high density lipoprotencholesterol,HDLC)和载脂蛋白AI(apolipoprotein Al,apo Al)是高密度脂蛋白(HDL)的主要蛋白质成分，是心肌梗死(myocardial infarction,MI)的独立危险因素［1］。动脉实验证明apo AI转基因(transgenic)过度表达有助于预防甚至逆转动脉粥样硬化(Atherosclerosis,As)［2］。这些资料显示低HDLC与MI的危险性相关。可是，在大多数人群中发现，低HDLC是代谢综合征的常见因子(如与高脂血症、高血压、，肥胖、糖尿病等因素协同作用)［3］，很多低HDLC患者存在空腹胰岛素(insulin,Ins)升高，Ins及葡萄糖耐量降低或患2型糖尿病(type 2 diabetes mellitus,T2DM)危险性升高［4］。体外实验证明HDL和apoAI具有不同的抗动脉病变的作用，血清Ins也为冠心病(coronary heart disease CHD)的一个危险因子［5］。在此病例对照试验中，对HDLC，apo AI，葡萄糖，Ins或