北京部分职业人群血清非高密度脂蛋白胆固醇参考值及其分布
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首都医学发展科研基金(20023086)资助


Reference Values of Serum non-High Density Lipoprotein Cholesterol of Beijing Institutional Populations
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    摘要:

    非高密度脂蛋白胆固醇代表除高密度脂蛋白胆固醇以外一切有致动脉粥样硬化作用的脂蛋白(以胆固醇含量表示)的总和,用总胆固醇减去高密度脂蛋白胆固醇即可算出。为了解北京部分职业人群非高密度脂蛋白胆固醇的参考值及其分布,选择调查2 0 0 0~2 0 0 1年来院体检的北京市事业及企业单位干部与职工(不包括体力劳动者) ,共计2 816 1人(男 女为6 4 ) ,年龄2 0~85岁。按标准化要求空腹测定总胆固醇、高密度脂蛋白胆固醇及甘油三酯水平,以Freidewald公式计算低密度脂蛋白胆固醇水平。结果发现,非高密度脂蛋白胆固醇随年龄上升,5 0岁以下男性高于女性,5 0岁以上女性高于男性。非高密度脂蛋白胆固醇年龄标化均值男为3.4 7mmol L、女为3.2 9mmol L ,但老年男为3.90mmol L、老年女高达4 .2 1mmol L。假定甘油三酯在临界值(1.7mmol L)时,非高密度脂蛋白胆固醇比低密度脂蛋白胆固醇高0 .77mmol L ,由于该组人群甘油三酯水平较低,各年龄组两项指标的差距都或多或少地低于0 .77mmol L。调查所得非高密度脂蛋白胆固醇水平比美国全国有代表性的数据大约低2 0 % (男女相近) ,以上表明北京部分职业人群动脉粥样硬化性心血管病危险明显低于美国人。

    Abstract:

    Aim Except high density lipoprotein cholesterol(HDLC), all the atherogenic lipoprotein cholesterol [including Iow density lipoprotein cholesterol (LDLC), cholesterol of lipoprotein riched triglycerides(TG) and lipoprotein (a) cholesterol] are included in the non-HDLC, which can be used in prediction of the atherogenic cardio vascular risk and as secondary target of lipid lowering therapy. The non-HDLC level can be simply estimated by subtract HDLC from total cholesterol(TC). This study was to provide the reference values and its distribution of serum non-HDLC data of Beijing populations. Methods 28 161 Beijing institutional employees (including those retired, but physical workers were excluded), male/female 6∶4, aged 20~85 years were enrolled in this study. All the subjects participated regular physical examination and well standardized lipid analysis with fasting blood samples (including TC, HDLC and TG. LDLC was calculated by Friedewald formula). Results Non-HDLC levels elevated gradually with increase in age. Male groups had higher average non-HDLC than female groups before age 50, but it was reversed due to much more increase in non-HDLC levels in women after age 50. Age adjusted mean non-HDLC were 3.47 mmol/L in men and 3.29 mmol/L in women. However, in the elderly men and women, the corresponding mean levels were 3.90 and 4.21 mmol/L respectively. It was supposed that the cutoff point of normal TG is 1.7 mmol/L, then the non-HDLC should be 0.77 mmol/L higher then LDLC at that point. But the TG level of most subjects in this study were lower then 1.7 mmol/L, the differences in the level between non-HDLC and LDLC were more or less lower then 0.77 mmol/L in different age groups, the non-HDLC level in this study was 20% lower than the report of Third National Health and Nutrition Examination Survey of US. It indicates that the atherogenic cardiovascular risk is much lower in the subjects of this studied group. Conclusion In the case of higher TG levels (>2.3 mmol/L), non-HDLC will better represent the concentrations of all atherogenics lipoproteins then LDLC alone. The method of non-HDLC estimation is simple and accurate.

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王抒,李红霞,满永,董军,唐蔚青,国汉邦,夏永静,李健斋.北京部分职业人群血清非高密度脂蛋白胆固醇参考值及其分布[J].中国动脉硬化杂志,2004,12(6):719~722.

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  • 收稿日期:2004-02-26
  • 最后修改日期:2004-10-30
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