High Density Lipoprotein Protects against Polymicrobe-induced Sepsis in Mice

HDL has been considered to be a protective factor in sepsis; however, most contributing studies were conducted using the endotoxic animal model, and evidence from clinically relevant septic animal models remains limited and controversial. Furthermore, little is known about the roles of HDL in sepsis other than LPS neutralization. In this study, we employed cecal ligation and puncture (CLP), a clinically relevant septic animal model, and utilized apoA-I knock-out (KO) and transgenic mice to elucidate the roles of HDL in sepsis. ApoA-I-KO mice were more susceptible to CLP-induced septic death as shown by the 47.1% survival of apoA-I-KO mice versus the 76.7% survival of C57BL/6J (B6) mice (p = 0.038). ApoA-I-KO mice had exacerbated inflammatory cytokine production during sepsis compared with B6 mice. Further study indicated that serum from apoA-I-KO mice displayed less capacity for LPS neutralization compared with serum from B6 mice. In addition, apoA-I-KO mice had less LPS clearance, reduced corticosterone generation, and impaired leukocyte recruitment in sepsis. In contrast to apoA-I-KO mice, apoA-I transgenic mice were moderately resistant to CLP-induced septic death compared with B6 mice. In conclusion, our findings reveal multiple protective roles of HDL in CLP-induced sepsis. In addition to its well established role in neutralization of LPS, HDL exerts its protection against sepsis through promoting LPS clearance and modulating corticosterone production and leukocyte recruitment. Our study supports efforts to raise HDL levels as a therapeutic approach for sepsis.     

LOX-1与动脉粥样硬化

氧化低密度脂蛋白(oxidizedlow-densitylipoprotein,Ox-LDL)是修饰脂蛋白中的一种,其与动脉粥样硬化的发生发展密切相关。1997年,Sawamura等在牛主动脉内皮细胞上发现了Ox-LDL的一种新型受体,即植物凝集素样氧化型低密度脂蛋白受体-1(lectin-likeoxidizedlowdensitylipoproteinreceptor-1,LOX-1),其在结构和功能上不同于其他类型的巨噬细胞清道夫受体。该文介绍LOX-1在近几年来的一些研究新进展,及其与动脉粥样硬化发病机制间的相互关系。     

Effects of High Fat Feeding and Diabetes on Regression of Atherosclerosis Induced by Low-Density Lipoprotein Receptor Gene Therapy in LDL Receptor-Deficient Mice

We tested whether a high fat diet (HFD) containing the inflammatory dietary fatty acid palmitate or insulin deficient diabetes altered the remodeling of atherosclerotic plaques in LDL receptor knockout (Ldlr^-/-) mice. Cholesterol reduction was achieved by using a helper-dependent adenovirus (HDAd) carrying the gene for the low-density lipoprotein receptor (Ldlr; HDAd-LDLR). After injection of the HDAd-LDLR, mice consuming either HFD, which led to insulin resistance but not hyperglycemia, or low fat diet (LFD), showed regression compared to baseline. However there was no difference between the two groups in terms of atherosclerotic lesion size, or CD68+ cell and lipid content. Because of the lack of effects of these two diets, we then tested whether viral-mediated cholesterol reduction would lead to defective regression in mice with greater hyperglycemia. In both normoglycemic and streptozotocin (STZ)-treated hyperglycemic mice, HDAd-LDLR significantly reduced plasma cholesterol levels, decreased atherosclerotic lesion size, reduced macrophage area and lipid content, and increased collagen content of plaque in the aortic sinus. However, reductions in anti-inflammatory and ER stress-related genes were less pronounced in STZ-diabetic mice compared to non-diabetic mice. In conclusion, HDAd-mediated Ldlr gene therapy is an effective and simple method to induce atherosclerosis regression in Ldlr^-/- mice in different metabolic states.     

Interfacial Tension and Surface Pressure of High Density Lipoprotein,Low Density Lipoprotein,and Related Lipid Droplets

Lipid droplets play a central role in energy storage and metabolism on a cellular scale. Their core is comprised of hydrophobic lipids covered by a surface region consisting of amphiphilic lipids and proteins. For example, high and low density lipoproteins (HDL and LDL, respectively) are essentially lipid droplets surrounded by specific proteins, their main function being to transport cholesterol. Interfacial tension and surface pressure of these particles are of great interest because they are related to the shape and the stability of the droplets and to protein adsorption at the interface. Here we use coarse-grained molecular-dynamics simulations to consider a number of related issues by calculating the interfacial tension in protein-free lipid droplets, and in HDL and LDL particles mimicking physiological conditions. First, our results suggest that the curvature dependence of interfacial tension becomes significant for particles with a radius of ～5 nm, when the area per molecule in the surface region is <1.4 nm². Further, interfacial tensions in the used HDL and LDL models are essentially unaffected by single apo-proteins at the surface. Finally, interfacial tensions of lipoproteins are higher than in thermodynamically stable droplets, suggesting that HDL and LDL are kinetically trapped into a metastable state.     

MicroRNA-590 Inhibits Lipoprotein Lipase Expression and Prevents Atherosclerosis in apoE Knockout Mice

Recent studies have suggested that miR-590 may play critical roles in cardiovascular disease. This study was designed to determine the effects of miR-590 on lipoprotein lipase (LPL) expression and development of atherosclerosis in apolipoprotein E knockout (apoE^−/−) mice and explore the potential mechanisms. En face analysis of the whole aorta revealed that miR-590 significantly decreased aortic atherosclerotic plaque size and lipid content in apoE^−/− mice. Double immunofluorescence staining in cross-sections of the proximal aorta showed that miR-590 agomir reduced CD68 and LPL expression in macrophages in atherosclerotic lesions. MiR-590 agomir down-regulated LPL mRNA and protein expression as analyzed by RT-qPCR and western blotting analyses, respectively. Consistently, miR-590 decreased the expression of CD36 and scavenger receptor A1 (SRA1) mRNA and protein. High-performance liquid chromatography (HPLC)analysis confirmed that treatment with miR-590 agomir reduced lipid levels either in plasma orinabdominal cavity macrophages of apoE^−/− mice. ELISA analysis showed that miR-590 agomir decreased plasma levels of pro-inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α), monocyte chemotactic protein-1 (MCP-1), interleukin-1β (IL-1β)and interleukin-6 (IL-6). In contrast, treatment with miR-590 antagomir prevented or reversed these effects. Taken together, these results reveal a novel mechanism of miR-590 effects, and may provide new insights into the development of strategies for attenuating lipid accumulation and pro-inflammatory cytokine secretion.     

Endogenous Androgen Deficiency Enhances Diet-Induced Hypercholesterolemia and Atherosclerosis in Low-Density Lipoprotein Receptor-Deficient Mice

BackgroundDespite numerous clinical and animal studies, the role of sex steroid hormones on lipoprotein metabolism and atherosclerosis remain controversial.ObjectiveWe sought to determine the effects of endogenous estrogen and testosterone on lipoprotein levels and atherosclerosis using mice fed a low-fat diet with no added cholesterol.MethodsMale and female low-density lipoprotein receptor-deficient mice were fed an open stock low-fat diet (10% of kcals from fat) for 2, 4, or 17 weeks. Ovariectomy, orchidectomy, or sham surgeries were performed to evaluate the effects of the presence or absence of endogenous hormones on lipid levels, lipoprotein distribution, and atherosclerosis development.ResultsFemale mice fed the study diet for 17 weeks had a marked increase in levels of total cholesterol, triglycerides, apolipoprotein-B containing lipoproteins, and atherosclerosis compared with male mice. Surprisingly, ovariectomy in female mice had no effect on any of these parameters. In contrast, castration of male mice markedly increased total cholesterol concentrations, triglycerides, apolipoprotein B-containing lipoproteins, and atherosclerotic lesion formation compared with male and female mice.ConclusionsThese data suggest that endogenous androgens protect against diet-induced increases in cholesterol concentrations, formation of proatherogenic lipoproteins, and atherosclerotic lesions formation. Conversely orchidectomy, which decreases androgen concentrations, promotes increases in cholesterol concentrations, proatherogenic lipoprotein formation, and atherosclerotic lesion formation in low-density lipoprotein receptor-deficient mice in response to a low-fat diet.     

次氯酸与Cu^2＋氧化修饰高密度脂蛋白

为了进一步研究氧化修饰高密度脂蛋白（Ox－HDL）的性质,观察了次氯酸（HOCl )及Cu^2 氧化修饰,使其颗粒表面负电荷增加,TBARS值上升;另外,在HOCl氧化修饰下,HDL的载脂蛋白AI及AII发生降解,而在Cu^2 氧化下,HDLapoAI则聚合为二聚体;HOCl和Cu^2 诱导下Ox－HDL卵磷脂降解成溶血卵磷脂,同时其载脂蛋白还发生羰基修饰。然而HOCl和Cu^2 诱导下Ox-HDL卵磷脂降解成溶血卵磷脂,同时其载脂蛋白还发生羰基修饰。然而HOCl和Cu^2 介导的HDL氧化修饰在性质及动力学改变上各不相同。     

高脂饮食豚鼠高密度脂蛋白代谢的特点

目的研究豚鼠高脂饮食后高密度脂蛋白代谢的特点,并与大鼠进行比较。方法将豚鼠和大鼠分别随机分为正常组（NC）和高脂组（HF）,正常组均给予普通饲料,高脂组给予高脂饲料诱导10周后,测定血清LDL-C、HDL-C水平,HDL3/HDL2比值和LCAT、CETP的表达;采用real-time RT-PCR方法检测肝脏SR-BI表达的变化。结果与正常组相比,豚鼠高脂组血清HDL-C水平显著升高,高密度脂蛋白亚型HDL3/HDL2的比值升高,血清CETP表达均显著增加,血清LCAT表达下降,肝脏SR-BI mRNA表达水平是正常组的2.27倍。而相同高脂饲料条件下,大鼠的上述指标均无明显变化。结论豚鼠摄入高脂饮食后HDL代谢与大鼠有所不同,主要表现为血清HDL-C升高,肝脏SR-BI受体表达增加,高密度脂蛋白亚型组分发生变化,大颗粒HDL2含量相对减少,小颗粒HDL3堆积,其机制与血清CETP、LCAT的变化密切相关。     

Leukocytosis and Enhanced Susceptibility to Endotoxemia but Not Atherosclerosis in Adrenalectomized APOE Knockout Mice

Hyperlipidemic apolipoprotein E (APOE) knockout mice show an enhanced level of adrenal-derived anti-inflammatory glucocorticoids. Here we determined in APOE knockout mice the impact of total removal of adrenal function through adrenalectomy (ADX) on two inflammation-associated pathologies, endotoxemia and atherosclerosis. ADX mice exhibited 91% decreased corticosterone levels (P<0.001), leukocytosis (WBC count: 10.0 ± 0.4 x 10E9/L vs 6.5 ± 0.5 x 10E9/L; P<0.001) and an increased spleen weight (P<0.01). FACS analysis on blood leukocytes revealed increased B-lymphocyte numbers (55 ± 2% vs 46 ± 1%; P<0.01). T-cell populations in blood appeared to be more immature (CD62L+: 26 ± 2% vs 19 ± 1% for CD4+ T-cells, P<0.001 and 58 ± 7% vs 47 ± 4% for CD8+ T-cells, P<0.05), which coincided with immature CD4/CD8 double positive thymocyte enrichment. Exposure to lipopolysaccharide failed to increase corticosterone levels in ADX mice and was associated with a 3-fold higher (P<0.05) TNF-alpha response. In contrast, the development of initial fatty streak lesions and progression to advanced collagen-containing atherosclerotic lesions was unaffected. Plasma cholesterol levels were decreased by 35% (P<0.001) in ADX mice. This could be attributed to a decrease in pro-atherogenic very-low-density lipoproteins (VLDL) as a result of a diminished hepatic VLDL secretion rate (-24%; P<0.05). In conclusion, our studies show that adrenalectomy induces leukocytosis and enhances the susceptibility for endotoxemia in APOE knockout mice. The adrenalectomy-associated rise in white blood cells, however, does not alter atherosclerotic lesion development probably due to the parallel decrease in plasma levels of pro-atherogenic lipoproteins.     

Fenofibrate Increases Very Low Density Lipoprotein Triglyceride Production Despite Reducing Plasma Triglyceride Levels in APOE*3-Leiden.CETP Mice

The peroxisome proliferator-activated receptor alpha (PPARα) activator fenofibrate efficiently decreases plasma triglycerides (TG), which is generally attributed to enhanced very low density lipoprotein (VLDL)-TG clearance and decreased VLDL-TG production. However, because data on the effect of fenofibrate on VLDL production are controversial, we aimed to investigate in (more) detail the mechanism underlying the TG-lowering effect by studying VLDL-TG production and clearance using APOE*3-Leiden.CETP mice, a unique mouse model for human-like lipoprotein metabolism. Male mice were fed a Western-type diet for 4 weeks, followed by the same diet without or with fenofibrate (30 mg/kg bodyweight/day) for 4 weeks. Fenofibrate strongly lowered plasma cholesterol (−38%) and TG (−60%) caused by reduction of VLDL. Fenofibrate markedly accelerated VLDL-TG clearance, as judged from a reduced plasma half-life of glycerol tri[³H]oleate-labeled VLDL-like emulsion particles (−68%). This was associated with an increased post-heparin lipoprotein lipase (LPL) activity (+110%) and an increased uptake of VLDL-derived fatty acids by skeletal muscle, white adipose tissue, and liver. Concomitantly, fenofibrate markedly increased the VLDL-TG production rate (+73%) but not the VLDL-apolipoprotein B (apoB) production rate. Kinetic studies using [³H]palmitic acid showed that fenofibrate increased VLDL-TG production by equally increasing incorporation of re-esterified plasma fatty acids and liver TG into VLDL, which was supported by hepatic gene expression profiling data. We conclude that fenofibrate decreases plasma TG by enhancing LPL-mediated VLDL-TG clearance, which results in a compensatory increase in VLDL-TG production by the liver.     

低密度脂蛋白胆固醇升高在家兔动脉粥样硬化发生发展中的意义

目的：观察低密度脂蛋白胆固醇（LDL-c）对家兔动脉粥样硬化（AS）形成的影响,探讨AS的发生机制.方法：以高脂饲料复制家兔实验性AS模型,分阶段检测家兔血清胆固醇（TC）、甘油三脂（TG）、高密度脂蛋白胆固醇（HDL-c）和低密度脂蛋白胆固醇（LDL-c）含量;观察主动脉内膜病理学变化;分析主动脉内膜增生程度及AS斑块面积与血浆脂蛋白水平的相关性.结果：高脂组家兔主动脉粥样硬化面积和内膜增生程度明显较对照组增加（P〈0.01）,血浆LDL-c水平明显较对照组升高（P〈0.01）;动脉内膜增生程度及AS斑块面积均与血浆LDL-c水平呈非常显著正相关（r=0.837,P〈0.001）.结论：提示血浆LDL-c水平升高,是致AS发生发展的重要原因.     

低密度脂蛋白胆固醇升高在家兔动脉粥样硬化发生发展中的意义

目的观察低密度脂蛋白胆固醇(LDL-c)对家兔动脉粥样硬化(AS)形成的影响,探讨AS的发生机制。方法以高脂饲料复制家兔实验性AS模型,分阶段检测家兔血清胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-c)和低密度脂蛋白胆固醇(LDL-c)含量;观察主动脉内膜病理学变化;分析主动脉内膜增生程度及AS斑块面积与血浆脂蛋白水平的相关性。结果高脂组家兔主动脉粥样硬化面积和内膜增生程度明显较对照组增加(P<0.01),血浆LDL-c水平明显较对照组升高(P<0.01);动脉内膜增生程度及AS斑块面积均与血浆LDL-c水平呈非常显著正相关(r=0.837,P<0.001)。结论提示血浆LDL-c水平升高,是致AS发生发展的重要原因。     

脂蛋白(a)与动脉粥样硬化及脑梗死的研究进展

脂蛋白(a)是由载脂蛋白(a)和低密度脂蛋白构成的。脂蛋白(a)不随血浆中同型半胱氨酸、载脂蛋白A、高密度脂蛋白的变化而变化,是一种相对独立的脂蛋白。脂蛋白(a)的合成过程主要是在肝脏中完成的,脂蛋白(a)可以抑制NO介导的血管舒张,破坏血管壁中促凝与抗凝因子的平衡,参与动脉粥样硬化斑块的形成。动脉粥样硬化是脑梗死最基本的病因之一,在临床工作中我们应当重视脂蛋白(a)与脑梗死的关系,我们可以通过测定血清中脂蛋白(a)的水平来预测脑梗死的患病风险,尤其能对病变损害程度重,病变累及范围广的脑梗死的发生提出预警。高水平的血浆脂蛋白(a)是脑梗死及动脉粥样硬化的独立危险因素,本文就脂蛋白(a)与动脉粥样硬化及脑梗死研究中的进展做一综述,为脑梗死的预防提供参考和研究依据。     

Vitamin D Deficiency Induces High Blood Pressure and Accelerates Atherosclerosis in Mice

Multiple epidemiological studies link vitamin D deficiency to increased cardiovascular disease (CVD), but causality and possible mechanisms underlying these associations are not established. To clarify the role of vitamin D-deficiency in CVD in vivo, we generated mouse models of diet-induced vitamin D deficiency in two backgrounds (LDL receptor- and ApoE-null mice) that resemble humans with diet-induced hypertension and atherosclerosis. Mice were fed vitamin D-deficient or -sufficient chow for 6 weeks and then switched to high fat (HF) vitamin D-deficient or –sufficient diet for 8–10 weeks. Mice with diet-induced vitamin D deficiency showed increased systolic and diastolic blood pressure, high plasma renin, and decreased urinary sodium excretion. Hypertension was reversed and renin was suppressed by returning chow-fed vitamin D-deficient mice to vitamin D-sufficient chow diet for 6 weeks. On a HF diet, vitamin D-deficient mice had ∼2-fold greater atherosclerosis in the aortic arch and ∼2–8-fold greater atherosclerosis in the thoracic and abdominal aorta compared to vitamin D-sufficient mice. In the aortic root, HF-fed vitamin D-deficient mice had increased macrophage infiltration with increased fat accumulation and endoplasmic reticulum (ER) stress activation, but a lower prevalence of the M1 macrophage phenotype within atherosclerotic plaques. Similarly, peritoneal macrophages from vitamin D-deficient mice displayed an M2-predominant phenotype with increased foam cell formation and ER stress. Treatment of vitamin D-deficient mice with the ER stress reliever PBA during HF feeding suppressed atherosclerosis, decreased peritoneal macrophage foam cell formation, and downregulated ER stress proteins without changing blood pressure. Thus, we suggest that vitamin D deficiency activates both the renin angiotensin system and macrophage ER stress to contribute to the development of hypertension and accelerated atherosclerosis, highlighting vitamin D replacement as a potential therapy to reduce blood pressure and atherosclerosis.     

ApoE基因缺失幼龄小鼠动脉粥样硬化相关基因的时序表达研究

利用RT-PCR技术检测apoE基因缺失(apoE-/-小鼠在1、2和3月龄3个年龄段主动脉以及14天、1、2和3月龄4个年龄段肝脏中动脉粥样硬化(atherosclerosis,AS)重要相关基因的时序表达特点,并通过血清牛化检测结合主动脉根部病理形态学特征的分析,探讨AS重要相关基因时序表达特点与AS早期病变的关系.在主动脉检测的9条AS相关基因中,apoE-/-与野生型(WT)小鼠相比,1、2和3月龄时IL-1β的mRNA表达水平均显著上调.1月龄时VCAM-1、IKB和TGF-β,2月龄时PDGF-α和CD36,3月龄时TNF-α和MM2的mRNA表达水平均显著上调,其他年龄段无显著变化.在肝脏检测的2条AS相关基因中,C反应蛋白(CRP)的mRNA表达水平在14天到2月龄时无显著变化,3月龄时显著上调.NF-kB在各年龄段apoE-/-小鼠主动脉和肝脏中的基因表达量与同龄WT小鼠相比均无显著差异.不同年龄段的apoE-/-小鼠血清TC、TG和LDL-C水平均明显高于同龄WT小鼠.2月龄apoE-/-小鼠主动脉内膜出现散在的脂质沉积,并随年龄增长逐渐加重.上述结果显示,时序表达上调的AS重要相关基因构成了以NF-kB为核心的复杂调控网络,它们之间相互作用,共同参与慢性炎症过程,在apoE-/-小鼠AS的早期发生发展中发挥重要作用.     

Identification of Critical Paraoxonase 1 Residues Involved in High Density Lipoprotein Interaction

Paraoxonase 1 (PON1) is a high density lipoprotein (HDL)-associated protein with atherosclerosis-protective and systemic anti-oxidant functions. We recently showed that PON1, myeloperoxidase, and HDL bind to one another in vivo forming a functional ternary complex (Huang, Y., Wu, Z., Riwanto, M., Gao, S., Levison, B. S., Gu, X., Fu, X., Wagner, M. A., Besler, C., Gerstenecker, G., Zhang, R., Li, X. M., Didonato, A. J., Gogonea, V., Tang, W. H., et al. (2013) J. Clin. Invest. 123, 3815–3828). However, specific residues on PON1 involved in the HDL-PON1 interaction remain unclear. Unambiguous identification of protein residues involved in docking interactions to lipid surfaces poses considerable methodological challenges. Here we describe a new strategy that uses a novel synthetic photoactivatable and click chemistry-taggable phospholipid probe, which, when incorporated into HDL, was used to identify amino acid residues on PON1 that directly interact with the lipoprotein phospholipid surface. Several specific PON1 residues (Leu-9, Tyr-185, and Tyr-293) were identified through covalent cross-links with the lipid probes using affinity isolation coupled to liquid chromatography with on-line tandem mass spectrometry. Based upon the crystal structure for PON1, the identified residues are all localized in relatively close proximity on the surface of PON1, defining a domain that binds to the HDL lipid surface. Site-specific mutagenesis of the identified PON1 residues (Leu-9, Tyr-185, and Tyr-293), coupled with functional studies, reveals their importance in PON1 binding to HDL and both PON1 catalytic activity and stability. Specifically, the residues identified on PON1 provide important structural insights into the PON1-HDL interaction. More generally, the new photoactivatable and affinity-tagged lipid probe developed herein should prove to be a valuable tool for identifying contact sites supporting protein interactions with lipid interfaces such as found on cell membranes or lipoproteins.     

Isolation of High Density Lipoprotein Subclasses by Electrofiltration and Their Chemical Components

Abstract

The exact role of high density lipoprotein in atheroprotection is not well understood yet due to its complex nature; it comprises more than ten subclasses that vary in size, composition, and function. Isolation and characterization of these subclasses is an important step for further studies addressing their functions in health and disease. In this work, we present a novel method that is relatively simple and efficient for isolation of high density lipoprotein subclasses. The method depends on fractional filtration of the subclasses through a preformed gel membrane system under the effect of an electric field, where the stepwise isolation of the subclasses depends on differences in their rates of migration in polyacrylamide gel. Using this design, we were able to isolate seven high density lipoprotein subclasses with relative molecular masses of 42,000–50,000; 71,000; 103,000; 124,000; 150,000; 182,000; and 219,000. All the subclasses contained apolipoprotein A-I, phosphatidylcholine, sphingomyelin, free cholesterol, esterified cholesterol, and triacylglycerols. Some fractions of some samples contained the apolipoproteins A-II, C-I, C-II, C-III, and E. A subclass of molecular mass of 106,000 was identified and isolated from a healthy young subject that contained albumin and apoA-I with some free and esterified cholesterol, but with no triacylglycerols. This electrofiltration technique offers a novel tool for isolating pure native high density lipoprotein subclasses in a concentrated form that can be used directly for detailed studies of their physicochemical and physiological properties.     

吡格列酮联合瑞舒伐他汀钙对2型糖尿病患者高密度脂蛋白的干预效应

动脉粥样硬化性心血管疾病是糖尿病最常见的并发症,而患者高密度脂蛋白(high density lipoprotein,HDL)水平和功能是影响AS发生发展的重要指标之一。本文旨在探讨吡格列酮与瑞舒伐他汀钙联合治疗对2型糖尿病(type 2 diabetes mellitus, T2DM)患者HDL的改善作用,以期在临床上预测该治疗措施对糖尿病并发症的防治效果。将70例T2DM患者,按年龄、性别、病情、药物基本匹配的原则,分为对照组和吡格列酮组,每组35人,两组患者除常规使用胰岛素降糖治疗外,对照组给予瑞舒伐他汀钙片,吡格列酮组给予瑞舒伐他汀钙片及盐酸吡格列酮片,治疗3个月后临床观察患者空腹血糖(fasting blood sugar, FPG)、餐后血糖（post-prandial glycaemia, PPG）、糖化血红蛋白(glycated hemoglobin, HbA1c)、甘油三酯(triglycerides, TG)、总胆固醇(total cholesterol, TC)、高密度脂蛋白胆固醇（high density lipoprotein cholesterol, HDL-C）、低密度脂蛋白胆固醇(low density lipoprotein cholesterol, LDL-C)水平,同时提取患者HDL,检测不同药物治疗对HDL功能的改善效果。与治疗前相比,吡格列酮组患者FPG、PPG、HbA1c、TC、TG及LDL-C 均明显下降,HDL-C水平明显升高;治疗后组间比较显示：与对照组相比,吡格列酮干预后患者HDL-C水平升高10.67%。HDL功能检测显示：药物治疗3月后,与对照组相比,吡格列酮组患者HDL介导细胞胆固醇外排效率增加25%,并使细胞内相关转运蛋白ATP结合盒转运体A1 (ATP-binding cassette transporter A1,ABCA1)表达增加;同时,吡格列酮组患者HDL抗巨噬细胞凋亡功能亦明显提高。在2型糖尿病治疗中,吡格列酮联合瑞舒伐他汀钙不仅可以稳定血糖、血脂水平,而且可以升高HDL水平,改善HDL的功能,对于延缓T2DM患者出现心血管并发症具有重要意义。