青少年家族性高胆固醇血症患者血浆同型半胱氨酸和高敏C 反应蛋白水 平的临床价值及与血脂相关性研究

目的:探讨血浆同型半胱氨酸(Homocysteine,Hcy)、高敏C反应蛋白(Hypersensitive C-reactive protein,hs-CRP)在家族性高胆固醇血症(FH)的纯合子和杂合子患者中的水平及其与临床生化指标的相关性。方法:入选在2013.10~2015.7期间在动脉硬化门诊随访、确诊的家族性高胆固醇患者34人(纯合子14例,杂合子20例)。根据FH纯合子、杂合子、健康体检者分成三组,分别测定其总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(Glu)、Hcy、hs-CRP水平,并比较FH患者血浆LDL-C、非高密度脂蛋白(non-HDL)水平Hcy、hs-CRP水平的相关性。结果:FH组的TC、LDL-C、non-HDL、Hcy水平显著高于正常对照组(P0.05)。FH根据基因型亚组分析中,青少年纯合子组HDL-C(0.78±0.21)vs(1.25±0.40)mmol/L]小于杂合子组(P0.001),而TC(16.11±2.66)vs(7.30±2.54)mmol/L]、LDL-C(14.06±2.22)vs(5.25±2.16)mmol/L]、non-HDL(15.33±2.60)vs(6.05±2.61)mmol/L]、Hcy(19.3±11.58)vs(11.29±3.42)μmol/L]水平显著高于杂合子组(P0.05)。Pearson相关性分析显示,FH患者血浆LDL-C、non-HDL水平与Hcy水平呈正相关(P0.05),而与hs-CRP无相关性。结论:FH患者,特别是青少年的纯合子患者,与对照组相较,具有较高的TC、LDL-C和Hcy水平,并且与血浆LDL-C、non-HDL水平呈正相关。FH患者hs-CRP的水平高于健康人,但差异无统计学意义,与血浆LDL-C、non-HDL水平也无明显相关性。

Clinical Value of SerumHomocysteine and Hypersensitive C-reactive Protein and the Correlation with SerumLipid Levels in Adolescents with Familial Hypercholesterolemia

Objective:To investigate the plasma homocysteine (Hcy), high-sensitivity C-reactive protein (hs-CRP) levels in both homozygote and heterozygote patients with familial hypercholesterolemia (FH) and the correlation with serum lipid levels.Methods:Enrolled 34 FH patients (14homozygotes, 20 heterozygote) fromour Atherosclerosis Department during 2013.10~2015.7. Three groups, including homozygotes, heterozygotes and healthy control, were measured total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), fasting blood glucose (Glu), Hcy, hs-CRP levels. In addition, we investigated the correlation between LDL-C, non-high-density lipoprotein (non-HDL) levels with Hcy, hs-CRP levels in patients with FH.Results:The level of TC, LDL-C, non-HDL and Hcy in FH group were significantly higher than the control (P <0.05). According to genotype subgroup analysis, HDL-C level of adolescent homozygous group were lower than heterozygous group. But the level of TC (16.11± 2.66) vs (7.30± 2.54) mmol/L], LDL-C (14.06± 2.22) vs (5.25± 2.16) mmol/L], non-HDL (15.33 ± 2.60) vs (6.05± 2.61) mmol/L] and Hcy (19.3± 11.58) vs (11.29± 3.42) umol/L] were significantly higher than the heterozygous group (P <0. 05). Pearson correlation analysis showed that in FH group, plasma LDL-C and non-HDL levels were positively correlated with Hcy levels (P <0.05). However, plasma LDL-C and non-HDL levels were not correlated with hs-CRP in FH paients.Conclusion:FH patients,particularly homozygous adolescents have significantly higher TC, LDL-C and Hcy levels than the control group. In addition, the level of LDL-C, non-HDL levels in FH patients were positively correlated with Hcy levels.