妊娠期糖尿病患者高密度脂蛋白糖基化与妊高征发病的关系

目的：了解妊娠期糖尿病孕妇体内高密度脂蛋白（ＨＤＬ）糖化程度及受体代谢途径情况，探讨其与妊高征发病的关系。方法：用荧光法测定妊娠期糖尿病患者糖化血红蛋白，≤８．０％为组Ⅰ，共３２例、＞８．０％为组Ⅱ，共３４例，并测定正常妊娠组３６例及正常非妊娠组３２例ＨＤＬ糖化值。用酶联免疫受体法观察ＨＤＬ与培养的人胚肺成纤维细胞表面受体特异结合情况。结果：妊娠期糖尿病患者组Ⅰ、组ⅡＨＤＬ糖化值明显高于正常妊娠组和正常非妊娠组（Ｐ＜０．０１）。其细胞结合、摄入和降解糖化ＨＤＬ均较正常妊娠组和正常非妊娠组升高，使细胞内总胆固醇含量升高（Ｐ＜０．０１）。结论：妊娠期糖尿病患者ＨＤＬ糖化值含量的变化及脂质沉积，可能是妊高征小动脉痉挛的原因之一。     

Charge-based interactions of mammalian sperm with oocytes: inhibition of fertilization of mouse oocytes by ligands of macrophage scavenger receptor(s)

Objective: To determine whether anionic ligands for the macrophage scavenger receptor inhibit the fertilization of mouse oocytes by mouse spermatozoa.

Design: In vitro study of sperm binding and two-cell embryo formation in the presence of scavenger receptor ligands. Sperm-oocyte interaction may be mediated by sulfated sugars. In this study, we tested other nonsulfated anionic ligands for the scavenger receptor for their ability to affect fertilization. The only common feature of these ligands is their anionic nature.

Setting: Oocytes and sperm from mice were used.

Main Outcome Measure(s): Binding of sperm to oocytes and subsequent formation of two cell embryos were determined.

Result(s): Fucoidin, polyinosinic acid, oxidized low-density lipoprotein, acetyl low-density lipoprotein, and malondialdehyde-modified LDL inhibited the binding and fertilization of mouse sperm to mouse oocytes. Addition of fresh sperm to oocytes previously treated with sperm in the presence of these agents restored the binding and fertilization.

Conclusion(s): These results show that charge-based interactions analogous to the interactions of the scavenger receptor with its ligands may play an important role in mammalian fertilization.     

High-density lipoprotein subclasses and esterification rate of cholesterol in children: effect of gender and age

Since the development of coronary heart disease (CAD) is affected by a specific pattern of plasma high density lipoprotein (HDL) effects it may be useful to know whether this occurs already in childhood. In this study we evaluated particle size distribution of HDL by gradient gel electrophoresis and the determination of cholesterol esterification rate (FER_HDL) in plasma depleted of apo B lipoproteins in 221 children (108 boys and 113 girls) aged 4 months to 20 years. Total plasma- (TC), low-density lipoprotein- (LDL-C) and HDL- (HDL-C) cholesterol, HDL unesterified cholesterol (HDL-UC) and plasma triglycerides (TG) were also measured. There were no significant gender and age differences with respect to the plasma TC, LDL-TC and TG but concentration of HDL-TC increased with age. Post-pubertal girls had significantly higher relative concentrations of HDL_2b compared to boys (30.4% vs 17.2%), while HDL_3b,c was lower in post-pubertal girls (8.7% vs. 16.5 %). FER_HDL correlated inversely with HDL_2b and positively with HDL_3b,c particles and was significantly higher in boys of the post-pubertal group compared to girls (16.9%/h vs 12.5%/h). While in girls there was a positive correlation between age and HDL-C, HDL-UC and the relative concentration of HDL_2b no significant correlation were observed in boys. In girls the increase in TC showed a significant correlation with a simultaneous increase in HDL-C, HDL-UC and HDL_2b. In boys TC correlated significantly with changes in TG only. When HDL_2b and HDL_3b,c cholesterol levels are calculated from HDL-C concentration and per cent distribution the differences between males and females are further emphasized. These data indicate that HDL particle size distribution is age- and gender-dependent.     

磺脲类降糖药格列齐特剂量与血脂学相关性研究

目的：探讨2型糖尿病（T2DM）磺脲类口服降糖药剂量与血脂学指标异常之间的关系。方法：选择76例T2DM患者，均口服格列齐特共计57d，药物剂量逐渐增大至血糖达标或格列齐特达240mg／d，所有观察对象的最大用药量（DI）经体质量校正后排序，以50百分位数分为小剂量A组、大剂量B组，比较2组一般情况及血脂情况。结果：（1）2组除体质量指数（BMI）外，其余基线指标差异无统计学意义。（2）2组除TC外，DI、TG、HDL-C、LDL-C、TG／HDL-C及AIP差异均有统计学意义。（3）单因素直线相关分析DI与动脉硬化指数（AIP）、TG／HDL呈正相关（P〈0．01）；DI与BMI呈负相关（P〈0．01）。（4）DI（Y）与血脂指标及其他各因素（X）作多元逐步回归分析，AIP（X1）、体质量（X2）、胆固醇（X3）、TG／HDL-C（X4）。回归方程：Y=6．011X1-0．0346X2-0．0217X3-0．66X4＋4．022。结论：血脂异常与T2DM患者格列齐特用量具有良好的相关性，T2DM患者磺脲口服降糖药剂量大小与脂毒性有关。     

松花粉和松针提取物在亲脂性体外模型系统中抗氧化能力和机制的研究

目的:对松花粉和松针提取物在亲脂性抗氧化模型系统中的抗氧化能力和机制进行研究。方法:采用铜诱导的LDL氧化反应模型和Rose Bengal反应模型分别进行评价。结果:松花粉乙醇提取液具有较好的自由基链式反应阻断剂的作用,有效地推迟人血浆中低密度脂蛋白(LDL)氧化生成共轭二烯。松针乙醇提取液对LDL的保护作用优于松花粉。在Rose Bengal系统中,松花粉以清除自由基和螯合铜的两种机制抑制脂质过氧化反应的发生,而松针主要作为自由基清除剂发挥抗氧化作用。结论:松花粉和松针在两个亲脂性体外模型中均发挥很好的抗氧化能力,而抗氧化机制不尽相同。     

高脂血症患者氧化修饰低密度脂蛋白对内皮依赖性血管舒张的影响

目的：探讨氧化修饰低密度脂蛋白（Ox-LDL）对血管舒张的影响及高脂血症男性患者易患动脉粥样硬化（AS）的机制。方法：采用Cu^2＊ 对13例健康自愿者及29例高脂血症患者的低密度脂蛋白(LDL)进行氧化修饰，硫代巴比妥酸法测定丙二醛（MDA）含量，Bartlett法测定溶血卵磷脂(LPC)含量，乙酰胆碱诱发血管舒张。结果：健康人和高脂血症患者血浆LDL被氧化修饰后与修饰前比较MDA含量显著增高（P<0.01）；两组Ox-LDL中的LPC水平均 明显高于各自天然低密度脂蛋白(N-LDL)中的LPC水平（P<0.05）；且健康人及高脂血症男性患者N- LDL中的LPC含量与女性基本相同，但两组男性Ox-LDL中的LPC含量高于女性（P<0.05）,男性高脂血症患 者Ox-LDL的LPC含量最高；两组Ox-LDL均明显抑制血管内皮依赖性舒张，与女性相比，健康男性Ox-LDL抑制血管舒张程度略强，但高脂血症男性患者Ox-LDL抑制血管舒张程度明显增强。高脂血症男性及女性患者Ox-LDL的抑制血管舒张效应与LPC量呈正相关（r ＝0.592，P<0.05；r＝0.816，P<0.05)。结论：男性高脂血症患者易患AS可能与Ox-LDL增加LPC含量及抑制内皮依赖性血管舒张有关。     

巨噬细胞泡沫化抑制剂的研究进展

胆固醇酯蓄积的巨噬细胞(泡沫细胞)是早期动脉粥样硬化斑块的主要组成和特征。它通过其细胞表面的多种受体无限制地摄取氧化型低密度脂蛋白(ox-LDL)颗粒及其他配体,结果在巨噬细胞内有大量的胆固醇酯和三酰甘油蓄积,使巨噬细胞发展成为泡沫细胞。因此,通过各种途径抑制这种在巨噬细胞的过量脂质蓄积,可以起到预防和治疗动脉粥样硬化的作用。     

西红花苷对氧化性低密度脂蛋白致内皮细胞损伤的保护作用

目的:探讨西红花苷对氧化性低密度脂蛋白(Ox-LDL)致内皮细胞损伤的保护作用.方法:在体外培养牛主动脉内皮细胞中,加入不同剂量的西红花苷培养12h后,再加入50μg·mL-1的Ox-LDL继续培养24h,测定培养液中乳酸脱氢酶(LDH)活性和一氧化氮(NO)的含量,测定细胞中一氧化氮合酶(NOS)的活性;利用流式细胞仪观察其对Ox-LDL诱导的内皮细胞凋亡的影响.结果:西红花苷(10,10-7,10-6mol·L-1)可剂量依赖性地抑制LDH活性及外漏(P＜0 01),提高细胞内NOS的活性(P＜0.01),使细胞分泌的NO含量升高(P＜0.01);西红花苷对Ox-LDL诱导的内皮细胞凋亡有抑制作用.结论:西红花苷对Ox-LDL致内皮细胞损伤有保护作用.     

针刺治疗对血脂影响的观察

目的 :观察醒脑开窍法针刺治疗动脉粥样硬化对高脂血症的影响。方法 :选取中风合并高血压患者 34例 ,另取年龄、性别相同其它条件相当的健康人群 34例作对照 ,观察针刺前两组 HDL、TC的差别及治疗组治疗前后的变化。结果 :治疗组治疗前与对照组相比 ,HDL - C明显降低 (P <0 .0 1) ,TC显著升高 (P <0 .0 1) ;治疗后 ,治疗组 HDL - C显著升高 (P <0 .0 1) ,TC明显降低 (P <0 .0 1)。结论 :醒脑开窍法针刺治疗中风合并高血压者可调节血脂的变化 ,从而起到治疗该病的作用。     

2型糖尿病肾病患者脂蛋白(a)的临床应用价值探讨

目的 探讨24 h-UAER、Lp(a)对2型糖尿病肾病早期诊断的临床应用价值.方法 选取糖尿病患者329例,根据尿蛋白实验阳性程度分为4组,采用免疫透射比浊法分别定量检测24 h-UAER、Lp(a),对两定量指标进行相关分析,并与健康对照组比较.结果 方差分析显示,各组24 h-UAER、Lp(a)水平均不同(P＜0.01),糖尿病患者各组均高于健康对照组.经q检验显示,尿蛋白阴性组与健康对照组比较,Lp(a)水平差异无统计学意义(P＞0.05),24 h-UAER水平差异有统计学意义(P＜0.01);尿蛋白阳性病例Lp(a)与24 h-UAER呈正相关,相关性较好;Lp(a)水平高于正常参考值上限的检出率,尿蛋白阴性组和尿蛋白±～+组分别为11.4%和18.7%,与健康对照组比较差异无统计学意义(P＞0.05);尿蛋白++组、尿蛋白+++以上组分别为55.0%和80.2%,与健康对照组比较差异有统计学意义(P＜0.05,P＜0.01).结论 Lp(a)可作为2型糖尿病早期肾损害的实验性指标,对糖尿病肾病早期诊断和防治具有现实的指导意义和临床应用价值.