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目的探讨脂蛋白(a)[Lipoprotein(a),Lp(a)]与代谢综合征(MS)各组分的关系,及与MS组分数目的关系。方法选取符合MS诊断标准的患者147例。收集详细病史及各项临床检查指标,根据血清Lp(a)浓度将入选患者分为高Lp(a)组[Lp(a)≥300mg/L]和Lp(a)正常组[Lp(a)<300mg/L]。比较Lp(a)浓度与组分数目、MS各组分和颈动脉内膜中层厚度(IMT)的关系。结果高Lp(a)组较Lp(a)正常组的总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及IMT明显升高,差异有统计学意义(P<0.05或0.01)。Lp(a)正常组较高Lp(a)组甘油三脂(TG)明显升高,差异有统计学意义(P<0.05)。随着组分数目的增加,Lp(a)水平也显著增加,5个组分组(230.891±201.40)mg/L>4个组分组(180.78±141.94)mg/L>3个组分组(156.21±147.54)mg/L,差异有统计学意义(P<0.05)。MS患者血清Lp(a)水平与IMT(r=0.569)、餐后2h血糖(r=0.440)、LDL-C(r=0.398)、TC(r=0.299)、收缩压(SBP)(r=0.179)水平呈正相关,差异有统计学意义(P<0.05)。结论 Lp(a)水平与MS组分数目及SBP、血脂、血糖密切相关,可作为MS患者脂代谢异常的重要指标和代谢异常聚集状态的常用指标。Lp(a)与IMT呈正相关,其可作为MS患者发生动脉粥样硬化(AS)的早期预测和防治的指标。
Objective To investigate the relationship between lipoprotein (a), lipoprotein (a), Lp (a) and various components of metabolic syndrome (MS) and its relationship with the number of MS components. Methods 147 patients with MS diagnosis criteria were selected. The patients were divided into high Lp (a) group [300 mg / L] and normal Lp (a) group [Lp (a)] according to the serum concentration of Lp <300mg / L]. The relationship between the concentration of Lp (a) and the number of components, MS components and carotid artery intima-media thickness (IMT) was compared. Results The levels of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and IMT in high Lp (a) group were significantly higher than those in normal Lp (a) group, with statistical significance (P <0.05 or 0.01). In Lp (a) normal group, triglyceride (TG) was significantly increased in Lp (a) group, the difference was statistically significant (P <0.05). The level of Lp (a) also increased significantly with the increase of the number of components (230.891 ± 201.40 mg / L> 180.78 ± 141.94 mg / L> 156.21 ± 147.54 ) mg / L, the difference was statistically significant (P <0.05). Serum Lp (a) levels in MS patients were significantly higher than those in patients with IMT (r = 0.569), postprandial 2h blood glucose (r = 0.440), LDL-C 0.179), the difference was statistically significant (P <0.05). Conclusions The level of Lp (a) is closely related to the number of MS components, SBP, blood lipids and blood glucose, which may be used as an important index of abnormal lipid metabolism and metabolic abnormal aggregation in MS patients. Lp (a) is positively correlated with IMT, which can be used as an indicator of the early prediction and prevention of atherosclerosis (AS) in MS patients.