甘孜县藏族成年高脂血症人群蛋白水平与肝功指标的相关性研究

摘要

目的 调查甘孜县藏族成年人群不同临床类型高脂血症患者清蛋白(ALB)和总蛋白(TP)水平,探讨其与血清中肝功指标的相关性.方法 采集甘孜县661例藏族成年志愿者血清,测定血脂代谢指标、肝功指标和血清蛋白水平.参照2007年《中国成人血脂异常防治指南》进行高脂血症临床分型.用方差分析、相关性分析和多元线性回归分析方法进行统计学分析处理.结果 研究人群中高胆固醇血症组、高三酰甘油血症组、混合型高脂血症组和低高密度脂蛋白血症组发生例数分别为212、140、85和43例,非高脂血症组181例.混合型高脂血症患者总蛋白水平显著高于非高脂血症患者,差异有统计学意义(P<0.05).高胆固醇血症组、高三酰甘油血症组和混合型高脂血症组肝功指标丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)和γ-谷氨酰氨基转移酶(γ-GGT)水平明显高于非高脂血症组,差异有统计学意义(P<0.05).高三酰甘油血症和混合型高脂血症组血清蛋白水平与ALT、AST相关性较强,差异有统计学意义(P<0.05).TP为因变量,ALB,ALT和AST为自变量的回归分析显示:高胆固醇血症,TP=25.149+1.066(ALB)-0.158(ALT)+0.268(AST);混合型高脂血症,TP=28.211+1.011(ALB)-0.067(ALT)+0.176(AST);非高脂血症,TP=37.86+0.79(ALB)-0.079(ALT)+0.162(AST).结论 高脂血症中总胆固醇(TC)和三酰甘油(TG)可诱发肝功能损害,AST和ALT是影响高脂血症患者血清蛋白水平的重要指标.在甘孜县藏族成年人群中,仅混合型高脂血症患者TP水平改变明显,这可能与该区藏族人群的肝功代偿能力较强有关.%Objective To investigate the albumin(ALB) and total protein(TP) levels among adult Tibetans with different clinical types of hyperlipidemia in Ganzi County and its correlation with serum liver function in-dexes .Methods The serum was collected from 661 volunteers in Ganzi County .The blood lipid metabolism indexes ,liver function indexes and serum protein levels were measured .The hyperlipidemia was performed the clinical typing according to the Guide on Prevention and Treatment of Chinese Adult Dyslipidemia in 2007 . The statistical analysis was conducted by using the one-way ANOVA variance ,Pearson correlation and multi-ple linear regression analytical methods .Results The hypercholesterolemia group ,hypertriglyceridemia group ,mixed hyperlipidemia group and low high-density lipoprotein hyperlipidemia group had 212 ,140 ,85 ,43 cases respectively ,while 181 cases were in the non-hyperlipidemia .The TP level in the patients with mixed hy-perlipidemia was significantly higher than that in the patients with non-hyperlipidemia ,the difference was sta-tistically significant (P<0 .05) .The liver function indexes ALT ,AST and γ-GGT levels in the hypercholes-terolemia group ,hypertriglyceridemia group and mixed hyperlipidemia group were significantly higher than those in the non-hyperlipidemia group ,the difference was statistically significant (P<0 .05) .The serum pro-tein level was strongly correlated with ALT and AST in the hypertriglyceridemia group and mixed hyperlipi-demia group ,the difference was statistically significant (P<0 .05) .TP serving as the dependent variable and ALB ,ALT and AST as independent variables ,the regression analysis showed TP=25 .149+1 .066(ALB)-0 .158(ALT)+0 .268(AST) in hypercholesterolemia ,TP= 28 .211+ 1 .011(ALB) -0 .067(ALT)+ 0 .176 (AST) in mixed hyperlipidemia and TP=37 .86+0 .79(ALB)-0 .079(ALT)+0 .162(AST) in non-hyperlipi-demia .Conclusion TC and TG can induce the damage of liver function in hyperlipidemia ,ALT and AST are the important indicators affecting serum protein level in the patients with hyperlipidemia .In Tibetan adult population of the Ganzi county ,only the TP level change is noticeably among the patients with mixed hyperlip-idemia ,which may be related with strong compensatory ability of liver function in Tibetan population .