Correlation Analysis Of Lipoprotein Subclasses And Visceral Obesity Indexes In Patients With Hypertriglyceridemia And Its Follow-up Study Of Patients

Part 1Objective:The study intends to investigate the correlation between lipoprotein subclasses indexes and visceral obesity indexes in patients with hypertriglyceridemia,and to evaluate the prediction performance between the two sets of indicators.Methods:A retrospective analysis was performed on the clinical information of160 patients with hypertriglyceridemia and 190 healthy medical examiners who were tested by vertical auto profile（VAP）technology and vertical lipoprotein profile from July 2020 to December 2021,and the clinical information and laboratory test indicators of the two groups were collected.Indicators of lipoprotein subclasses included non-high-density lipoprotein cholesterol（non-HDL-C）,low-density lipoprotein particles（LDL-P）and remnant-like particle cholesterol（RLP-C）,and calculated the visceral obesity indexes,including visceral adiposity index（VAI）and lipid accumulation product（LAP）.The differences in lipoprotein subclasses,VAI,LAP and related biochemical indexes between the two groups were compared.Patients were grouped according to the thirdtile values of VAI and LAP levels,the general clinical data of the three groups were evaluated by one-way ANOVA.Spearman correlation analysis and multiple linear regression analysis were adopted to determine the correlation between lipoprotein subclasses indexes and visceral obesity indexes.Canonical correlation analysis was used to further investigate the overall association between the lipoprotein subclasses indexes and the visceral obesity indexes.The Receiver operating characteristic（ROC）curve was employed to investigate the predictive performance of visceral obesity indicators on the high risk of LDL-P.Results:1.Spearman correlation analysis showed that VAI was significantly positively correlated with non-HDL-C,LDL-P and RLP-C（P<0.01）,and LAP was significantly positively correlated with non-HDL-C,LDL-P and RLP-C（P<0.01）.2.Multiple linear regression showed that VAI was independently correlated with LDL-P（β=0.345,P<0.001）and RLP-C（β=0.208,P=0.018）,and LAP was independently correlated with LDL-P（β=0.275,P=0.003）and RLP-C（β=0.256,P=0.010）.3.Canonical correlation analysis showed that there was a significant overall correlation between visceral obesity indexes and lipoprotein subclasses indexes（P<0.001）.4.ROC curve showed that the AUC of high risk of LDL-P corresponding to VAI and LAP are 0.766（95%CI=0.682～0.851,P<0.001）and 0.718（95%CI=0.625～0.810,P<0.001）.Conclusion:There are independent positive linear correlations between the visceral obesity indexes of VAI and LAP in patients with hypertriglyceridemia and LDL-P.There is a significant overall correlation between visceral obesity indexes of VAI and LAP and lipoprotein subclasses indexes of non-HDL-C,LDL-P and RLP-C.Among the indexes of visceral obesity,VAI has good recognition performance for high risk of LDL-P in patients with hypertriglyceridemia.Part 2Objective:The study intends to analyze the characteristics of lipoprotein subclasses of family members with a familial hypertriglyceridemia（FHTG）,and end-point events of cardio-cerebrovascular were observed through follow-up of family members.Methods:Taking one family with FHTG as the research object,the clinical data of the proband and its three generations of family members were collected for 10 years（August 2013～May 2022）.VAP was used to determine lipoprotein subclasses and vertical lipoprotein profile was adopted to detect serum LDL-P of study subjects.Independent sample t-test and Fisher’s exact probability method were used to compare the differences at the levels of vertical lipoprotein profile in the control group and the high TAG group.Results:Among 7 patients,6 were males and 1 was female.All patients with FHTG suffered from hyperuricemia,and 2 of 7 patients have developed end-point events of cardio-cerebrovascular.Compared with the control group,the high TAG group had remarkably higher level of TAG,very low-density lipoprotein（VLDL）,very low-density lipoprotein 3（VLDL₃）and low-density lipoprotein particle（LDL-P）（P=0.003,P=0.033,P=0.020,P=0.043）,and remarkably lower level of high-density lipoprotein cholesterol（HDL-C）,high-density lipoprotein 2（HDL₂）,high-density lipoprotein 3（HDL₃）（P<0.001,P=0.001,P=0.001）.The LDL pattern in the high TAG group was small and dense,while the LDL pattern in the normal control group was mixed,or large and sparse.There were no significant differences in other indicators.Conclusion:Patients with FHTG are at risk of end-point events of cardio-cerebrovascular.In addition to the TAG and HDL-C commonly used in clinical practice,VLDL,VLDL₃,LDL-P,small and dense LDL,HDL₂ and HDL₃ are expected to become indicators of FHTG diagnosis and treatment.