Research Of Relationship Between Upper Gastrointestinal Hemorrhage And Abnormal Lipid Levels

Purpose: The goal of our present study is to explore the relationship between blood lipid levels and incidence of gastrointestinal bleeding,especially when low blood lipid effects on gastrointestinal bleeding.Methods: We collected 212 patients(male 128, female 84) with upper gastrointestinal bleeding from January 2013 to December 2014 consecutively in the second affiliated hospital of chongqing medical university digestive department, during the same period, 223 patients(male 132,female 91) without bleeding events were divided into the control group. The next morning of hospital, fasting venous blood was pumped, choose detection of blood lipid related indicators and statistical analysis.Results:(1)Group of triglycerides(TG)(1.67± 1.29)mmol/L and TG in the control group(1.53±1.01) mmol/L compared with no significant difference(P > 0.05). Group of Total cholesterol(TC)(3.51 ± 1.05) mmol/L is lower than the control group TC(4.73±1.08) mmol/L,and have obvious difference(P < 0.01). Group of High density Lipoprotein(HDL)(0.86 ± 0.29)mmol/Lis significantly lower than control group(1.17 ± 0.32) mmol/L, the difference was statistically significant(P<0.01). Group ofLow density Lipoprotein(LDL)(1.91 ± 0.79) mmol/L is significantly lower than control group in LDL(2.76 ± 0.91) mmol/L,the difference was statistically significant(P<0.01). Experimental group of Apolipoprotein(APOA1)(1.23 ± 0.33) mmol/L and the control group(1.53 ± 0.31) mmol/L have difference obvious(P < 0.01). Experimental group of Apolipoprotein B(APOB)(0.82 + 0.26) mmol/L is significantly lower than the control group(1.04 + 0.29) mmol/L(P < 0.01). Experimental group of apolipoprotein E(APOE)(32.3 + 13.18) mmol/L is lower than the control group(35.6 + 11.56)mmol/L, the difference was statistically significant(P < 0.05).(2) Single factor logistic regression results show that TC reduce, reduced HDL and LDL lowering, APOA1, APOB reduce, APOE correlated with lower and upper gastrointestinal bleeding(P < 0.05). Multiariable logistic regression analysis showed that TC, LDL lowering closely associated with gastrointestinal bleeding(OR = 0.33, 0.40), the TC and LDL can be used as a predictor of upper gastrointestinal bleeding. Receiver operating characteristics curve and area under the curve suggests the TC(AUC=0.805) and LDL(AUC=0.769) is a predictor of upper gastrointestinal bleeding. When TC belows 4.145mmol/L, the risks of were upper gastrointestinal bleeding significantly increased,LDL below 2.345 mmol/L, increased risk of upper gastrointestinal bleeding.Conclusions: Blood lipid metabolic abnormalities are closely associated with gastrointestinal bleeding, TC, LDL is the protection factor of gastrointestinal bleeding, in patients with acute upper gastrointestinal bleeding, TC and LDL lowering may participate in the development of gastrointestinal bleeding,especially when TC belows 4.145mmol/L, LDL belows 2.345mmol/L.