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@# Dyslipidaemia is a recognised conventional risk factor for cardiovascular disease (CVD). However, even when traditional lipid parameters are normal, CVD risk can exist. Small dense lowdensity lipoprotein cholesterol (sdLDL) has appeared as a significant risk marker for CVD. This study aimed to determine the prevalence and associated factors of atherogenic lipoprotein Pattern B in the Malaysian population. Materials and Methods: This cross-sectional study included 150 subjects aged 30 years and above who attended a health screening in a Malaysian tertiary institution. Sociodemographics, clinical characteristics and laboratory parameters (lipids, glucose, and sdLDL) were obtained. Lipoprotein subfraction was analysed using the polyacrylamide gel electrophoresis method. Results: Malays and females made up the majority of subjects and the median age was 37 years. Normolipidaemic Pattern B was significantly higher in women (p=0.008). Significant independent predictors of Pattern B were gender (p=0.02), race (p=0.01), body mass index (BMI) [p=0.02] and lipid status (p=0.01). Triglyceride was the only independent predictor of sdLDL (p=0.001). Conclusion: The prevalence of Pattern B of 33% in this study was comparatively high, of which 6.7% were normolipidaemic. Chinese males with dyslipidaemia and increased BMI independently predicted Pattern B. Differences in triglyceride levels alone among these ethnic groups do not fully explain the differences in the prevalence of Pattern B although it was the only lipid parameter to independently predict sdLDL. Individuals with atherogenic normolipidaemia are at greater risk for a CVD event as they are not included in the protective measures of primary CVD prevention.
RESUMO
Objective To explore the application value of superior mesenteric vein-caval-right atrium Y shape shunt (abbr.SMV-CV-RA Y shape shunt) as a new approach for treatment of mixed pattern Budd-Chiari syndrome (B-CS).Methods The clinical data of 101 cases of mixed pattern B-CS patients were evaluated for the curative effect.Of the 101 patients,62 were treated with superior ruesenteric vein-caval-right atrium Y shape shunt,26 with splenic vein-caval shunt and 13 with superior mesenteric vein-caval shunt using artificial vascular graft.Results Compared with the plastocyte count of patients receiving splenic vein-caval shunt and superior mesenteric vein-caval shunt,the plastocyte count of 62 cases undergoing SMV-CV-RA shunt increased obviously after operation (P＜0.05).The portal vein pressure of patients with SMV-CV-RA shunt decreased significantly (P＜0.05),but the pressure of patients in splenic vein-caval shunt group and superior mesenteric vein-caval shunt group deceased slightly (P＞0.05).The incidence of hepatic encephalopathy in one year after operation was not significantly different among the 3 groups (P＞0.05).The incidence was 3.2%(2/62),0% (0/26),0% (0/13),respectively.The recanalization rate of artificial vascular graft was 95.2%(59/62),69.2%(18/25),38.4%(5/13),respectively in SMV-CV-RA shunt group,splenic vein-caval shunt group and superior mesenteric vein-caval shunt group.The recanalization rate of artificial vascular graft in SMV-CV-RA shunt group was increased significantly (P＜0.05).Conclusion Compared with splenic vein-caval shunt and superior mesenteric vein-caval shunt,the SMV-CV-RA Y shape shunt can get satisfactory effeet in curing massive hemorrhage of gastrointestinal tract for cutting down the pressure of portal vein and inferior vena.Otherwise,the shunt could eliminate hypersplenia of patients.The splenic vein-caval shunt and superior mesenteric vein-caval shunt are not effective in curing the mixed pattern B-CS.