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2023-01-23   ES  

2012 national survey results show
, the average of 4.50 mmol/L (TCAL), a total of 4.50 mmol/L (TC), and the prevalence of hypertrophy is 4.9%; Triglyceride (TG) average is 1.38 mmol/L.

The prevalence of

High TG hemophilia is 13.1%; high-density lipoprotein cholesterol (HDL-C) average is 1.19 mmol/L, and the prevalence of low HDL-C hemidarity is 33.9%. The general prevalence of abnormal blood lipids in China is as high as 40.40%.
Blood lipids are general names of cholesterol, TG, and lipids (such as phospholipids) in serum. The blood lipids that are closely related to clinical are mainly cholesterol and TG. Cholesterol in the human body is mainly based on the form of free cholesterol and cholesterol ester; TG is a hydroxyl group in glycerin molecules. Blood lipids are insoluble in water. It must form lipoprotein with special protein, that is, lipoprotein, to form lipoprotein in order to dissolve the blood and be transported to the tissue for metabolism. Lipin is divided into: CM, VLDL, IDL, LDL, HDL, and LP (A).
Non-high-density lipoprotein cholesterol (non-HDL-C)
non–HDL-C refers to the sum of the cholesterol contained in other lipoprotein other than HDL. The calculation formula is as follows: non-HDL-C = TC-HDL-C. Non-HDL-C, as the secondary goal of lipid adjustment treatment during the prevention and treatment of ASCVD and its high-risk population, is suitable Individual of treatment goals. Internationally, there is a guidelines for blood lipids to list non–HDL-C as the primary goal of ASCVD first-level prevention and secondary prevention
Total cholesterol (TC)
TC refers to the sum of cholesterol contained in various lipoprotein in the blood. The main factors affecting the TC level are:
(1) Age and Gender: The TC level often increases with age, but after 70 years of age, it no longer rises or even declines. Middle -aged and young women are lower than men. After menstruation, the TC level is higher than that of men of the same age.
(2) Eating habits: Long -term high cholesterol, high saturated fatty acid intake can increase TC.
(3) genetic factors: mutations related to lipoprotein metabolic enzymes or receptor genes are the main causes of TC significantly increased.
Survey data shows that the risk of risk of coronary heart disease in serum TG levels is light to moderate to moderate elevated. [18]
. When TG rises severely, acute pancreatitis can often be accompanied.
Blood APO A1 can reflect the level of HDL, which is significantly positively related to the HDL-C level, and its clinical significance is also large.
Compared with large and light LDL (Type A LDL), the APO B content in SLDL particles is more and less cholesterol. Symptoms, it reflects the increase in B -type LDL.
The level of LP (A) in normal crowd is obviously distributed. Although individuals can be as high as 1,000 mg/L or more, 80 % of normal people are below 200 mg/L. Usually with 300 mg/L as the cut point, the risk of coronary heart disease higher than this level is significantly increased. It is prompted that LP (A) may have analgesic sclerosis, but lack of clinical research evidence [20]
. In addition, the increase in LP (A) can also be seen in various acute time, nephropathy syndrome, diabetic nephropathy, pregnancy and growth hormone. In the case of excluding rising stress, LP (A) is considered an independent risk factor for ASCVD.
Blood lipid abnormal cause classification
secondary hyperlipidemia
secondary hyperlipidemia refers to abnormal blood lipids caused by other diseases. Mainly diseases that cause abnormal blood lipids are: obesity, diabetes, nephropathy syndrome, thyroid dysfunction, renal failure, liver disease, systemic lupus erythematosus, glycogen accumulation, osteoma, fat atrophy, acute pyrodoline disease , Polycystic ovary syndrome, etc. In addition, some drugs such as diuretics, non-cardiac selective β-receptor blockers, glucocorticoids, etc. may also cause secondary blood lipids.
Primary hyperlipidemia
In addition to bad lifestyles (such as high energy, high -fat and high -sugar diet, excessive drinking, etc.), it is related to abnormal blood lipids. Most of the primary hyperlipidemia is caused by a single gene or multiple gene mutations. Due to genetic mutations, high -fat leeming is mostly family aggregation and has obvious genetic tendencies, especially those with single gene mutations. Therefore, clinically called family hyperlipidemia. For example, a lack of dysfunction of the LDL receptor gene, or the APO B gene mutation combined with the LDL receptor, or the pre -protein transforme enzyme -proof bacterium 9 of the LDL receptor 9 (PROPROTEIN Convertases Subtilisin/Kexin Type 9, PCSK9) The function of genes obtains mutations, or the LDL receptor adjustment of the LDL receptor to the surface of the cell membrane plasma can cause family hypertrophylolmia (FH). More than 80% of patients with FH are caused by a single gene mutation, but hypertrophy have the characteristics of multiple gene mutations. The lack of dysfunction of the LDL receptor gene is the main cause of FH. Homozygous Familial HyperCholesterolemia (HOFH) incidence rate is about 1/300,000 ~ 1/160,000, Heterozygous FamiliLecholemia (Hefh) incidence rate is about 1/300,000 to 1/160,000. 500 ~ 1/2. Family high TG hemophilia is caused by a single gene mutation. It is usually caused by the lipoprotein lipidase involved in TG metabolism, or the APO C2, or the APO A5 gene mutation, which manifests as severe high TG hemidiers (TG> 10 mmol/L/L ), Its incidence is 1/1 million. Mild moderate high TG hemother usually has multiple genetic mutation characteristics [25, 26].
Blood lipid abnormal clinical classification
From a practical perspective, abnormal blood lipids can be made simple clinical classification (Table 3).

In the risk assessment, those who have diagnosed ASCVD are directly listed as extremely high -risk people; those who meet the following conditions are directly listed as high -risk people:

(1)LDL-C ≥ 4.9mmol/L (190 mg/dl)。
(2)1.8 mmol/L (70 mg/dl) ≤ LDL-C<4.9 mmol/L(190 mg/dl)
Patients with diabetes at the age of 40 and above.
Extremely high -risk and high -risk groups that meet the above conditions do not need to perform ASCVD risk layers according to the number of risk factors.
Point prompt:
1. Clinically, according to the danger of individual ASCVD, decide whether to start drug liposuction treatment.
2. The LDL-C level will be reduced as the primary intervention target for preventing and controlling ASCVD hazards. Non-HDL-C can be used as secondary intervention targets.
3. Developed target value: LDL-C <1.8 mmol/L; high-risk LDL-C <2.6 mmol/L/L; Essence
4. LDL-C baseline value cannot reach the target value, LDL-C is reduced by at least 50%. LDL-C baseline is within the target value, LDL-C should still be reduced by about 30%.
5. Clinical liposuction adjustment standards, the first choice of lipidum regulatory drugs. Beginning should be used to apply medium -intensity, and according to the effects and tolerance of the individual’s lipid regulation, the dosage is appropriately adjusted. If the cholesterol level cannot meet the standard, it is combined with other lipid regulatory drugs.
It is recommended to consume carbohydrate daily to account for 50%to 65%of the total energy. Choose carbohydrates rich in dietary fiber and low sugar index instead of saturated fatty acids. The daily diet should include 25 ~ 40 g dietary fiber (of which 7 ~ 13 g are water -soluble dietary fibers). Carbohydrate intake is mainly valley, potatoes and whole grains, and the addition of sugar intake should not exceed 10%of the total energy (the proportion of obesity and high TG blood disease is lower). Food additives such as plant sterol / alkanol (2 ~ 3 g / d), water -soluble / viscous dietary fiber (10 ~ 25 g / d) is conducive to blood lipid control, but it should be monitored for a long time.
Atherosclerotic Cardiovascular Disease, ASCVD: atherosclerotic sclerosis cardiovascular disease
Total Cholesterol, TC: Total cholesterol
triglyceride, TG: triglyceride


“Ideal Value” definition: No cardiovascular risk caused by cardiovascular risk (excluding “no other diseases, but exhaustion of the total number of heart beating”)
specific values are as follows:
Total cholesterol <3.1mmol/L
HDL (only the minimum value> 1mmol/L is prompted in the domestic guide, HDL>1.5516 mmol/L)

triglyceride <1.7mmol/L (≈150mg/dl)
2012 national statistics (now 2022, the probability of various foods is more “good” than before):
TOTAL Cholesterol (TC) average is 4.50 mmol/L.
Triglyceride (TG) average is 1.38 mmol/L.
high-density lipoprotein cholesterol (HDL-C) average is 1.19 mmol/L.
If the average blood lipids of the national population are worse than the national population, even if the doctor says it is normal, you should start paying attention.
Attachment (unit conversion relationship):
national standard is mmol/L,
Internationally, some countries use mg/dl = 10 mg/l = 10mg/L.
The conversion coefficient is as follows:
TC、HDL-C、LDL-C:1 mg/dl=0.0259 mmol/L;
TG:1 mg/dl=0.0113 mmol/L。


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