中文摘要：

目的探讨老年亚临床动脉粥样硬化（AS）患者血清胆固醇酯脂肪酸水平，以期为早期预防AS提供实验室数据支持。方法回顾性研究纳入2013年8—12月北京医院老年体检志愿者180例（年龄≥60岁），包括颈动脉内中膜中层厚度（cIMT）〉1（亚临床AS组）92例和健康对照者（对照组）88例，抽取空腹静脉血。用液相色谱串联质谱法测定志愿者血清中11种胆固醇酯脂肪酸，计算各脂肪酸脱氢酶及脂肪酸碳链延长酶活性。同时用常规方法分析血清中总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白AI（ApoAI）、载脂蛋白B（ApoB）、超敏c反应蛋白（hsCRP）等生化指标，用独立样本t检验、非参数检验、Logistic回归等对以上数据进行分析。结果与对照组相比，老年亚临床AS患者的年龄、TC、LDL—C和ApoB的水平显著偏高，血清CE16：1和△9-脂肪酸脱氢酶（A9-desaturase）显著升高，CE22：6则显著降低；校正年龄、性别、体质指数、TC、TG、HDL-C、LDL-C等可能混杂因素影响后，与最低四分位数（Q1：CE22：6≤0．44％）相比，CE22：6最高四分位数（Q4：CE22：6〉0．71％）患亚临床AS的比值比为0．29（95％CI：0．11～0．78，Wald x2值6．009，P〈0．05）；CE16：1和A9-desaturase在校正混杂因素后差异无统计学意义。Spearman偏相关分析结果显示CE22：6与心血管疾病危险指标中的ApoA、TC和HDLC显著负相关（r分别为-0．166、-0．149和-0．194；均P〈0．05），而与其他指标关系差异无统计学意义。结论CE22：6可能对亚临床AS具有保护作用，平衡脂肪酸摄入对早期预防基于AS的心血管疾病具有重要意义。

英文摘要：

Objective To investigate serum levels of cholesterol, ester fatty acids in elderly patients with subclinical atherosclerosis （AS）, in order to provide supportive laboratory data for early prevention of AS. Methods A retrospective study was undertaken on 180 elderly volunteers （age 60 years） who had received regular health checkups at Beijing Hospital in 2013, including 92 subclinical AS patients （the subclinical AS group） with carotid intima-media thickness （clMT） greater than 1 mm and 88 healthy subjects （the control group）. Venous blood samples were taken. Liquid chromatography tandem mass spectrometry was used to determine eleven serum cholesterol ester fatty acids,and enzyme activities of desaturases and elongases were estimated from product-to-precursor ratios. Serum total cholesterol （TC）, triglyeeride （TG）, high-density lipoprotein cholesterol （HDL- C）, low-density lipoprotein cholesterol （LDL-C）, apolipoprotein AI （ApoAI）, ApoB, high sensitivity C-reactive protein （hsCRP） and other biochemical indicators were analyzed with automatic biochemistry analyzers and the results were analyzed with independent sample t-test, nonparametric test and logistic regression. Results Compared with the control group, age, TC, LDL-C, ApoB, serum CE16：1 and A9-desaturase were higher, and serum CE22：6 was lower in the subclinical AS group （P〈0.05）. After adjustment for confounding factors such as age, gender, body mass index, TC, TG, HDL-C, and LDL-C, the odds ratio of serum CE22：6 was 0.29 （95%CI：0. 11-0.78, Wald ） x2 ：6. 009, P %0.05）, compared with the highest quartile and the lowest quartile. However, no significant difference was found in serum CE16：1 and A9-desaturase. Spearman partial correlation analysis was used to analyze the relationship between CE22：6 and the cardiovascular disease risk index and revealed that CE22：6 was negatively correlated with Apo A, TC and HDL C （r= -0. 166, - 0. 149 and -0. 194, respectively, each P〈0.05）, while no