脂蛋白A1/载脂蛋白B与2型糖尿病血管并发症的相关性
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摘要
目的了解陕西西安地区2型糖尿病患者血清中载脂蛋白A1、载脂蛋白B含量的差异,并进一步探讨两者与2型糖尿病患者血管病变的相关关系。方法选择2016-03～2018-03在我科住院的150例2型糖尿病患者为研究组,其中78例合并血管病变、72例无血管病变,同期我院健康体检的115例同龄健康人为对照组。全自动生化仪上测定所有受试者血清载脂蛋白A1、载脂蛋白B含量。结果 2型糖尿病患者载脂蛋白A1水平与健康对照组间差异无统计学意义(P≥0. 05),载脂蛋白B水平明显高于健康对照组且差异有统计学意义(P <0. 05)、ApoA1/ApoB明显低于健康对照组且差异有统计学意义(P <0. 05);在2型糖尿病患者中,有血管并发症者中ApoA1、ApoA1/ApoB明显低于无血管并发症者且差异有统计学意义(P<0. 05),而有血管并发症者ApoB明显高于无血管并发症者且差异有统计学意义(P <0. 05)。结论 2型糖尿病与血脂关系密切,载脂蛋白代谢紊乱是导致糖尿病患者血管并发症的重要因素之一,临床治疗中不应忽视对血脂异常的治疗,这对预防2型糖尿病及其血管并发症具有重要意义。
Objective To understand the difference of serum apolipoprotein A1 and apolipoprotein B in type 2 diabetes mellitus,and to explore the correlation between them and vascular diseases in type 2 diabetes mellitus. Methods Totally 150 type 2 diabetes hospitalized in our department from March 2016 to March 2018 were enrolled as experimental group,among which 78 were combined with vascular diseases and 72 were free of vascular diseases. Serum apolipoprotein A1 and apolipoprotein B contents of all subjects were determined by automatic biochemical analyzer. Results There was no significant difference in apolipoprotein A1 level between type 2 diabetes mellitus group and healthy control group( P > 0. 05). There apolipoprotein B level was significantly higher in type 2 diabetes mellitus group than in healthy control group( P < 0. 05). The apoA1/apoB ratio was significantly lower in type 2 diabetes mellitus group than in healthy control group( P < 0. 05). Among type 2 diabetes mellitus,the apolipoprotein A1 level and ApoA1/ApoB were significantly lower in vascular complications than in free-vascular complications( P < 0. 05),while the apolipoprotein B level was higher( P <0. 05). Conclusion Type 2 diabetes mellitus is closely related to blood lipids. The disorder of apolipoprotein metabolism may be one of the important factors leading to vascular complications in diabetes mellitus.
Objective To understand the difference of serum apolipoprotein A1 and apolipoprotein B in type 2 diabetes mellitus,and to explore the correlation between them and vascular diseases in type 2 diabetes mellitus. Methods Totally 150 type 2 diabetes hospitalized in our department from March 2016 to March 2018 were enrolled as experimental group,among which 78 were combined with vascular diseases and 72 were free of vascular diseases. Serum apolipoprotein A1 and apolipoprotein B contents of all subjects were determined by automatic biochemical analyzer. Results There was no significant difference in apolipoprotein A1 level between type 2 diabetes mellitus group and healthy control group( P > 0. 05). There apolipoprotein B level was significantly higher in type 2 diabetes mellitus group than in healthy control group( P < 0. 05). The apoA1/apoB ratio was significantly lower in type 2 diabetes mellitus group than in healthy control group( P < 0. 05). Among type 2 diabetes mellitus,the apolipoprotein A1 level and ApoA1/ApoB were significantly lower in vascular complications than in free-vascular complications( P < 0. 05),while the apolipoprotein B level was higher( P <0. 05). Conclusion Type 2 diabetes mellitus is closely related to blood lipids. The disorder of apolipoprotein metabolism may be one of the important factors leading to vascular complications in diabetes mellitus.
引文
[1]罗建平,钟琳玲,许祖芳,等.糖尿病患者载脂蛋白A1与载脂蛋白B比值与冠状动脉病变关系研究[J].当代医学,2015,21(35):16-17.
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[5]杨文英.从脂毒性到糖尿病再到血脂异常[J].国外医学内分泌学分册,2004,24(19):287-288.
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[7]张德娟.糖尿病患者血清载脂蛋白ApoA、ApoB和血脂水平的观察及意义[J].中国临床医药研究杂志,2003,4(89):8765-8766.
[8] Tian L,Fu MD,Jia LQ,et al. Relationship Between Apolipoprotein Concentrations and HDL Subclasses Distribution[J]. Lipids,2007,42(5):419-426.
[9]余叶蓉,梁荩忠.糖尿病血脂代谢紊乱研究[J].中国糖尿病杂志,1996,4(1):47-48.
[10]叶桂云,胡望平,池细俤,等.载脂蛋白B与A1比值对预测血管疾病风险的价值[J].诊断与治疗杂志,2012,32(4):336-341.
[11] Sung K C,Hwang S T. Association between insulin resistance and apolipoprotein B innormoglycemic Koreans[J]. Atherosclerosis,2005,180:161-169.
[12] Ying X,Qian Y,Jiang Y,et al. Association of the apolipoprotein B/apolipoprotein A-I ratio and low density lipoprotein cholesterol with insulin resistance in a Chinese population with abdominal obesity[J]. Acta Diabetol,2012,49(6):465-472.
[13] Hwang Y C,Aha H Y,Kim W J,et al. Increased apoB/A-I ratio independently associated with Type 2 diabetes mellitus cross-sectional study in a Korean population[J]. Diabet Med,2012,29(9):1165-1170.
[14] Leivisk J,Sundvall J,Alfthan G,et al. apolipoprotein A,apolipoprotein B,and apolipoprotein B/apolipoprotein A-I ratio:reference intervals compared with values in different pathophysiological conditions from the FINRISK 2007 study[J]. Clin Chim Acta,2011,412(11-12):1146-1150.
[2] Diaf M,Khaled BM,Sellam F. Impact of corpulence parameters and haemoglobin A1c on metabolic control in type 2 diabetic patients:comparison of apolipoprotein B/A-I ratio with fasting and postprandial conventional lipid ratios[J]. Libyan J Med,2015,10(10):27400-27409.
[3]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中国糖尿病杂志,2014,30(8):26-89.
[4]叶睿,任力杰. 2型糖尿病患者下肢动脉病变发生率及危险因素分析[J].陕西医学杂志,2016,45(10):1426-1427.
[5]杨文英.从脂毒性到糖尿病再到血脂异常[J].国外医学内分泌学分册,2004,24(19):287-288.
[6]谷成英,贺艳菊,曾艺鹏,等.脂代谢紊乱对2型糖尿病患者胰岛功能的影响[J].中国现代医生,2010,18(6):3-5.
[7]张德娟.糖尿病患者血清载脂蛋白ApoA、ApoB和血脂水平的观察及意义[J].中国临床医药研究杂志,2003,4(89):8765-8766.
[8] Tian L,Fu MD,Jia LQ,et al. Relationship Between Apolipoprotein Concentrations and HDL Subclasses Distribution[J]. Lipids,2007,42(5):419-426.
[9]余叶蓉,梁荩忠.糖尿病血脂代谢紊乱研究[J].中国糖尿病杂志,1996,4(1):47-48.
[10]叶桂云,胡望平,池细俤,等.载脂蛋白B与A1比值对预测血管疾病风险的价值[J].诊断与治疗杂志,2012,32(4):336-341.
[11] Sung K C,Hwang S T. Association between insulin resistance and apolipoprotein B innormoglycemic Koreans[J]. Atherosclerosis,2005,180:161-169.
[12] Ying X,Qian Y,Jiang Y,et al. Association of the apolipoprotein B/apolipoprotein A-I ratio and low density lipoprotein cholesterol with insulin resistance in a Chinese population with abdominal obesity[J]. Acta Diabetol,2012,49(6):465-472.
[13] Hwang Y C,Aha H Y,Kim W J,et al. Increased apoB/A-I ratio independently associated with Type 2 diabetes mellitus cross-sectional study in a Korean population[J]. Diabet Med,2012,29(9):1165-1170.
[14] Leivisk J,Sundvall J,Alfthan G,et al. apolipoprotein A,apolipoprotein B,and apolipoprotein B/apolipoprotein A-I ratio:reference intervals compared with values in different pathophysiological conditions from the FINRISK 2007 study[J]. Clin Chim Acta,2011,412(11-12):1146-1150.