【摘要】 为了探讨糖尿病脂蛋白异常血症的发生机理，研究了53例糖耐量异常者（糖耐量异常组）和27例糖耐量正常者（对照组）的血脂和血浆载脂蛋白水平，以及进行了葡萄糖耐量试验和胰岛素释放试验。结果发现，糖耐量异常组空腹及口服葡萄糖后60min血糖和血浆胰岛素水平与对照组无显著差异（P＞0．05），而口服葡萄糖后120min血糖（P＜0．05）、血浆胰岛素水平（P＜0．01）和口服葡萄糖后180min血糖（P＜0．01）、血浆胰岛素水平（P＜0．05）均比对照组显著升高。糖耐量异常组血浆甘油三酯和总胆固醇显著升高（P＜0．01和P＜0．05），同时伴有一定程度的低密度脂蛋白胆固醇升高和高密度脂蛋白胆固醇降低，以及载脂蛋白CⅡ、CⅢ及E显著增高（P＜0．01、P＜0．001和P＜0．005），这些血脂改变与糖尿病脂蛋白异常血症类似。此结果表明，胰岛素抵抗、高胰岛素血症在糖尿病脂蛋白异常血症的发生中起着重要的作用。同时也提示对一些空腹血糖正常，糖耐量异常，但还没有临床诊断为糖尿病患者，应进行常规血脂检查，筛选出脂蛋白异常者，并采取相应的措施予以纠正。更多还原

【Abstract】 Aim To observe the changes of plasma lipid and apolipoprotein levels in subjects aged over 40 with im-paired glucose tolerance.Methods 53 subjects whose fasting blood sugar(FBS)<6. 11 mmol/L and 2 h postprandial BS≥6. 66mmol/L were selected as the impaired glucose toler-ance (IGT) group: 27 subjects whose FBS<6.11mmol/L and 2 h postprandial BS<6. 66 mmol/L wereselected as control group. Oral glucose tolerance test and insulin release test were performed by routine methods. Plasma glucose and lipids such as triglyceride (TG), total cholesterol (TC) and high densitylipoprotein cholesterol (HDLC) were measured by en-zyme methods. The plasma low density lipoproteincholesterol (LDLC) was determined by calculation.Plasma insulin was measured by radioimmunoassay.Plasma apolipoproteins were measured by radial im-munodiffusion methods.Results The body mass index (BMI), FBS and fasting plasma insulin of the two groups were statistically the same (P>0. 05). 2 h postprandial BS of IGT group was 47.9%, and 2 h postprandial insulin was 69. 8% higher than those of the control group (P<0.05 and P<0.01). The serum levels of TG and TC of IGT group were significantly higher than those of the control group (P<0. 01 and P<0.05). To some extent but not statistically, HDLC was lower,LDLC was higher than those of the control group. The serum apo CII, CIII and E levels of IGT group were statistical-ly higher than those of the control group (P<0. 01, P<0. 001and P<0. 005). To some extent but not statistically, apo B was higher and apo AI was lower than those of the controlgroup.Conclusion Plasma lipid changes of subjects aged over 40 with impaired glucose tolerance are similar todiabetic dyslipoproteinemia and these changes may berelated to the changes of plasma insulin.更多还原