【摘要】 目的进一步了解2型糖尿病(DM)糖代谢紊乱与脂代谢紊乱的临床关系及其对DM慢性并发症影响的差别。方法对160例2型DM患者分血脂正常组和脂代谢紊乱组(后者据血脂谱特点再分亚组),分析组间糖代谢紊乱程度、基础胰岛分泌和慢性并发症等临床指标的统计学差异。结果(1)脂代谢紊乱情况160例(男/女=82/78)患者血脂正常组34例,仅占21.3%;脂代谢紊乱组126例,占78.7%。其中高总胆固醇(TC)亚组患者16.3%、高甘油三酯(TG)亚组27.5%和混合脂代谢紊乱亚组35%。3个亚组患者均有不同程度低密度脂蛋白(LDL-C)水平增高和高密度脂蛋白(HDL-C)水平低下。(2)糖代谢紊乱情况血脂正常组糖化血红蛋白(10.1±1.9)%,脂代谢紊乱组(8.5±2.6)%,P<0.05;糖化血红蛋白和空腹血糖由高到低的排序分别为血脂正常组、高TC亚组、混合亚组和高TG亚组;而空腹胰岛素水平的排序反之。3组脂代谢紊乱者的糖代谢紊乱程度并非重于血脂正常组,但胰岛素抵抗程度高于血脂正常组。(3)高血压情况诊断DM之前分别有高血压病史混合亚组7.4年、高TG亚组6.5年、高TC亚组1.4年和血脂正常组0.8年(前两组分别与正常组比较,P均<0.05,后两组比较,P>0.05)。(4)慢性并发症情况共发现合并慢性并发症50例(31.3%),其中75%为大血管病变,发现率由高到低依次为混合亚组、高TG?更多还原

【Abstract】 Objective To evaluate the relationship between dyslipidemia and hyperglycemia in patients with type 2 diabetes mellitus and the impacts of hyperglycemia or hyperlipidemia on the complications. Methods 160 cases (82 males and 78 females)with type 2 diabetes was assigned into two groups without or with dyslipidemia and the differences between these two groups in clinical characteristics such as contents of blood glucose and insulin, BMI, blood pressure and complications were analyzed. Results 1. of all 160 cases, 126 cases (78.7%) were found with dyslipidemia, in which 26 cases (16.3%) with hypercholesterolemia, 44(27.5%) with hypertriglyceridemia, 56 (35%) with mixed-dyslipidemia and 34 cases (21.3%) without dyslipidemia; 2. Mild hyperglycemia, higher BMI and hypertension were the characteristics previous to clinical diabetes in the groups of hypertriglyceride and mixed-dyslipidemia, and more complications were also found in this two groups; 3. There were no significant differences in the majority of clinical parameters(P>0.05,respectively)between the normal-lipidemia and hypercholesterolemia groups, while fasting insulin, BMI, blood pressure were higher in hypertriglyceridemia group than those in hypercholesterolemia group(P<0.05, resprectively); 4. There were 44.6%,36.4%,23.1% and 11.3% cases with complications in groups of mixed-dyslipidemia, hypertriglyceridemia, hypercholesterolemia and normal-lipidemia, resprectively. Conclusions Dyslipidemia was found in the majority of the patients with type 2 diabetes. There were the heterogeneity in type 2 diabetic patients with normal-lipidemia and dyslipidemia.更多还原