【摘要】 目的研究2型糖尿病患者脂蛋白各亚组份与颈动脉内膜中层厚度的关系。方法采用超速离心及高效液相色谱法测定55例2型糖尿病患者的血清脂蛋白亚组份,根据超声检测颈动脉内膜中层厚度分为有、无病变组,分析其与脂蛋白亚组份之间的关系。结果(1)有病变组的年龄高于无病变组(P<0.05)。(2)有病变组脂蛋白(a)水平高于无病变组。其余脂蛋白及其亚型组间差异无统计学意义。(3)调整年龄、性别、体质指数后,颈动脉内膜中层增厚分别与脂蛋白(a)和B型低密度脂蛋白呈正相关;脂蛋白(a)与低密度脂蛋白呈正相关;甘油三酯分别与空腹血糖、B型低密度脂蛋白呈正相关,与高密度脂蛋白、高密度脂蛋白2和A型低密度脂蛋白呈负相关(P<0.05)。以有病变、无病变为因变量进行多因素Logistic回归分析发现,年龄、脂蛋白(a)水平升高是2型糖尿病患者颈动脉内膜中层增厚的独立危险因素(P<0.001和P=0.021)。结论脂蛋白(a)可能是2型糖尿病患者早期动脉粥样硬化的危险预测指标。更多还原

【Abstract】 Aim To investigate the association of lipoproteins subfractions with intimal medial thickness(IMT) of carotid artery in type 2 diabetic patients. Methods The subfractions of lipoproteins were determined by ultracentrifugation and high-performance liquid chromatiography,and the IMT of both sides carotid artery were measured by B-mode ultrasonography in 55 type 2 diabetic patients,divided into two groups by the IMT >1.2 mm(n=20) and ≤1.2 mm(n=35).The relationship between the lipoprotein subfractions and IMT was investigated. Result The older age was more common in patients with IMT>1.2 mm compared to those with IMT≤1.2 mm(P<0.05).The serum level of lipoprotein(a) was higher in group IMT>1.2 mm(0.122±0.077 mmol/L vs 0.081±0.049 mmol/L,P<0.05).After adjusting the age,sex and BMI,the higher IMT was positively correlated with Lp(a) and LDLb;Lp(a) was positively correlated with LDL;TG was positively correlated with fasting blood glucose and LDLb,inverse correlated with HDL、HDL2 and LDLa(P<0.05). With stepwise multivariate logistic regression analysis,older age and Lp(a) were identified as significant and independent risk factors for higher IMT of carotid artery in type 2 diabetic patients(P<0.001 and P=0.021 respectively). Conclusion The results suggest that Lp(a) has a strong association with IMT of carotid arteries and might be the important predictor for early atherosclerosis in type 2 diabetic patients.更多还原