【摘要】 目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清高密度脂蛋白(high-density lipoprotein,HDL)亚组分HDL2b的变化特点及对预测冠状动脉粥样硬化性心脏病(coronary heart disease,CHD)风险的意义。方法采用病例对照研究的方法观察41例T2DM患者及41例空腹血糖正常(normal fasting glucose,NFG)对照者,病例均来自于北京市顺义区南法信镇35～74岁自然人群,2组研究对象的年龄、性别、体质量指数(body mass index,BMI)、腰围、臀围、血压均匹配,采用微流芯片(microfluidic chip)技术测定空腹血清HDL、HDL2b、HDL2b/HDL比率,并对10年CHD发生风险(10-year CHD risk)进行评估。结果 T2DM组患者空腹血糖(fasting plasma glucose,FPG)、稳态模型胰岛素敏感指数(homeostasis model for insulin resistance,HOMA-IS)、胰岛素抵抗指数(homeostasis model assessment-insulin resistant index,HOMA-IR)、三酰甘油(triglycerides,TG)、血清总胆固醇(total cholesterol,TC)、10年CHD发生风险均显著高于对照组(P<0.05),HDL、HDL2b、HDL2b/HDL比率显著低于对照组(P<0.01),HDL2b与FBG、空腹胰岛素(fasting insulin,FINS)、TG、TC、HOMA-IR、10年CHD发生风险呈负相关,HDL2b与FBG及10年CHD发生风险相关性优于HDL。结论 T2DM患者HDL2b显著降低,10年CHD发生风险显著上升,与HDL相比,HDL2b预测CHD发生风险更加敏感。更多还原

【Abstract】 Objective To investigate the characteristics of plasma high-density lipoprotein(HDL) subfraction HDL2b changes and their significance in prediction of risks for coronary heart disease(CHD) in patients with type 2 diabetes mellitus(T2DM).Methods Totally 41 T2DM patients and 41 controls with normal fasting glucose matched in age,gender,body mass index(BMI),circumference of waist,circumference of hip,and blood pressure were enrolled.The controls were from a normal population aged 35~74 year-old from Nanfaxin,a town in Shunyi District,Beijing.A microfluidic chip method was adopted to measure total HDL,HDL2b and the ratio of HDL2b/HDL,and the 10-year CHD risk was evaluated.Results T2DM patients had higher fasting plasma glucose(FPG),Homeostasis model for insulin resistance(HOMA-IS),homeostasis model assessment-insulin resistant index(HOMA-IR),triglycerides(TG),total cholesterol(TC) and 10 year CHD risk than the controls(P<0.05),while HDL,HDL2b and the ratio of HDL2b/HDL were lower in the T2DM patients(P<0.01).HDL2b was found to be negatively correlated with FBG,fasting insulin(FINS),TC,TG,HOMA-IR and 10 year CHD risk.The relationship of FBG and 10-year CHD risk with HDL2b was stronger than with HDL.Conclusion T2DM patients have significantly lower HDL2b levels,higher 10-year CHD risk.HDL2b is therefore a more sensitive predictor than HDL.更多还原