【摘要】 目的研究２型糖尿病患者的脂蛋白（ａ）〔Ｌｐ（ａ）〕浓度和载脂蛋白（ａ）〔ａｐｏ（ａ）〕的多态性以及与糖尿病慢性并发症的关系。方法本研究用改良的Ｕｔｅｒｍａｎｎ和Ｇｕｏ方法对４０名非糖尿病对照和１７６名２型糖尿病患者进行ａｐｏ（ａ）分型检测，观察其与Ｌｐ（ａ）浓度以及微血管和大血管并发症之间的关系，包括肾脏病变、视网膜病变、神经病变、高血压、冠心病、脑梗塞。结果４０名非糖尿病对照之ａｐｏ（ａ）分型：Ｓ３Ｓ２、Ｓ４和Ｓ４Ｓ２的发生频率分别为２０％、７０％和１０％，血清Ｌｐ（ａ）水平为（０．０８±０．０７）ｍｇ／Ｌ。而２型糖尿病患者Ｓ２、Ｓ３、Ｓ３Ｓ２、Ｓ４、Ｓ４Ｓ２和Ｓ４Ｓ３的发生频率分别为１８．１８％、２０．４５％、１７．０５％、３４．０９％、４．５５％和５．６８％，Ｌｐ（ａ）浓度为（０．１３±０．１１）ｍｇ／Ｌ，明显高于非糖尿病对照。与不伴有并发症的糖尿病患者比较，除糖尿病视网膜病变，伴肾脏病变、神经病变、高血压、冠心病、脑梗塞患者之ａｐｏ（ａ）分型分布频率有显著差异。与Ｓ２基因表现型患者比较，Ｓ４表现型患者之空腹血糖、餐后２小时血糖和糖基化血红蛋白水平明显降低。不同基因表现型患者之Ｌｐ（ａ）浓度和尿白蛋白?更多还原

【Abstract】 Objective To investigate the lipoprotein(a) concentration and apolipoprotein(a) apo(a) polymorphism in type 2 diabetic patients and its relationship to complications. Methods Apo(a) phenotypes were tested with modified Utermann and Guo method in 40 non diabetic controls and 176 type 2 diabetic subjects and the association between apo(a) phenotypes and micro and macrovascular complications including nephropathy, neuropathy, retinopathy, hypertension, coronary heart disease and cerebral infarction was analyzed. Results Among the 40 non diabetic controls, the frequencies of S3S2, S4 and S4S2 were 20%, 70% and 10% respectively and the serum Lp(a) level was (0.08±0.07)mg/L. While the frequencies of S2, S3, S3S2, S4, S4S2, S4S3 were 18.18%, 20.45%, 17.05%, 34.09%, 4.55% and 5.68% respectively in the diabetics and the Lp(a) concentration was (0.13±0.11)mg/L, significantly higher in the diabetics than the non diabetic controls. Compared with the diabetics without complications, the frequencies of apo(a) phenotypes significantly differed in patients with neuropathy, nephropathy, hypertension, coronary heart disease and cerebral infarction except diabetic retinopathy. Compared with patients with S2 phenotype, the levels of FPG, 2hPG and HbA 1c were lower in patients with S4 phenotype. The concentration of Lp(a) and Alb/Cr were significantly different among diabetics with different apo(a) phenotypes, being highest in patients with S2, then in S3, and lowest in S4. Conclusion There were significant differences in the frequencies of apo(a) phenotypes between type 2 diabetic subjects and non diabetic controls, and also between diabetics with and without microvascular and macrovascular complicatios. The underlying linkage might be microalbuminuria and insulin resistance.更多还原