| 摘要: |
| 目的 探讨新诊断2型糖尿病(T2DM)合并代谢综合征(MS)患者血清低密度脂蛋白胆固醇(LDL-C)/高密度脂蛋白胆固醇(HDL-C)比值变化及其与各临床指标的相关性。方法 选择新诊断T2DM患者140例, 根据是否合并MS分为MS组73例、非MS组67例, 另设立正常对照组73例。所有研究对象均行口服葡萄糖耐量试验(OGTT)及胰岛素释放试验, 并检测血糖、胰岛素、血脂等相关生化指标, 计算各组LDL-C/HDL-C比值。比较各组临床指标及LDL-C/HDL-C比值水平变化, 分析LDL-C/HDL-C比值与各指标的相关性。根据LDL-C/HDL-C水平三分位分组, 比较各组MS患病率。结果 MS组(3.18±0.85)及非MS组(2.61±0.93)LDL-C/HDL-C均高于对照组(2.26±0.70), 且MS组的LDL-C/HDL-C亦高于非MS组, 差异有统计学意义(P<0.05)。根据LDL-C/HDL-C水平三分位分组, 各组MS患病率分别为11.27%、35.21%、56.34%, 随着LDL-C/HDL-C水平升高MS患病率升高(P<0.05)。相关分析显示, LDL-C/HDL-C比值与体质指数(BMI)、腰围(WC)、腰臀比(WHR)、收缩压、舒张压、餐后2 h血糖(PPG)、空腹胰岛素( FINS)、餐后2 h胰岛素(PSI)、胰岛素抵抗指数(HOMA-IR)、三酰甘油(TG)、血浆总胆固醇(CHOL)、LDL-C呈正相关(P<0.05), 与HDL-C呈负相关(P< 0.01)。以LDL-C/HDL-C为因变量作多元逐步回归分析, 有HDL-C、LDL-C、FINS进入方程(P<0.01)。结论 T2DM合并MS患者LDL-C/HDL-C的比值升高, 且高水平LDL-C/HDL-C比值患者的MS患病率高, LDL-C/HDL-C比值较单纯LDL-C浓度能更好地评估MS发生的危险性, 为MS的预防和治疗提供更简便、有效的方案。 |
| 关键词: 2型糖尿病 代谢综合征 LDL胆固醇 HDL胆固醇 |
| DOI：10.3724/SP.J.1008.2014.01396 |
| 投稿时间：2014-05-08修订日期：2014-09-25 |
| 基金项目:国家自然科学基金(81370965), 江苏省自然科学基金(BK2009208), 江苏省卫生厅国际交流支撑计划及面上科技项目(H201247), 镇江市社会发展科技支撑项目(SH2013027, SH 2012027), 镇江市科技支撑(社会发展)指导性项目 (FZ2012038). |
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| LDL cholesterol/HDL cholesterol ratio in newly diagnosed type 2 diabetic patients complicated with metabolic syndrome |
| JIA Jue,YU Shu-qin,YE Jing-jing,YIN Jiang-ning,WANG Dong,YUAN Guo-yue* |
(The Affiliated Hospital of Jiangsu University, Zhenjiang 212001, Jiangsu, China
*Corresponding author) |
| Abstract: |
| Objective To investigate the change of low-density lipoprotein cholesterol (LDL-C)/high-density lipoprotein cholesterol (HDL-C) ratio in newly diagnosed patients with type 2 diabetes mellitus (T2DM) and metabolic syndrome (MS), and to discuss its relationship with the clinical parameters. Methods Totally 140 newly diagnosed T2DM patients were selected for this study, and they were divided into MS group (n=73) and non-MS group (n=67) according to the presence of MS; the normal control group included 73 participants (NC group). All participants underwent an oral glucose tolerance test (OGTT) and insulin releasing test; meanwhile, the blood glucose, insulin, blood lipid and other items were measured. The LDL-C/HDL-C ratios of each group were calculated. Clinical parameters and LDL-C/HDL-C ratios were compared among different groups, and correlation analysis was made between LDL-C/HDL-C ratios and clinical indices. Furthermore, all participants were divided into three groups according to LDL-C/HDL-C levels and the prevalence rates of MS were compared. Results The LDL-C/HDL-C ratios of MS group (3.18±0.85) and non-MS group (2.61±0.93) were significantly higher than that in NC group (2.26±0.70, P<0.05), and the LDL-C/HDL-C ratio of MS group was significantly higher than that in non-MS group (P<0.05). The prevalence rates of MS were significantly increased in the patients with the elevation of LDL-C/HDL-C (11.27%, 35.21%, and 56.34%, P<0.05). Correlation analysis showed that LDL-C/HDL-C ratio was positively correlated with the body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), postprandial plasma glucose (PPG), fasting insulin (FINS), postprandial insulin (PSI), homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride (TG), cholesterol (CHOL) and LDL-C (P<0.05), and negatively correlated with HDL-C (P<0.01). When LDL-C/HDL-C was taken as the dependent variable, multiple regression analysis showed that HDL-C, LDL-C and FINS entered the equation (P<0.01). Conclusion The LDL-C/HDL-C ratio is increased in T2DM patients complicated with MS, and the prevalence rate of MS is higher in patients with high LDL-C/HDL-C value. The ratio of LDL-C/HDL-C may be a better index for the early detection of MS compared with LDL-C, which provides a simple, feasible strategy for the prevention and treatment of MS. |
| Key words: type 2 diabetes mellitus metabolic syndrome LDL cholesterol HDL cholesterol |
