中华糖尿病杂志
中華糖尿病雜誌
중화당뇨병잡지
CHINES JOURNAL OF DLABETES MELLITUS
2012年
4期
202-207
,共6页
田丽%李传伟%陈玉成%曾智%刘英辉%付明德
田麗%李傳偉%陳玉成%曾智%劉英輝%付明德
전려%리전위%진옥성%증지%류영휘%부명덕
冠状动脉疾病%糖尿病%脂蛋白类,HDL
冠狀動脈疾病%糖尿病%脂蛋白類,HDL
관상동맥질병%당뇨병%지단백류,HDL
Coronary disease%Diabetes mellitus%Lipoproteins,HDL
目的 研究经他汀类药物治疗后,冠心病合并糖尿病患者血浆高密度脂蛋白(HDL)亚类分布的谱型特点.方法 选取2009年7月至2010年12月就诊于四川大学华西医院心内科的冠心病住院患者212例为研究对象,其中男108例、女104例,年龄(67±8)岁.依据有无合并糖尿病,分为冠心病伴糖尿病患者115例,冠心病未伴糖尿病患者97例.抽取受试者空腹12 h静脉血,24 h内进行血脂和载脂蛋白分析,高密度脂蛋白(HDL)各亚组分含量的测定采用非变性聚丙烯酰胺凝胶电泳免疫印迹法.两组样本间比较采用t检验,相关性分析采用Pearson相关以及多元线性逐步回归.结果(1)与冠心病未合并糖尿病患者比较,HDL3a[分别为(310±45),(272±38) mg/L]和HDL3b[分别为(170±21),( 142±18) mg/L]水平及Gcnsini评分(分别为54 ±9,23±6)在冠心病合并糖尿病患者中显著增加(t=1.061、0.229、2.531,均P＜0.05)；HDL-C[分别为(1.0±0.2),(1.3±0.2) mmol/L]及HDL2a[分别为(190±26),(286±42) mg/L]和HDL2b[( 245±32),( 334±50) mg/L]含量则在这些患者中显著减少(t=1.406、3.759、4.012,均P＜0.05).上述变化在FPG≥6.1 mmol/L亚组的冠心病合并糖尿病患者中表现的更为明显(t=1.674、1.528、1.620、1.537、3.531、3.608,均P＜0.05).(2)Pearson相关及多元线性逐步回归分析的结果也表明,Gensini评分与大颗粒的HDL2a(β=-0.572,P＜0.01)和HDL2b(β=-0.598,P＜0.01)含量呈显著、独立负相关.结论 (1)冠心病合并糖尿病患者中HDL亚类分布较非糖尿病患者更为异常,推测可能是促发糖尿病患者剩留心血管病风险的一个重要因素.(2)对于LDL-C、TG及HDL-C水平达标的冠心病患者,监测血浆HDL亚组分布谱型及颗粒大小变化有助于评估其冠状动脉阻塞程度.
目的 研究經他汀類藥物治療後,冠心病閤併糖尿病患者血漿高密度脂蛋白(HDL)亞類分佈的譜型特點.方法 選取2009年7月至2010年12月就診于四川大學華西醫院心內科的冠心病住院患者212例為研究對象,其中男108例、女104例,年齡(67±8)歲.依據有無閤併糖尿病,分為冠心病伴糖尿病患者115例,冠心病未伴糖尿病患者97例.抽取受試者空腹12 h靜脈血,24 h內進行血脂和載脂蛋白分析,高密度脂蛋白(HDL)各亞組分含量的測定採用非變性聚丙烯酰胺凝膠電泳免疫印跡法.兩組樣本間比較採用t檢驗,相關性分析採用Pearson相關以及多元線性逐步迴歸.結果(1)與冠心病未閤併糖尿病患者比較,HDL3a[分彆為(310±45),(272±38) mg/L]和HDL3b[分彆為(170±21),( 142±18) mg/L]水平及Gcnsini評分(分彆為54 ±9,23±6)在冠心病閤併糖尿病患者中顯著增加(t=1.061、0.229、2.531,均P＜0.05)；HDL-C[分彆為(1.0±0.2),(1.3±0.2) mmol/L]及HDL2a[分彆為(190±26),(286±42) mg/L]和HDL2b[( 245±32),( 334±50) mg/L]含量則在這些患者中顯著減少(t=1.406、3.759、4.012,均P＜0.05).上述變化在FPG≥6.1 mmol/L亞組的冠心病閤併糖尿病患者中錶現的更為明顯(t=1.674、1.528、1.620、1.537、3.531、3.608,均P＜0.05).(2)Pearson相關及多元線性逐步迴歸分析的結果也錶明,Gensini評分與大顆粒的HDL2a(β=-0.572,P＜0.01)和HDL2b(β=-0.598,P＜0.01)含量呈顯著、獨立負相關.結論 (1)冠心病閤併糖尿病患者中HDL亞類分佈較非糖尿病患者更為異常,推測可能是促髮糖尿病患者剩留心血管病風險的一箇重要因素.(2)對于LDL-C、TG及HDL-C水平達標的冠心病患者,鑑測血漿HDL亞組分佈譜型及顆粒大小變化有助于評估其冠狀動脈阻塞程度.
목적 연구경타정류약물치료후,관심병합병당뇨병환자혈장고밀도지단백(HDL)아류분포적보형특점.방법 선취2009년7월지2010년12월취진우사천대학화서의원심내과적관심병주원환자212례위연구대상,기중남108례、녀104례,년령(67±8)세.의거유무합병당뇨병,분위관심병반당뇨병환자115례,관심병미반당뇨병환자97례.추취수시자공복12 h정맥혈,24 h내진행혈지화재지단백분석,고밀도지단백(HDL)각아조분함량적측정채용비변성취병희선알응효전영면역인적법.량조양본간비교채용t검험,상관성분석채용Pearson상관이급다원선성축보회귀.결과(1)여관심병미합병당뇨병환자비교,HDL3a[분별위(310±45),(272±38) mg/L]화HDL3b[분별위(170±21),( 142±18) mg/L]수평급Gcnsini평분(분별위54 ±9,23±6)재관심병합병당뇨병환자중현저증가(t=1.061、0.229、2.531,균P＜0.05)；HDL-C[분별위(1.0±0.2),(1.3±0.2) mmol/L]급HDL2a[분별위(190±26),(286±42) mg/L]화HDL2b[( 245±32),( 334±50) mg/L]함량칙재저사환자중현저감소(t=1.406、3.759、4.012,균P＜0.05).상술변화재FPG≥6.1 mmol/L아조적관심병합병당뇨병환자중표현적경위명현(t=1.674、1.528、1.620、1.537、3.531、3.608,균P＜0.05).(2)Pearson상관급다원선성축보회귀분석적결과야표명,Gensini평분여대과립적HDL2a(β=-0.572,P＜0.01)화HDL2b(β=-0.598,P＜0.01)함량정현저、독립부상관.결론 (1)관심병합병당뇨병환자중HDL아류분포교비당뇨병환자경위이상,추측가능시촉발당뇨병환자잉류심혈관병풍험적일개중요인소.(2)대우LDL-C、TG급HDL-C수평체표적관심병환자,감측혈장HDL아조분포보형급과립대소변화유조우평고기관상동맥조새정도.
Objective To study phenotype of high-density lipoprotein (HDL) subclasses distribution in coronary heart disease (CHD) patients with diabetes,which might provide useful data in decreasing the incidence of risk among CHD patients with diabetes. Methods 212 patients of coronary heart disease who were dignosed as coronary heart disease by coronary angiography having one or more artery lesion degree ＞ 50％.They were divided into two groups:the CHD with diabetic mellitus (DM)group and the CHD without DM group.All the diagnosis of DM including having the history of diabetes and diagnosis of diabetes after hospitalization.Plasma HDL subclasses contents were quantified in patients with CHD by 2-dimensional gel electrophoresis coupled with immunodetection.Results Although the particle size of HDL shifted toward smaller,the mean levels of low density lipoprotein (LDL-C) and total cholesterol (TC) have achieved normal or desirable for total CHD patients who received statins treatment.Fasting plasma glucose (FPG),triglyceride (TG),TC,LDL-C concentrations,and HDL3b ( ( 170 ± 21 ),( 142 ± 18) mg/L,respectively) and HDL3a( (310 ± 45),(272 ± 38)mg/L,separately) contents along with Gensini Score (54 ± 9,23 ± 6,respectively ) were significantly increased ( t =1.061,0.229,2.531,P ＜ 0.05 ) ; but those of HDL-C ( ( 1.0 ± 0.2 ),( 1.3 ± 0.2 ) mmol/L,respectively ),HDL2b ( ( 245 ± 32 ),( 334 ± 50 ) mg/L,respectively),and HDL2a ( ( 190 ± 26 ),( 286 ± 42 ) mg/L,respectivcly) were significantly decreased in CHD patients with diabetes ( t =1.406,3.759,4.012,P ＜ 0.05 ) versus CHD patients with non-diabetes ; The changes more marked for CHD patients with diabetes in FPG ≥ 6.1 mmol/L (t =1.674,1.528,1.620,1.537,3.531,3.608,P ＜0.05).Pearson correlation and multiple stepwise regression results revealed that the Gensini Score independently and inversely with large-sized HDL2b (β =- 0.598,P ＜ 0.01 ) and HDL2a (β =- 0.572,P ＜ 0.01 ). Conclusion The abnormality of HDL subpopulations distribution may contribute to CHD risk in diabetic patients.CHD patients with diabetes or without diabetes who using statins therapy,the HDL subclasses profile modification behind the improvement of plasma lipids levels.The HDL subclasses distribution may help in severity of coronary artery and risk stratification,particularly in CHD patients with normal or desirable LDL,TG and HDL levels.
