CAJ | 학술논문

目的探讨2型糖尿病患者正常范围内血清DBil水平与血脂的相关性.方法收集2012年6月-2013年6月在解放军总医院收治的979例2型糖尿病患者临床资料,记录DBil、TC、TG、HDL-C、LDL-C.将DBil按四分位数分为Q1组(＜2.2μmol/L)、Q2组(2.2～＜2.9 μmol/L)、Q3组(2.9 ～＜3.9 μmol/L)、Q4组(≥3.9μmol/L),分析血清DBil水平与血脂的相关性.结果 (1)协方差分析中,调整年龄、性别、糖尿病病程、BMI、吸烟、饮酒、糖化血红蛋白(HbA1c)、空腹血糖、药物治疗、ALT、AST和脂肪肝因素后,Q4组TC、TG、LDL-C水平明显低于Q1～ Q3组,各组间HDL-C水平差异无统计学意义(P=0.65);(2) Pearson相关分析显示,DBil与TC(r=-0.33,P＜0.01)、TG (r=-0.23,P＜0.01)、LDL-C(r=-0.18,P＜0.01)呈负相关,仅在男性中与HDL-C呈正相关(r=0.14,P＜0.01);多元线性回归分析显示DBil是TC、TG、LDL-C的独立影响因素;(3)采用logistic回归分析,以Q1组为对照,调整年龄、性别、糖尿病病程、BMI、吸烟、饮酒、HbA1c、空腹血糖、药物治疗、ALT、AST和脂肪肝因素后,Q2 ～ Q4组血脂异常患病风险OR值分别为0.54(95％CI0.35 ～ 0.82,P＜0.01)、0.56(95％ CI0.37 ～0.85,P＜0.01)和0.44 (95％CI0.29～0.69,P＜0.01);此外,男性、年龄＜55岁、HbA1c≥6.5％、BMI＜ 25 kg/m2和无脂肪肝的患者中Q4组血脂异常患病风险较Q1组显著降低.结论 2型糖尿病患者中正常范围内血清DBil水平与血脂密切相关,可能是血脂异常的独立保护因素.
목적 탐토2형당뇨병환자정상범위내혈청DBil수평여혈지적상관성.방법 수집2012년6월-2013년6월재해방군총의원수치적979례2형당뇨병환자림상자료,기록DBil、TC、TG、HDL-C、LDL-C.장DBil안사분위수분위Q1조(＜2.2μmol/L)、Q2조(2.2～＜2.9 μmol/L)、Q3조(2.9 ～＜3.9 μmol/L)、Q4조(≥3.9μmol/L),분석혈청DBil수평여혈지적상관성.결과 (1)협방차분석중,조정년령、성별、당뇨병병정、BMI、흡연、음주、당화혈홍단백(HbA1c)、공복혈당、약물치료、ALT、AST화지방간인소후,Q4조TC、TG、LDL-C수평명현저우Q1～ Q3조,각조간HDL-C수평차이무통계학의의(P=0.65);(2) Pearson상관분석현시,DBil여TC(r=-0.33,P＜0.01)、TG (r=-0.23,P＜0.01)、LDL-C(r=-0.18,P＜0.01)정부상관,부재남성중여HDL-C정정상관(r=0.14,P＜0.01);다원선성회귀분석현시DBil시TC、TG、LDL-C적독립영향인소;(3)채용logistic회귀분석,이Q1조위대조,조정년령、성별、당뇨병병정、BMI、흡연、음주、HbA1c、공복혈당、약물치료、ALT、AST화지방간인소후,Q2 ～ Q4조혈지이상환병풍험OR치분별위0.54(95％CI0.35 ～ 0.82,P＜0.01)、0.56(95％ CI0.37 ～0.85,P＜0.01)화0.44 (95％CI0.29～0.69,P＜0.01);차외,남성、년령＜55세、HbA1c≥6.5％、BMI＜ 25 kg/m2화무지방간적환자중Q4조혈지이상환병풍험교Q1조현저강저.결론 2형당뇨병환자중정상범위내혈청DBil수평여혈지밀절상관,가능시혈지이상적독립보호인소.
Objective To investigate the association between DBil with normal range and serum lipid in type 2 diabetic patients.Methods A total of 979 subjects with type 2 diabetes admitted to the Department of Endocrinology of Chinese PLA General Hospital from June 2012 to June 2013 were included for the study.Serum DBil,TC,TG,HDL-C and LDL-C levels were collected for the analyses.Subjects were divided into four groups based on the DBil levels:Q1 group (＜2.2 μmol/L),Q2 group(2.2-＜ 2.9 μmol/L),Q3 group (2.9-＜ 3.9 μmol/L) and Q4 group (≥3.9 μmol/L).Results (1)TC,TG,LDL-C levels were significantly lower in Q4 group than those in the other three Q groups after adjustment of age,gender,duration of diabetes,BMI,smoking,drinking,glycosylated hemoglobin A1 c (HbA1 c),fasting plasma glucose(FPG),medication,ALT,AST and fatty liver.No difference could be viewed in HDL-C level between each group (P =0.65).(2) Pearson correlation analyses showed that DBil was inversely correlated withTC (r=-0.33,P＜ 0.01),TG (r=-0.23,P＜ 0.01),LDL-C(r =-0.18,P＜ 0.01),and positively correlated with HDL-C level in men (r =0.14,P ＜ 0.01),respectively.Multiple linear regression analyses showed DBil was an independent impact factor for TC,TG and LDL-C.(3) Compared with Q1 group,the odds ratio (OR) for dyslipidemia was 0.54 (95％ CI 0.35-0.82,P ＜ 0.01),0.56 (95％CI0.37-0.85,P＜0.01) and 0.44 (95％CI0.29-0.69,P＜0.01) in Q2,Q3 and Q4 group,respectively,after age,gender,duration of diabetes,BMI,smoking,drinking,HbA1c,FPG,medication,ALT,AST and fatty liver were adjusted.Moreover,the OR for dyslipidemia was much lower in Q4 man subjects with age ＜ 55 years,HbAlc ≥ 6.5％,BMI ＜ 25 kg/m2,and with no fatty liver.Conclusion DBil in normal range was closely associated with lipid profile in type 2 diabetes.It might play a protective effect in dyslipidemia.