中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
2期
199-203
,共5页
类风湿关节炎%糖尿病,2型%红细胞沉降率%血糖%血脂
類風濕關節炎%糖尿病,2型%紅細胞沉降率%血糖%血脂
류풍습관절염%당뇨병,2형%홍세포침강솔%혈당%혈지
Rheumatoid arthritis%Diabetes mellitus,type 2%Erythrocyte sedimentation rate%Blood glucose%Blood lipids
目的 探讨合并类风湿关节炎(RA)的2型糖尿病(T2DM)患者血糖及血脂代谢的特点.方法 选择73例合并RA的T2DM患者作为观察组,不合并RA的T2DM患者60例作为对照组.2组分别检测体重指数、收缩压、舒张压、血清中三酰甘油、总胆固醇、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖,餐后2h血糖(PBG)、C反应蛋白(CRP)、糖化血清白蛋白(GA)及糖化血红蛋白(HbA1c)及红细胞沉降率(ESR),比较2组患者各指标的差异.按照ESR是否升高将T2DM合并RA患者分为2组,比较各实验室指标的差异.结果 合并RA的T2DM患者血清总胆固醇为(4.3±1.0) mmol/L,明显低于不合并RA的T2DM患者(4.7±0.9) mmol/L,差异有统计学意义(P＜0.05);合并RA的T2DM患者总胆固醇/HDL-C (4.0±1.0)明显低于不合并RA的T2DM患者(4.5±1.4),差异有统计学意义(P＜0.05);LDL-C水平(2.6±0.7) mmol/L与不合并RA的T2DM患者(3.0±0.4)mmol/L比较,差异有统计学意义(P＜0.01);合并RA的T2DM患者血清CRP中位数为14.54(1.62,17.95) mg/L,明显高于不合并RA的T2DM患者2.13(0.83,4.77) mg/L(P＜ 0.01),ESR(38±22) mm/1 h也较不合并RA的T2DM患者(16±11)mm/1 h明显升高,差异有统计学意义(P＜0.01);2组患者体重指数、收缩压及舒张压比较差异无统计学意义,2组三酰甘油、空腹血糖、PBG、GA及HbA1c比较差异亦无统计学意义.在合并RA的T2DM患者中,ESR升高组总胆固醇/HDL-C (4.2 ± 1.0) mmol/L明显高于ESR正常组(3.7±0.8) mmol/L(P＜0.05),ESR升高组GA水平(28±11)％明显高于ESR正常组(18±5)％(P＜0.05),CRP水平中位数为15.52(6.47,28.67) mmol/L亦明显高于ESR正常组3.14(1.17,6.18) mmol/L(P ＜0.01);2组空腹血糖、PBG及HbA1c比较差异无统计学意义.结论 合并RA的T2DM患者血脂水平明显低于不合并RA的T2DM患者,RA患者风湿活动使机体维持在高水平的炎症状态,导致血糖及血脂代谢紊乱,可能进一步加重T2DM患者的患心血管疾病的风险.
目的 探討閤併類風濕關節炎(RA)的2型糖尿病(T2DM)患者血糖及血脂代謝的特點.方法 選擇73例閤併RA的T2DM患者作為觀察組,不閤併RA的T2DM患者60例作為對照組.2組分彆檢測體重指數、收縮壓、舒張壓、血清中三酰甘油、總膽固醇、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)、空腹血糖,餐後2h血糖(PBG)、C反應蛋白(CRP)、糖化血清白蛋白(GA)及糖化血紅蛋白(HbA1c)及紅細胞沉降率(ESR),比較2組患者各指標的差異.按照ESR是否升高將T2DM閤併RA患者分為2組,比較各實驗室指標的差異.結果 閤併RA的T2DM患者血清總膽固醇為(4.3±1.0) mmol/L,明顯低于不閤併RA的T2DM患者(4.7±0.9) mmol/L,差異有統計學意義(P＜0.05);閤併RA的T2DM患者總膽固醇/HDL-C (4.0±1.0)明顯低于不閤併RA的T2DM患者(4.5±1.4),差異有統計學意義(P＜0.05);LDL-C水平(2.6±0.7) mmol/L與不閤併RA的T2DM患者(3.0±0.4)mmol/L比較,差異有統計學意義(P＜0.01);閤併RA的T2DM患者血清CRP中位數為14.54(1.62,17.95) mg/L,明顯高于不閤併RA的T2DM患者2.13(0.83,4.77) mg/L(P＜ 0.01),ESR(38±22) mm/1 h也較不閤併RA的T2DM患者(16±11)mm/1 h明顯升高,差異有統計學意義(P＜0.01);2組患者體重指數、收縮壓及舒張壓比較差異無統計學意義,2組三酰甘油、空腹血糖、PBG、GA及HbA1c比較差異亦無統計學意義.在閤併RA的T2DM患者中,ESR升高組總膽固醇/HDL-C (4.2 ± 1.0) mmol/L明顯高于ESR正常組(3.7±0.8) mmol/L(P＜0.05),ESR升高組GA水平(28±11)％明顯高于ESR正常組(18±5)％(P＜0.05),CRP水平中位數為15.52(6.47,28.67) mmol/L亦明顯高于ESR正常組3.14(1.17,6.18) mmol/L(P ＜0.01);2組空腹血糖、PBG及HbA1c比較差異無統計學意義.結論 閤併RA的T2DM患者血脂水平明顯低于不閤併RA的T2DM患者,RA患者風濕活動使機體維持在高水平的炎癥狀態,導緻血糖及血脂代謝紊亂,可能進一步加重T2DM患者的患心血管疾病的風險.
목적 탐토합병류풍습관절염(RA)적2형당뇨병(T2DM)환자혈당급혈지대사적특점.방법 선택73례합병RA적T2DM환자작위관찰조,불합병RA적T2DM환자60례작위대조조.2조분별검측체중지수、수축압、서장압、혈청중삼선감유、총담고순、고밀도지단백담고순(HDL-C)、저밀도지단백담고순(LDL-C)、공복혈당,찬후2h혈당(PBG)、C반응단백(CRP)、당화혈청백단백(GA)급당화혈홍단백(HbA1c)급홍세포침강솔(ESR),비교2조환자각지표적차이.안조ESR시부승고장T2DM합병RA환자분위2조,비교각실험실지표적차이.결과 합병RA적T2DM환자혈청총담고순위(4.3±1.0) mmol/L,명현저우불합병RA적T2DM환자(4.7±0.9) mmol/L,차이유통계학의의(P＜0.05);합병RA적T2DM환자총담고순/HDL-C (4.0±1.0)명현저우불합병RA적T2DM환자(4.5±1.4),차이유통계학의의(P＜0.05);LDL-C수평(2.6±0.7) mmol/L여불합병RA적T2DM환자(3.0±0.4)mmol/L비교,차이유통계학의의(P＜0.01);합병RA적T2DM환자혈청CRP중위수위14.54(1.62,17.95) mg/L,명현고우불합병RA적T2DM환자2.13(0.83,4.77) mg/L(P＜ 0.01),ESR(38±22) mm/1 h야교불합병RA적T2DM환자(16±11)mm/1 h명현승고,차이유통계학의의(P＜0.01);2조환자체중지수、수축압급서장압비교차이무통계학의의,2조삼선감유、공복혈당、PBG、GA급HbA1c비교차이역무통계학의의.재합병RA적T2DM환자중,ESR승고조총담고순/HDL-C (4.2 ± 1.0) mmol/L명현고우ESR정상조(3.7±0.8) mmol/L(P＜0.05),ESR승고조GA수평(28±11)％명현고우ESR정상조(18±5)％(P＜0.05),CRP수평중위수위15.52(6.47,28.67) mmol/L역명현고우ESR정상조3.14(1.17,6.18) mmol/L(P ＜0.01);2조공복혈당、PBG급HbA1c비교차이무통계학의의.결론 합병RA적T2DM환자혈지수평명현저우불합병RA적T2DM환자,RA환자풍습활동사궤체유지재고수평적염증상태,도치혈당급혈지대사문란,가능진일보가중T2DM환자적환심혈관질병적풍험.
Objective To investigate the characteristics of blood glucose and lipid metabolism in patients of type 2 diabetes mellitus (T2DM)concomitant with rheumatoid arthritis (RA).Methods Totally 73 patients of T2DM concomitant with RA were enrolled; T2DM patients without RA were as controls.Body mass index (BMI),systolic blood pressure (SBP) and diastolic blood pressure (DBP) in patients of T2DM with and without RA were measured.Serum triglyceride (TG),total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),fasting blood glucose (FBG),2 h postprandial blood glucose (PBG),C-reactive protein (CRP),glycated albumin (GA),glycosylated hemoglobin (HbA1 c) and erythrocyte sedimentation rate (ESR) were detected; the differences of each index between 2 groups were compared; patients of T2DM concomitant with RA were divided into abnormal ESR and normal ESR groups.Results Levels of serum TC were lower in T2DM combined with RA patients (4.3 ± 1.0) mmol/L than those of controls (4.7 ± 0.9) mmol/L(P ＜0.05) ; TC / HDL-C (4.0 ± 1.0) were lower in T2DM concomitant with RA patients (4.5 ± 1.4) (P ＜ 0.05) ;LDL-C levels in patients of T2DM concomitant with RA (2.6 ± 0.7) mmol/L were significantly lower (3.0 ±0.4) mmol/L (P ＜ 0.01) ; serum CRP and ESR were significantly higher in patients of T2DM concomitant with RA than those in control group 14.54 (1.62,17.95) mg/L vs 2.13 (0.83,4.77) mg/L and (38 ± 22) vs (16 ± 11) mm/1 h,respectively (all P ＜ 0.01) ; BMI,SBP and DBP in patients of T2DM with and without RA did not show any differences; TG,FBG,PBG,GA and HbAlc did not show significant differences between 2 groups.In patients of T2DM concomitant with RA,TC/HDL-C were significantly higher in abnormal ESR group (4.2 ± 1.0)mmol/L (P ＜ 0.05) ; GA levels were higher in abnormal ESR group(28 ± 11)％ than those in normal ESR group (18 ± 5) ％ (P ＜ 0.05) ; CRP level was significantly higher in abnormal ESR group 15.52 (6.47,28.67) mg/L than that in normal ESR group 3.14 (1.17,6.18)nmg/L(P ＜ 0.01) ; FBG,PBG and HbA1c did not show any differences between 2 groups.Conclusions The levels of lipids metabolism in patients of T2DM concomitant with RA are significantly lower than those in patients of T2DM without RA ; the lipids metabolism disorders may be caused by RA itself.Elevated activity of RA disease may increase the level of inflammatory response and disorders of blood glucose and lipids metabolism,which may further aggravate the risk of cardiovascular disease in patients with T2DM.
