86例1型糖尿病血脂与糖尿病肾病的关系  

Relationship between plasma lipid and diabetic nephropathy:report of 86 cases

作　　者：裴宁[1] 张烁[1] 林亚静 

机构地区：[1]复旦大学附属华山医院内分泌科,上海200032 [2]浙江省宁海第一医院内分泌科

出　　处：《临床医学》2006年第4期16-17,共2页Clinical Medicine

摘　　要：目的探讨血脂和脂蛋白代谢的改变与1型糖尿病肾病的关系。方法将86例1型糖尿病患者参照Mogens-en关于糖尿病肾病(DN)分类标准,分为DN组(65例)和糖尿病无肾病组(21例),根据尿白蛋白排泄率(UAER)及血肌酐水平将DN又分为三个亚组,分为早期肾病组(n=28),临床肾病组(n=23)和晚期肾病组(n=14)。观测患者血糖、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)和脂蛋白A(ApoA)、脂蛋白B(ApoB)变化。结果与糖尿病无肾病组比较,DN组血清甘油三酯、低密度脂蛋白胆固醇(LDL-C)水平升高(P<0.05或P<0.01);DN三亚组之间血脂、载脂蛋白随着DN程度加重而升高,差异有统计学意义(P<0.01);血清甘油三酯、LDL-C、载脂蛋白B水平与UAER、血糖呈正相关(P<0.01)。结论DN患者存在明显的脂质代谢异常,与血糖控制不良有关,且随着肾脏损害程度加重而加重,高血脂促进DN的发生和发展,糖尿病则加重血脂紊乱,形成恶性循环。Objective To study the relationship between diabetic nephropathy（DN） and impaired lipid metabolism. Methods Eighty - six patients with type 1 diabetes mellitus （DM） were divided into two groups according to the Mogensen criterion of DN ： groupA , 65 DN patients who were divided into 3 subgroups according to levels of urinary album excretion rate （UAER） and creatinine, and group B , 21 nonDN DM patients. Plasma total lipid , apolipoprotein and GHbA1c were tested in all of them, and compared with control group. Results Levels of plasma triglycerides （TG） and low density lipoprotein cholesterol （ LDL - C） in group B were high compared with control group （ P 〈 0. 05 orP 〈 0. 01） . Differences of level of plasma lipid and apolipoprotein among the 3 subgroups in group A were statistically significant different （ P 〈 0. 01 ） , while levels of plasma TG, LDL and apolipoprotein B were positively correlated with UAER and plasma glucose （ P 〈 0. 01 ） . Conclusion Impaired lipid metabolism is obvious in DN patients , which is correlated with bad controlled plasma glucose and degree of impaired kidney function. Hyperlipidemia accelerates the occurrence and development of DN , while hyperglycaemia aggravates impaired lipid metabolism , and a vicious circle is established.

关 键 词：1型糖尿病 糖尿病肾病 血脂 脂蛋白 

分 类 号：R587.2[医药卫生—内分泌]