2型糖尿病伴血脂异常患者HDL-C与内皮依赖性血管舒张功能的关系  

The association between high-density lipoprotein cholesterol and endothelium-dependent arterial dilation in type 2 diabetes mellitus with dyslipidemia

作　　者：向光大[1] 何玉生[1] 赵林双[1] 侯洁[1] 乐岭[1] 

机构地区：[1]广州军区武汉总医院内分泌科,武汉430070

出　　处：《中国糖尿病杂志》2007年第8期474-477,共4页Chinese Journal of Diabetes

摘　　要：目的探讨2型糖尿病(T2DM)血脂异常患者HDL-C对血管并发症的保护作用。方法选择无血管并发症的T2DM并血脂异常患者48例,根据HDL-C水平将T2DM患者分为两组:正常HDL组(HDL-C≥1.04mmol/L)和低HDL组(HDL-C<1.04mmol/L)。同期,选择26例健康个体作为对照。采用高分辨血管外超声法检测肱动脉血流介导的内皮依赖性血管舒张功能(EDD)和硝酸甘油介导的内皮非依赖性血管舒张功能。结果(1)与对照组相比,正常HDL组和低HDL组BMI、FPG、2hPG、TC、TG、LDL-C明显高于对照组(P<0.05～0.01)。低HDL组HDL-C明显低于对照组及正常HDL组(P<0.01),而正常HDL组HDL-C水平又低于对照组(P<0.05)。(2)与对照组相比,正常HDL组和低HDL组EDD明显降低(P<0.01)。与正常HDL组相比,低HDL组EDD明显降低(P<0.01)。(3)多元线性相关分析表明,年龄、FPG、2hPG、LDL-C、HDL-C与EDD相关(P<0.05)。结论在T2DM患者中,HDL-C对早期血管并发症具有保护作用。　Objective To investigate the protective effect of high-density lipoprotein cholesterol（HDL-C） on the early phase of atherosclerosis for type 2 diabetes mellitus with dyslipidemia.Methods Forty-eight type 2 diabetic patients with dyslipidemia were selected,and classified into 2 groups of normal HDL（HDL-C≥ 1.04 mmol/L,n=25） and low HDL（HDL-C 〈 1.04 mmol/L,n=23）.All patients were without clinically detectable angiopathy.Meanwhile,26 healthy subjects were selected as control.High resolution ultrasound was used to measure endothelium-dependent arterial dilation（EDD） and endothelium-independent arterial dilation.Results（1） The levels of BMI,FPG,2h PG,TC,TG,LDL-C of in both normal and low HDL groups were significantly higher than those in control（all P 〈 0.05 or P 〈 0.01）.The HDL-C level was significantly lower in low HDL group than in both normal HDL and control groups（P 〈 0.001）,and the HDL-C level was significantly lower in normal HDL group than in control（P 〈 0.05）.（2） The EDD were significantly lower in both normal and low HDL groups than in control（P〈0.001）.The EDD was significantly lower in low HDL group than in normal HDL group（P 〈 0.001）.（3） On multiple linear regression analysis,the FPG,2h PG,LDL-C,age were associated with a lower EDD,and HDL-C was an independent factor for a greater EDD（P 〈 0.05）.Conclusion Our data show a protective effect of HDL-C in the early phase of atherosclerosis for type 2 diabetes mellitus with dyslipidemia.

关 键 词：糖尿病 2型 高密度脂蛋白胆固醇 血管内皮功能 

分 类 号：R587.1[医药卫生—内分泌] R589.2[医药卫生—内科学]