血清空腹血糖、糖化血红蛋白、脂蛋白(a)、小而密低密度脂蛋白胆固醇水平与2型糖尿病患者大血管病变的相关性  

Relationship between fasting blood glucose,glycosylated hemoglobin and lipoproteins(a),small dense low density lipoprotein-cholesterol and vascular disease in type 2 diabetic patients

作　　者：黄建刚[1] 戴婉如 詹文芳[3] 周欢 HUANG Jiangang;DAI Wanru;ZHAN Wenfang;ZHOU Huan(Fujian Provincial Center for Clinical Laboratory,Fuzhou,Fujian 350001,China)

机构地区：[1]福建省临床检验中心,福州350001 [2]福建医科大学省立临床医学院 [3]福建医科大学医学检验技术系

出　　处：《福建医药杂志》2018年第5期19-22,共4页Fujian Medical Journal

摘　　要：目的探讨血清空腹血糖(FPG)、糖化血红蛋白(GHbA1c)、脂蛋白a [Lp (a)]、小而密低密度脂蛋白(sdLDL-C)水平与2型糖尿病(T2DM)患者大血管病变的相关性。方法收集入院行颈动脉彩超的T2DM患者105例(T2DM组)和健康体检者40例(正常对照组),分别检测两组的血清FPG、GHbA1c、Lp (a)、sdLDL-C水平,并比较两组间统计学差异;同时,通过颈动脉彩超检查,根据颈动脉内中膜厚度(IMT)将T2DM组分为IMT<1.0mm和IMT≥1.0mm两类,并分析两类患者血清FPG、GHbA1c、Lp (a)、sdLDL-C水平的统计学差异,以及血清FPG、GHbA1c、Lp(a)、sdLDL-C水平与IMT的直线相关。结果 T2DM组的FPG、GHbA1c、Lp (a)、sdLDL-C水平明显高于正常对照组,两组比较差异有统计学意义(P<0.05)。ITM≥1.0 mm的T2DM患者的GHbA1c和sdLDL-C水平明显高于IMT<1.0mm的T2DM患者,差异有统计学意义(P<0.05);Lp (a)和FPG水平比较差异无统计学意义(P>0.05)。直线相关结果发现,GHbA1c水平与IMT呈正相关(r=0.214,P=0.028);FPG、Lp (a)与sdLDL-C水平与IMT无明显相关性(r=0.066,P=0.504;r=0.080,P=0.419;r=-0.139,P=0.157)。结论血清FPG、GHbA1c、Lp (a)和sdLDL-C水平参与了T2DM的发生、发展,其中GHbA1c与IMT呈现正相关,除了密切监测血清GHbA1c水平,同时监控sdLDL-C水平,对于预示T2DM并发大血管病变具有一定的临床价值。Objective To investigate the correlation between serum fasting blood glucose （FPG）, glycosylated hemoglo bin （GHbAlc） , lipoprotein （a） and small dense low density lipoprotein （sdLDL-C） and macrovascular diseases in type 2 dia betes. Methods A total of 105 type 2 diabetes （TEI）M group） who admitted the carotid artery color doppler flow imaging and 40 healthy persons （normal control group） were collected. Serum FPG, GHbAlc, Lp（a）, and sdLDL- C levels were measured in the two groups. Dividing diabetes into two groups through the carotid artery color ultrasound： IMT〈1.0 mm group and the IMT≥1.0 mm group, which is based on carotid artery intima media thickness （IMT）, and the differences of serum FPG, GHbAlc, Lp （a） and sdLDL-C levels in two groups of patients were analyzed, and serum levels of FPG, GHbAlc, Lp（a） and sdLDL-C were linearly correlated with IMT. Results The level of FPG, GHbAlc, Lp（a） and sdLDL in T2DM group were higher than normal control group, the differences were statistically significant （P〈0.05）. Comparing with IMT≥1.0 group and IMT〈1.0 group, there was a significant difference in GHbA1c and sdLDL-C levels （P〈0.05）, and there was no signifi cant difference in FPGand Lp（a） level （P〉0.05）. The level of GHbA1c was positiveiy correlated with ITM （r=0.214, P〈0.05）. The level of FPG、Lp （a） and sdLDL-C were not significantly associated with IMT （P〉0.05）. Conclusion The level of serum FPG, GHbA1c, Lp（a） and sdLDL-C are involved in the development of diabetes. The level of GHbAlcis closely re lated to the development of type 2 diabetic macroangiopathy. In addition to closely monitoring serum GHbAlc levels and monito ring sdLDL-C levels, it has certain clinical value in predicting T2DM complicated with macroangiopathy.

关 键 词：糖化血红蛋白 空腹血糖 脂蛋白A 小而密低密度脂蛋白 2型糖尿病 颈动脉内中膜厚度 

分 类 号：R34[医药卫生—基础医学]