超重及肥胖2型糖尿病患者血浆脂蛋白相关磷脂酶A2水平与颈动脉内膜中层厚度的相关性研究  

A study on the correlation between plasma lipoprotein-associated phospholipase A2 level and carotid intima-media thickness in overweight and obese patients with type 2 diabetes mellitus

作　　者：荀靖琼[1] 康省 唐敏娟[1] 刘晓玲[1] 骆翠琼[1] 苏珂[1] XUN Jing-qiong;KANG Sheng;TANG Min-juan(Department of Endocrinology, Affiliated Hospital of Guilin Medical University, Guangxi 541000, China)

机构地区：[1]桂林医学院附属医院内分泌科,广西541000 [2]兰陵县人民医院内分泌科,山东277799

出　　处：《中国临床新医学》2021年第5期460-463,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：广西卫健委科研课题(编号:Z20180408)。

摘　　要：目的探讨超重及肥胖2型糖尿病(T2DM)患者血浆脂蛋白相关磷脂酶A2(Lp-PLA_(2))水平及其与颈动脉内膜中层厚度(IMT)的相关性。方法选择2018-01~2018-08桂林医学院附属医院收治的T2DM患者95例,根据体质量指数(BMI)将其分为单纯T2DM组(BMI<24 kg/m^(2))56例和超重及肥胖T2DM组(BMI≥24 kg/m^(2))39例。比较两组空腹血糖(FBG)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹胰岛素(FINS)、胰岛素抵抗指数(IRI)、糖化血红蛋白(HbA1c)、颈动脉IMT和Lp-PLA_(2)。分析Lp-PLA_(2)与颈动脉IMT的相关性。结果与单纯T2DM组相比,超重及肥胖T2DM组的FINS、IRI、TC、LDL-C、Lp-PLA_(2)及颈动脉IMT水平较高,HDL-C水平较低,差异有统计学意义(P<0.05)。两组FBG、HbA1c、TG比较差异无统计学意义(P>0.05)。T2DM患者血浆Lp-PLA_(2)水平与颈动脉IMT水平呈正相关(r=0.388,P=0.000)。单纯T2DM组和超重及肥胖T2DM组血浆Lp-PLA_(2)水平与颈动脉IMT水平均呈正相关(r=0.292,P=0.029;r=0.470,P=0.003)。多元线性回归分析结果显示,较高水平的BMI、LDL-C及Lp-PLA_(2)是影响颈动脉IMT增厚的主要危险因素(P<0.05)。结论超重及肥胖T2DM患者的血浆Lp-PLA_(2)水平较高,且Lp-PLA_(2)水平与颈动脉IMT呈正相关,检测该指标可能有利于临床医师及早发现、干预糖尿病大血管病变的发生。Objective To investigate the plasma lipoprotein-associated phospholipase A2(Lp-PLA_(2))level in overweight and obese patients with type 2 diabetes mellitus(T2DM),and its correlation with carotid intima-media thickness(IMT).Methods Ninety-five T2DM patients who were admitted to the Affiliated Hospital of Guilin Medical University from January 2018 to August 2018 were selected.They were divided into simple T2DM group(BMI<24 kg/m^(2),n=56)and overweight and obese T2DM group(BMI≥24 kg/m^(2),n=39)according to their different values of Body Mass Index(BMI).The levels of fasting blood-glucose(FBG),total cholesterol(TC),triglyceride(TG),high density lipoprotein-cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C),fasting insulin(FINS),insulin resistance index(IRI),glycated haemoglobin A1c(HbA1c),carotid IMT and Lp-PLA_(2)were compared between the two groups.The correlation between Lp-PLA_(2)and carotid IMT was analyzed.Results The levels of FINS,IRI,TC,LDL-C,Lp-PLA_(2)and carotid IMT in the overweight and obese T2DM group were significantly higher than those in the simple T2DM group,while the level of HDL-C in the overweight and obese T2DM group was significantly lower than that in the simple T2DM group(P<0.05).There were no statistically significant differences between the two groups in the levels of FBG,HbA1c and TG(P>0.05).There was a positive correlation between plasma Lp-PLA_(2)level and carotid IMT level in the T2DM patients(r=0.388,P=0.000).There were positive correlations between plasma Lp-PLA_(2)level and carotid IMT level in the simple T2DM group and the overweight and obese T2DM group(r=0.292,P=0.029;r=0.470,P=0.003).The results of multiple linear regression analysis showed that higher levels of BMI,LDL-C and Lp-PLA_(2)were the main risk factors affecting carotid IMT thickening(P<0.05).Conclusion Overweight and obese T2DM patients have higher levels of plasma Lp-PLA_(2),and the level of Lp-PLA_(2)is positively correlated with carotid IMT.The detection of this index may be beneficial to clinicians fo

关 键 词：2型糖尿病 脂蛋白相关磷脂酶A_(2) 颈动脉内膜中层厚度 超重 肥胖 

分 类 号：R587.1[医药卫生—内分泌]