血清小而密低密度脂蛋白联合脂蛋白残粒在2型糖尿病患者合并动脉粥样硬化诊断中的价值  

Value of small dense low-density lipoprotein combined with residual lipoprotein particles in the diagnosis of atherosclerosis in patients with type 2 diabetes mellitus

作　　者：翟静晶 孙燕瑜 顾纯吉 陈燕 ZHAI Jingjing;SUN Yanyu;GU Chunji;CHEN Yan(Department of Medical Laboratory,Suzhou Municipal Hospital Suzhou Hospital Affiliated to Nanjing Medical University,Jiangsu Province,Suzhou 215000,China)

机构地区：[1]江苏省苏州市立医院,南京医科大学附属苏州医院医学检验科,江苏苏州215000

出　　处：《中国医药导报》2024年第5期123-126,共4页China Medical Herald

基　　金：江苏省自然科学基金面上项目(BK20181164)。

摘　　要：目的探究血清小而密低密度脂蛋白(sd-LDL)联合脂蛋白残粒(RLPs)检测在2型糖尿病(T2DM)患者合并动脉粥样硬化(AS)诊断中的价值。方法将江苏省苏州市立医院2020年1月至2022年6月收治的T2DM合并AS患者50例纳入研究组,另选T2DM未合并AS患者50例作为对照组。比较两组血脂、血糖指标、胰岛素抵抗指数、sd-LDL、RLPs及脂蛋白相关磷脂酶A2(Lp-PLA2)水平;采用logistic归回模型分析T2DM患者合并AS的影响因素,并采用受试者操作特征曲线分析sd-LDL、RLPs对该病的诊断价值。结果研究组总胆固醇、甘油三酯、低密度脂蛋白胆固醇、脂蛋白a、sd-LDL、RLPs及Lp-PLA2水平高于对照组,高密度脂蛋白胆固醇低于对照组,差异有统计学意义(P<0.05)。多因素分析结果显示,sd-LDL(OR=1.264,95%CI:1.019~1.568)、RLPs(OR=1.379,95%CI:1.064~1.786)、Lp-PLA2(OR=1.842,95%CI:1.135~2.990)、脂蛋白a(OR=1.704,95%CI:1.058~2.744)均为T2DM合并AS的独立影响因素(P<0.05)。受试者操作特征曲线分析结果显示,sd-LDL、RLPs单独及联合均对T2DM患者合并AS有一定的诊断价值(P<0.05)。结论T2DM合并AS患者血清sd-LDL、RLPs水平升高,对判断T2DM患者AS发病情况具有预测价值。Objective To explore the diagnostic value of serum small dense low-density lipoprotein(sd-LDL)combined with residual lipoprotein particles(RLPs)in patients with type 2 diabetes mellitus(T2DM)complicated with atherosclerosis(AS).Methods A total of 50 T2DM patients with AS admitted to Suzhou Municipal Hospital of Jiangsu Province from January 2020 to June 2022 were included in the study group,and 50 T2DM patients without AS were selected as the control group.The levels of blood lipids,blood glucose indexes,insulin resistance index,sd-LDL,RLPs,and lipoprotein-associated phospholipase A2(Lp-PLA2)were compared between the two groups.Logistic regression model was used to analyze the influencing factors of T2DM patients with AS,and receiver operating characteristic curve was used to analyze the diagnostic value of sd-LDL and RLPs for the disease.Results The levels of total cholesterol,triglyceride,low-density lipoprotein cholesterol,lipoprotein a,sd-LDL,RLPs,and Lp-PLA2 in the study group were higher than those in the control group,and the high density lipoprotein-cholesterol was lower than that in the control group,and the differences were statistically significant(P<0.05).Multivariate analysis showed that sd-LDL(OR=1.264,95%CI:1.019-1.568),RLPs(OR=1.379,95%CI:1.064-1.786),Lp-PLA2(OR=1.842,95%CI:1.135-2.990),and lipoprotein a(OR=1.704,95%CI:1.058-2.744)were independent influencing factors for T2DM with AS(P<0.05).Receiver operating characteristic curve analysis showed that sd-LDL and RLPs alone and in combination had certain diagnostic value for T2DM patients with AS(P<0.05).Conclusion The serum levels of sd-LDL and RLPs are increased in T2DM patients with AS,which have predictive value for the occurrence of AS in T2DM patients.

关 键 词：小而密低密度脂蛋白 脂蛋白残粒 动脉粥样硬化 2型糖尿病 

分 类 号：R543.1[医药卫生—心血管疾病]