2型糖尿病视网膜病变与小而密低密度脂蛋白胆固醇和脂蛋白a的相关性  

Correlation Analysis of Type 2 Diabetic Retinopathy with Small Dense Low-density Lipoprotein Cholesterol and Lipoprotein a

作　　者：张泉 万露 崔健 ZHANG Quan;WAN Lu;CUI Jian(Department of Clinical Laboratory,Huangshi Aikang Hospital,Huangshi 435000,China;Wuhan ADICON Medical Laboratory Co.,Ltd,Wuhan 430000,China)

机构地区：[1]黄石爱康医院检验科,黄石435000 [2]艾迪康医学检验所有限公司,武汉430000

出　　处：《微循环学杂志》2025年第1期50-55,共6页Chinese Journal of Microcirculation

摘　　要：目的:分析2型糖尿病视网膜病变(DR)患者小而密低密度脂蛋白胆固醇(sdLDL-C)和脂蛋白a[Lp(a)]的水平变化及临床意义。方法:纳入2023-06-2024-04黄石爱康医院内分泌科收治的2型糖尿病视网膜病变患者83例(DR组),根据DR患者严重程度分为非增殖性糖尿病视网膜病变(NPDR)组(50例)和增殖性糖尿病视网膜病变(PDR)组(33例);纳入同期住院的2型糖尿病患者95例(DM组)作为对照。测定空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、sdLDL-C、Lp(a)及糖化血红蛋白(HbA1c)水平。比较两组间以上指标的差异,应用单因素和多因素Logistic回归分析DR的影响因素。采用限制性三次样条分析sdLDL-C、Lp(a)与DR的非线性关系。结果:与DM组相比,DR组患者的TC、TG、HDL-C、sdLDL-C和Lp(a)水平均显著升高(P<0.05)。PDR组患者的sdLDL-C和Lp(a)水平显著高于DM组和NPDR组(P<0.05)。Logistic回归分析表明,sdLDL-C、Lp(a)是DR发生的危险因素。限制性三次样条分析发现,随着sdLDL-C、Lp(a)浓度的增加,DR的发生风险升高。结论:血清sdLDL-C和Lp(a)水平与DR的发生和发展密切相关,对预测DR具有重要意义。Objective:To analyze the association between small dense low-density lipoprotein cholesterol(sdLDL-C)and lipoprotein a[Lp(a)]with diabetic retinopathy(DR)in type 2 diabetes.Method:A total of 83 patients with type 2 diabetic retinopathy(DR group)were enrolled from June 2023 to April 2024.According to the severity of DR,the DR patients were divided into NPDR group(50 cases)and PDR group(33 cases).Ninety-five patients with type 2 diabetes who were hospitalized during the same period(DM group)were included.The levels of blood glucose(FPG),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),sdLDL-C,Lp(a)and glycosylated hemoglobin(HbA1c)were measured.Differences between the two groups in these indicators were compared,and sdLDL-C and Lp(a)were stratified into quartiles.Logistic regression analysis was used to examine the association of sdLDL-C and Lp(a)with DR.Finally,restricted cubic spline analyses was used to explore the nonlinear relationship between sdLDL-C,Lp(a)and DR.Results:Compared to the DM group,patients in the DR group had significantly higher levels of TC,TG,HDL-C,sdLDL-C,and Lp(a)with statistically significant differences(P<0.05).The levels of sdLDL-C and Lp(a)in the PDR group were significantly higher than those in the DM and NPDR groups(P<0.05).Logistic regression analysis indicated that sdLDL-C and Lp(a)were independent risk factors for DR in diabetic patients.The restricted cubic spline analysis found a nonlinear correlation between sdLDL-C,Lp(a)and DR.Conclusion:Serum levels of sdLDL-C and Lp(a)are closely related to the occurrence and progression of DR and are important for predicting DR in type 2 diabetic patients.

关 键 词：小而密低密度脂蛋白胆固醇 脂蛋白A 血脂 糖尿病视网膜病变 2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]