2型糖尿病患者尿白蛋白排出量与血脂代谢异常的关系

Relationship between Urinary Albumin Excretion and Abnormal Metabolism of Serum Lipids in Patients with Type 2 Diabetes

目的探讨2型糖尿病患者尿白蛋白排出量与血脂代谢异常的关系.方法根据尿白蛋白排出率（UAER）将73例2型糖尿病患者分为正常白蛋白尿（UAER＜20μg/min）、微量白蛋白尿（UAER 20～200μg/min）和大量白蛋白尿（UAER＞200μg/min）3个亚组,并选择28例健康人作为正常对照组.所有研究对象测定空腹血糖（FPG）、糖化血红蛋白（HbA1c）、血总胆固醇（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）、载脂蛋白A1（apoA1）、载脂蛋白B（apoB）、脂蛋白a[LP（a）].结果 2型糖尿病各组FPG及HbA1c与正常对照组的差异有显著性意义（P〈0.01）,而2型糖尿病三组之间FPG及HbA1c的差异无统计学意义.方差分析显示,4组间TG,HDL-C,LDL-C, LP（a） 的差异有显著意义（F分别为4.75,5.22,4.32,6.48;P＜0.05或P＜0.01）.多元线性回归分析显示,尿白蛋白排出量与TG和FPG成正相关（r^2=0.196）.结论 2型糖尿病患者血脂代谢异常与尿白蛋白排出率有一定的关系,血脂含量改变越明显,尿白蛋白排出率越高,血脂异常是糖尿病肾病的重要影响因素.

Objective To discuss the relationship between urinary albumin excretion and abnormal metabolism of serum lipids in patients with type 2 diabetes. Method According to urinary albumin excretion rate （UAER） ,73 cases of type 2 diabetes were divided into three subgroups：normal albuminuria subgroup（ UAER 〈 20 μg/min）, microalbuminuria subgroup （ UAER 20- 200 μg/min） and macroalbuminuria subgroup （ UAER 〉 200μg/min）. 28 normal people served as control group. Serum concentrations of total cholesterol （TC）, triglycerides（TG）, high density lipoprotein-cholesteerol （ HDL-C）, low density lipoprotein-cholesterol （LDL-C）, apolipoprotein A1 （ apoA1 ） ,apolipoprotein B（apoB） and lipoprotein a[ LP（a） ] ,as well as fasting plasma glucose（ FPG）, HbA1 c,and UAER were determinated in all cases. Results The differences in FPG and HbA1 c between type 2 diabetes group and control group were statistically significant（P 〈 0.01 ） ,but there was no statistical difference among three subgroups of type 2 diabetes. Analysis of variance indicated that differences in TG,LDL-C,HDL-C,LP（a） among three subgroups of type 2 diabetes and control group were statistically significant（ F =4.75,5.22,4.32,6.48, respectively;P 〈 0.05 or P 〈 0.01 ）. Multiple linear regression showed that UAER was positively correlated with TG and FPG（r^2 =0. 196）. Conclusions UAER is related to abnormal serum lipids metabolism in patients with type 2 diabetes. The higher the UAER is, the more obvious the change of concentration of serum lipids is. Abnormal serum lipids are important factors of diabetic nephropathy.