期刊文献+

新诊断2型糖尿病合并代谢综合征患者血清LDL-C/HDL-C比值的临床研究 被引量:9

LDL cholesterol/HDL cholesterol ratio in newly diagnosed type 2 diabetic patients complicated with metabolic syndrome
下载PDF
导出
摘要 目的探讨新诊断2型糖尿病(T2DM)合并代谢综合征(MS)患者血清低密度脂蛋白胆固醇(LDL-C)/高密度脂蛋白胆固醇(HDL-C)比值变化及其与各临床指标的相关性。方法选择新诊断T2DM患者140例,根据是否合并MS分为MS组73例、非MS组67例,另设立正常对照组73例。所有研究对象均行口服葡萄糖耐量试验(OGTT)及胰岛素释放试验,并检测血糖、胰岛素、血脂等相关生化指标,计算各组LDL-C/HDL-C比值。比较各组临床指标及LDL-C/HDL-C比值水平变化,分析LDL-C/HDL-C比值与各指标的相关性。根据LDL-C/HDL-C水平三分位分组,比较各组MS患病率。结果MS组(3.18±0.85)及非MS组(2.61±0.93)LDL-C/HDL-C均高于对照组(2.26±0.70),且MS组的LDL-C/HDL-C亦高于非MS组,差异有统计学意义(P<0.05)。根据LDL-C/HDL-C水平三分位分组,各组MS患病率分别为11.27%、35.21%、56.34%,随着LDL-C/HDL-C水平升高MS患病率升高(P<0.05)。相关分析显示,LDL-C/HDL-C比值与体质指数(BMI)、腰围(WC)、腰臀比(WHR)、收缩压、舒张压、餐后2h血糖(PPG)、空腹胰岛素(FINS)、餐后2h胰岛素(PSI)、胰岛素抵抗指数(HOMA-IR)、三酰甘油(TG)、血浆总胆固醇(CHOL)、LDL-C呈正相关(P<0.05),与HDL-C呈负相关(P<0.01)。以LDL-C/HDL-C为因变量作多元逐步回归分析,有HDL-C、LDL-C、FINS进入方程(P<0.01)。结论 T2DM合并MS患者LDL-C/HDL-C的比值升高,且高水平LDL-C/HDL-C比值患者的MS患病率高,LDL-C/HDL-C比值较单纯LDL-C浓度能更好地评估MS发生的危险性,为MS的预防和治疗提供更简便、有效的方案。 Objective To investigate the change of low-density lipoprotein cholesterol (LDL-C)/high-density lipoprotein cholesterol (HDL-C) ratio in newly diagnosed patients with type 2 diabetes mellitus (T2DM) and metabolic syndrome (MS) , and to discuss its relationship with the clinical parameters. Methods Totally 140 newly diagnosed T2DM patients were selected for this study, and they were divided into MS group (n=73) and non-MS group (n=67) according to the presence of MS; the normal control group included 73 participants (NC group). All participants underwent an oral glucose tolerance test (OGTT) and insulin releasing testl meanwhile, the blood glucose, insulin, blood lipid and other items were measured. The LDL-C/ HDL-C ratios of each group were calculated. Clinical parameters and LDL-C/HDL-C ratios were compared among different groups, and correlation analysis was made between LDL-C/HDL-C ratios and clinical indices. Furthermore, all participants were divided into three groups according to LDL-C/HDL-C levels and the prevalence rates of MS were compared. Results The LDL-C/HDL-C ratios of MS group (3.18±0.85) and non-MS group (2.61±0.93) were significantly higher than that in NCgroup (2.26±0.70, P〈0.05), and the LDL-C/HDL-C ratio of MS group was significantly higher than that in non-MS group (P〈0.05). The prevalence rates of MS were significantly increased in the patients with the elevation of LDL-C/HDL-C (11.27M, 35.21%, and 56.34%, P〈0.05). Correlation analysis showed that LDL-C/HDL-C ratio was positively correlated with the body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), postprandial plasma glucose (PPG), fasting insulin (FINS), postprandial insulin (PSI), homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride (TG), cholesterol (CHOL) and LDL-C (P〈0. 05), and negatively correlated with HDL-C (P〈0.01). When LDL-C/HDL-C was taken as the dependent variable, multiple regression analysis showed that HDL-C, LDL-C and FINS entered the equation (P〈0.01). Conclusion The LDL-C/HDL-C ratio is increased in T2DM patients complicated with MS, and the prevalence rate of MS is higher in patients with high LDL-C/HDL-C value. The ratio of LDL-C/HDL-C may be a better index for the early detection of MS compared with LDL-C, which provides a simple, feasible strategy for the prevention and treatment of MS.
出处 《第二军医大学学报》 CAS CSCD 北大核心 2014年第12期1396-1400,共5页 Academic Journal of Second Military Medical University
基金 国家自然科学基金(81370965) 江苏省自然科学基金(BK2009208) 江苏省卫生厅国际交流支撑计划及面上科技项目(H201247) 镇江市社会发展科技支撑项目(SH2013027 SH 2012027) 镇江市科技支撑(社会发展)指导性项目(FZ2012038)~~
关键词 2型糖尿病 代谢综合征 LDL胆固醇 HDL胆固醇 type 2 diabetes mellitus metabolic syndrome LDL cholesterol HDL cholesterol
  • 相关文献

参考文献10

  • 1Gobato A O, Vasques A C, Zambon M P, Barros Filho Ade A, Hessel G. Metabolic syndrome and insulin re- sistance in obese adolescents . Rev Paul Pediatr, 2014,32:55-62.
  • 2Yang Z J, Liu J, Ge J P,Chen L, Zhao Z G, Yang W Y; China National Diabetes and Metabolic Disorders Study Group. Prevalence of cardiovascular disease risk factor in the Chinese population:the 2007-2008 China Nation- al Diabetes and Metabolic Disorders Study [J]. Eur Heart J,2011,33.213-220.
  • 3Bigna J J, Bahebeck J, Sobngwi E, Mbanya J C. Meta- bolic syndrome for sub-Saharan Africans diabetes with peripheral arterial disease: a case-control study . BMC Res Notes,2014,7:104.
  • 4乙成成,刘雯雯,张颖秋,郭志军,王湘芸,袁志忠,周长林,殷仁富.低密度脂蛋白胆固醇与高密度脂蛋白胆固醇的比值与动脉粥样硬化的关系[J].第二军医大学学报,2011,32(2):224-226. 被引量:40
  • 5Heart Protection Study Collaborative Group. MRC/ BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals : a ran- domised placebo-controlled trial. Lancet, 2002,360: 7-22.
  • 6Zeljkovic A, Spasojevic-Kalimanovska V, Vekic J ,Jelic- Ivanovic Z, Topic A, Bogavac-Stanojevic N, et al. Does simultaneous determination of LDL and HDL particle size improve prediction of coronary artery disease risk [J]. Clin Exp Med, 2008,8 : 109-116.
  • 7Satoh H, Nishino T, Tomita K, Saijo Y, Kishi R, Tsut- sui H. Risk factors and the incidence of coronary artery disease in young middle-aged Japanese men: results from a 10-year cohort study. Intern Med, 2006,45 : 235-239.
  • 8Fernandez M L,Webb D. The LDL to HDL cholesterol ratio as a valuable tool to evaluate coronary heart dis- ease risk[J]. J Am Coll Nutr,2008,27(1) :1-5.
  • 9宋艳,王亚萍,索萌,卢群,田刚.急性冠脉综合征肥胖及非肥胖患者血清LDL-C/HDL-C比值与冠状动脉病变严重程度的相关性[J].西安交通大学学报(医学版),2013,34(1):54-57. 被引量:8
  • 10伍明,范学军,李梅笑,蒙巍,王扬,吴珊.中青年症状性动脉粥样硬化性颅内动脉狭窄患者中LDL-C/HDL-C比值分析[J].实用预防医学,2012,19(8):1253-1256. 被引量:8

二级参考文献40

  • 1Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S)[J].Lancet,1994,344:1383 -1389.
  • 2Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of ini tial cholesterol levels. The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group[J]. N Engl J Med,1998,339:1349-1357.
  • 3Downs J R, Clearfield M, Weis S, Whitney E, Shapiro D R, Beere P A, et al. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS/TexCAPS. Air Force/Texas Coronary Atherosclerosis Prevention Study[J]. JAMA, 1998,279: 1615- 1622.
  • 4Nakamura H, Arakawa K, Itakura H, Kitabatake A, Goto Y, Toyota T, et al. Primary prevention of cardiovascular disease with pravastatin in Japan (MEGA Study); a prospective randomised controlled trial[J]. Lancet, 2006,368 :1155-1163.
  • 5Cannon C, Braunwald E, MeCabe C, Rader D, Rouleau J, Belder R,et al. Intensive versus moderate lipid lowering with statins after acute coronary syndromes [J]. New Engl J Med, 2004, 350:1495 -1504.
  • 6Waters D,Guyton J, Herrington D, McGowan M, Wenger N, Shear C. Treating to New Targets (TNT) Study: does lowering low-density lipoprotein cholesterol levels below currently recommended guidelines yield incremental clinical benefit[J]?Am J Cardiol,2004,93:154-158.
  • 7Gordon T, Castelli W P, Hjortland M C, Kannel W B, Dawber T R. High density lipoprotein as a protective factor against coro nary heart disease: The Framingham study[J]. Am J Med, 1977,62:707- 714.
  • 8Miller N E, Thelle D S, Forde O H, Mjos O D. The Troms: heart-study. High-density lipoprotein and coronary heart-disease: a prospective case-control study[J]. Lancet, 1977,309: 965 -968.
  • 9Barter P, Gotto A M, LaRosa J C, Maroni J, Szarek M, Grundy S M, et al. HDL cholesterol, very low levels of LDL cholesterol, and cardiovascular events[J]. New Engl J Med, 2007,357: 1301- 1310.
  • 10Matsuzaki M, Kita T, Mahuchi H, Matsuzawa Y, Nakaya N, Oikawa S,et al. Large scale cohort study of the relationship be tween serum cholesterol concentration and coronary events with low dose simvastatin therapy in Japanese patients with hypercholesterolemia[J]. Circ J, 2002,66 : 1087 -1095.

共引文献51

同被引文献115

引证文献9

二级引证文献55

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部