糖尿病患者血浆丙酮酸与脂肪代谢的关系

PLASMA PYRUVIC ACID AND FAT METABOLISM IN DIABETIC PATIENTS

本文采用酶荧光法测定正常人和糖尿病患者血浆丙酮酸，并对丙酮酸和酮体（β－羟丁酸、乙酰乙酸等）、甘油三酯（ＴＧ）、空腹血糖（ＦＰＧ）、糖化血红蛋白（ＨｂＡ１）进行相关性分析，结果糖尿病组血浆丙酮酸明显高于对照组（Ｐ＜０．００１），其中Ⅱ型糖尿病患者血浆丙酮酸又高于Ⅰ型糖尿病患者（Ｐ＜０．０５）；Ⅱ型糖尿病患者中肥胖者的丙酮酸明显高于非肥胖者（Ｐ＜０．００１）。Ⅰ型糖尿病患者血浆丙酮酸与ＴＧ呈负相关（ｒ＝－０．６７００，Ｐ＜０．０５），丙酮酸与ＦＰＧ亦呈负相关（ｒ＝－０．５４２４，Ｐ＜０．０５）；丙酮酸与β－羟丁酸、乙酰乙酸、总酮体、β－羟丁酸／乙酰乙酸比值的多元线性回归分析发现丙酮酸与上述各项均不相关。结果反映糖尿病患者血浆丙酮酸浓度改变，可反映糖尿病患者代谢紊乱，在一定条件下与ＴＧ浓度相关，但与酮体水平不相夫，因此不能以此来估价糖尿病患者血酮水平。

lasma pyruvic acid was determined with enzymatic fluorescence method in diabeticpatients and normal controls.The results showed that the level of plasma pyruvic acid wassignificantly increased in diabetic patients(P<0.001),mong which the increase intype Ⅱ was higher than that in typeⅠ(P <0.05),and the obese type Ⅱ patients hada much higher pyruvic acid level than non-obese type Ⅱ patients(P<0.001).In ad-dition, in type Ⅰ group,the level of plasma pyruvic acid was negatively correlatedwith that of fasting plasma glucose(r=-0. 5424, P<0.05) and triglyceride(r=-0. 6700,P<0.05),but was not correlated with that of plasma ketone bodies.Theresults suggested that the change of plasma pyruvic acid could reflect the metabolicdisturbances in diabetic patients, but it has no value for screening diabetic ketoacidosis(DKA)and for assessing the severity of DKA.