脂代谢的测定对老年2型糖尿病患者临床意义

Determination of serum lipids、polipoprotein and lipooprotein (a) in elderly with non-insulin dependent diabetes mellitus

目的探讨老年2型糖尿病与血脂、载脂蛋白、脂蛋白(a)之间的关系及其临床测定的意义。方法对97例老年2型糖尿病患者及65例老年对照组进行了血清总胆固醇(TC)、甘油三脂(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AI(ApoAI)、载脂蛋白B(ApoB)及脂蛋白(a)[Lp(a)]的测定。结果老年2型糖尿病患者血清TC、TG、LDL-C、ApoB及Lp(a)水平均显著高于老年对照组。而血清HDL-C和ApoAI水平老年2型糖尿病组显著低于老年对照组。结论老年2型糖尿病患者由于体内胰岛素相对不足及胰岛素抵抗,使血脂、载脂蛋白、脂蛋白浓度和组成成分发生变化及功能发生异常,从而促进动脉粥样硬化,并伴随着血管并发症的发生。因此,在对老年糖尿病并发症的预防和控制上,应在控制血糖的基础上减少脂肪的摄入,以降低高脂血症的发生,从而降低血管并发症的发生。

Objective： To discuss the relationship between the levels of serum lipids,apolipopmtein（Apo）,lipopmtein（a） [Lp（a）] and elderly with non- insulin dependent diabetes mellitus （NIDDM）. Methods： The levels of serum lipids,Apo and Lp（a） in 97 edlerly cases with NIDDM and 65 cases control group were detemined. Results： The levels of triglyceride （TG）,total eholesterol（TC）,low density lipoprotein cholesterol （LDL- C） ,ApoB and Lp（a） in NIDDM were higher than those of the control group; While the high density lipoprotein cholesterol （HDL - C） and ApoAI were significantly lower than those of the control group. Conclusions： Abnormal serum lipid levels may be the risk factors of angiopathy in elderly with NIDDM. Chronic high glocose and high serum lipids levels play an important role in develpoping diabetic chronic complications of elderly with NIDDM.