老年2型糖尿病患者脂肪餐负荷后脂蛋白(a)水平变化

Changes of lipoprotein(a) level after fat meal in elderly type 2 diabetic patients

目的：观察老年2型糖尿病空腹及脂肪餐后脂蛋白(a)水平变化的规律，并与健康老年人比较。 方法：①选择2002-12／2003-12贵州省人民医院于医科住院老年2型糖尿病患者为老年糖尿病组21例，年龄(70±6)岁。选择本院健康体检老年入18例为对照组，年龄(68±8)岁。对实验目的及测定指标均知情同意。②纳入对象均进行脂肪餐负荷试验(热量为2520kJ／m^2体表面积，脂肪、蛋白质及碳水化物提供的能量分别占60％和14％及26％。多不饱和脂肪酸与饱和脂肪酸之比0．1)。③采用全自动生化分析仪测定空腹及脂餐后2，4，6，8h共5个时段的血标本中脂蛋白(a)水平。④脂蛋白(a)-曲线下面积=2[脂餐后2h脂蛋白(a)+脂餐后4h脂蛋白(a)+ 脂餐后6h脂蛋白(a)]+7空腹脂蛋白(a)。⑤组间差异分析采用Wilcoxon检验。 结果：老年2型糖尿病患者21例和健康老年人18例均进入结果分析。 ①老年糖尿病组空腹及脂餐后6h脂蛋白(a)的水平明显高于对照组[(179．0±152．0)，(177．5±243．9)mg／L；(109．0±93．3)，(109．5±88．9)mg／L，Z=-2．014，-2．383，P<0．05]，而其他各时段脂蛋白(a)的水平差异不明显。两组脂餐后各时段脂蛋白(a)的水平与空腹脂蛋白(a)水平差异不明显。②老年糖尿病组脂蛋白(a)-曲线下面积与对照组相近[(207．26±344．80)，(55．17±183．94)mg／L，P=0．213]。 结论：老年2型糖尿病患者有高脂蛋白(a)血症；但脂肪餐后老年2型糖尿病患者脂蛋白(a)水平无明显变化。

AIM： To observe the changing law of the fasting lipoprotein（a） level and that after fat meal in elderly type 2 diabetic patients, and compare with the healthy elderly people. METHODS： ① Between December 2002 and December 2003, 21 elderly type 2 diabetic inpatients aged （70±6） years （elderly diabetic group） and 18 healthy elderly physical examinees aged （68±8） years （control group）, who were selected from Guizhou Provincial People＇s Hospital, participated in the study voluntarily. ② All the subjects received fat tolerance test （the calorie for body surface area was 2520 kJ/m^2, 60%, 14% and 26% of the energy were supplied by fat, protein and carbohydrate, the ratio of polyunsaturated fatty acid to saturated fatty acid was 0.1）. ③ The fasting lipoprorein（a） level and those at 2, 4, 6 and 8 hours after fat meal in blood samples were determined with aufomatic biomechanical analyzer. ④ The area under the cure of lipeprotein（a）= 2[lipeprotein（a） at 2 hours after fat meal＋ lipeprotein（a） at 4 hours after fat meal ＋ lipoprotein（a） at 6 hours after fat meal]＋7 fasting lipeprotein（a）. ⑤ The intergroup differences were analyzed with the Wilcoxon test. RESULTS： All the 21 elderly type 2 diabetic patients and 18 healthy elderly people were involved in the analysis of results. ① The level of fasting lipoprotein（a） and that at 6 hours after fat meal were obviously higher in the elderly diabetic group than in the control group [（179.0±152.0）, （177.5±243.9） mg/L; （109.0±93.3）, （109.5±88.9） mg/L, Z=-2.014, -2.383, P 〈 0.05], but those at the other time points were not obviously different between the two groups. The lipoprotein（a） levels at the each time point after fat meal were not obviously different from the fasting one in both groups. ② The area under the cure of lipoprotein（a） in the elderly diabetic group was close to that in the control group [（207.26±344.80）, （55.17 ±183.94） mg/L, P=-0.213）. CONCLUSION： Elderly type 2 diabetic patients have obvious high lipoprotein（a） level; but the lipoprotein（a） level after fat meal has no obvious changes.