2型糖尿病家系成员血浆致动脉粥样硬化指数(AIP)变化及阿卡波糖或格列美脲治疗对2型糖尿病患者AIP的影响

The Change of Atherogenic Index of Plasma (AIP) Level in Type 2 Diabetic Pedigrees and the Response of AIP to Acarbose or Glimepiride in Therapy of Type 2 Diabetes Mellitus

为探讨2型糖尿病家系中患者(T2DM)与其糖耐量正常一级亲属(Normoglycemicfirst-degreerelatives,NFDR)血浆致动脉粥样硬化指数(Atherogenicindexofplasma,AIP)的特点及阿卡波糖或格列美脲治疗对T2DMAIP的影响,对29个家系中62例T2DM、67例NFDR及45例正常对照的血脂和99例T2DM在阿卡波糖或格列美脲治疗前后的血脂变化进行测定,以Log(TG/HDL-C)计算AIP指数。结果表明:T2DM及NFDR的AIP均显著高于对照组(P<0.01);T2DM与其子女AIP明显相关(P<0.05)。阿卡波糖可明显降低T2DM的AIP(P<0.05);格列美脲组AIP下降无统计学意义。由于AIP与小而密低密度脂蛋白(sdLDL)密切相关,本研究提示:2型糖尿病家系成员AIP显著增高,NFDR也具有较健康对照高的AIP;阿卡波糖在降糖同时可明显降低AIP,格列美脲使AIP下降幅度较小,对sdLDL的治疗也可能具有潜在的益处。

The alterations in atherogenic index of plasma （AIP） in type 2 diabetic patients and their normoglycemic first-degree relatives （NFDR） were investigated, and the effects of Acarbose or Glimepiride on AIP in 99 type 2 diabetic patients were evaluated. Triglycerride （TG）, total cholesterol, high density lipoprotein- cholesterol （HDL-C） levels were analyzed, and Log （TG/HDL-C） was calculated as AIP in 62 type 2 diabetic patients and their 67 NFDR from 29 type 2 diabetic pedigrees and in 45 healthy controls without family histories of diabetes. Also analyzed were the same parameters in 99 type 2 diabetic patients before and after therapy with Acarbose or Glimepiride. The results revealed that diabetic patients and their NFDR had significantly higher AIP than did the controls, whereas no significant differences were seen between diabetic patients and their NFDR. Positive correlation of AIP between type 2 diabetic patients and their offspring were observed （r= 0. 241, P〈 0.05）. After 8 weeks therapy with Acarbose, the AIP of type 2 diabetic patients was decreased significantly, and no differences were observed for AIP levels in Glimepiride group although the AIP was lower when compared with the untreated level. As a significant inverse correlation of small dense low density lipoprotein（sdLDL） with AIP was confirmed, our data suggest that diabetic patients and their NFDR from type 2 diabetic pedigrees had significantly higher AIP than did controls; AIP could be decreased by therapy with Acarbose in type 2 diabetic patients; Glimepiride may bring potential benefit to type 2 diabetic patients by influencing sdLDL.