血脂代谢异常与糖尿病视网膜病变及糖尿病肾病的关系

The Relationship among Diabetic Retinopathy,Diabetic Nephropathy and Blood Fat

目的探讨糖尿病视网膜病变、糖尿病肾病与血脂血糖及胰岛素抵抗的关系。方法随机选择160例2型糖尿病患者,按有无视网膜病变及糖尿病肾病分为DR组、DN组、DR合并DN组,非DN、DR组,检测血脂、脂蛋白、糖基化血红蛋白、胰岛素水平并进行分析总结。结果DR组,DN组,DR合并DN组分别与非DN、DR组比较血清总胆固醇(Tch)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、载脂蛋白B(APO-B)明显增高(P<0.05),血高密度脂蛋白(HDL-C)、载脂蛋白A(APO-A)明显下降(P<0.05);HbA1C明显增高(P<0.05)。DR合并DN组与非DR、DN组比较,TG显著增高(P<0.01),胰岛素抵抗指数有差异(P<0.01)。结论血脂代谢异常及胰岛素抵抗,影响着DN、DR的发生发展;反之,DN、DR的发生发展也促进血脂代谢异常及胰岛素抵抗的发生发展。因此,糖尿病患者应严格控制血糖、血脂水平。

Objective Discuss the relationship among diabetic retinopathy, diabetic nephropathy, blood fat,blood sugar and insulin resistance（IR）. Methods Random select 160 example type2 diabetic and divide into four groups by if not have retinopathy or diabetic nephropathy and detect their blood fat, lipoprotein, glycosylated hemoglobin, insulin level and analyze. Consequence： DR group, DN group, DR copticated DN group compare with non - DR and non - DN group, total cholesterol （ Tch）, triglyeride （ TG ）, low density lipoprotein （ LDL - C）, apolipoprotien - B （APO- B） manifest increased （P 〈0.05）,high density lipoprotein （HDL- C）,apolipoprotien- A （APO - A） obviously decreased （P 〈 0. 05） ; HbAI C increased obviously （ P 〈0. 05）. DR DN compare with DR group and DN group ,TG obviously increased （P 〈0. 01 ）. IR index have significant deviation （P 〈0. 01 ）. Conclusion blood lipid metabolism and IR influence the development of DN and DR;conversely,the occurrence of DN and DR promote blood lipid metabolism abnormality and the development of IR. Therefore, diabetic ought to control serum glucose, blood fat severely.