血脂异常与糖尿病视网膜病变发生和发展的关系

Relationship between Dyslipidemia and Diabestic Retinopathy in Non-insulin Dependent Diabetes Mellitus

目的探讨糖尿病病人血脂异常与视网膜病变发生和发展的关系。方法收集Ⅱ型糖尿病患者174例，包含无视网膜病变（NDR）51例、有视网膜病变（DR）123例，其中背景型糖尿病视网膜病变（BDR）65例和增殖型糖尿病视网膜病变（PDR）58例，检测病人的Tch、TG、HDL-C、LDL-C、VLDL-C、ApoA、ApoB、LP（α）和oxLDL水平，分析血脂水平和各组的关系。结果DR患者血清Tch、TG、LDL-C、VLDL-C、ApoB、LP（α）和oxLDL水平显著高于NDR患者，而HDL-C、ApoA较NDR患者低；PDR组的血清Tch、TG、LDL-C、VLDL-C、ApoB、LP（α）和oxLDL水平也显著高于BDR组，HDL-C、ApoA水平也较BDR者显著降低。结论DR的发生和发展与血脂异常相关，糖尿病病人应注意检测和调节血脂，防止DR的发生及发展。

Objective To investigate the relationship between dyslipidemia and diabetic retinopathy in non-insulin dependent diabetes mellitus. Methods Of the 174 patients recruited, the fasting serum total cholesterol（Tch）, triglyceride（TG）, high-density lipoprotein cholesterol（HDL-C）, low-density lipoprotein cholesterol（LDL-C）, very-low density lipoprotein cholesterol（VLDL）, apolipoprotein A（ApoA）, apolipoprotein B（ApoB）, lipoprotein were determined and oxidized density lipoprotein cholesterol（oxLDL）, and the relationship between them were also analyzed. Results Tch, TG, LDL-C, VLDL-C, ApoB, LP（α） and oxLDL were significantly higher in patients with diabetic retinopathy than those without diabetic retinopathy, but HDL-C and ApoA were decreased. Tch, TG, LDL-C, VLDL-C, ApoB, LP（α） and oxLDL were also markedly higher in background diabetic retinopathy patients than proliferative diabeticretinopathy patients, but HDL-C and ApoA were also reduced. Conclusion In order to avoid development and progression of diabetic retinopathy caused by dyslipidemia, we should detect and control blood lipid in non-insulin dependent diabetes mellitus.