血清脂蛋白(a)的水平变化与2型糖尿病肾病的关系

Relationship between the change of blood serum lipoprotein level and 2 type diabetic nephropathy

目的:探讨血清脂蛋白(a)的水平变化在2型糖尿病肾病中的临床意义。方法:根据尿白蛋白的测定结果,将326例糖尿病患者分为3组,糖尿病组(DM组),早期糖尿病肾病组(EDN组)和临床糖尿病肾病组(CDN组);120名健康者作对照组,分别测定各组血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、脂蛋白(a)[Lp(a)]的水平,并对全部患者Lp(a)与尿白蛋白测量结果呈直线相关分析。结果:DM组Lp(a)水平高于对照组(P<0.05),EDN组及CDN组Lp(a)水平明显高于DM组,Lp(a)与尿蛋白呈直线正相关(r=0.885,P<0.01)。结论:血清Lp(a)水平升高与EDN进展有关,提示测定血清Lp(a)的水平可间接反映2型糖尿病的严重程度。2型糖尿病合并糖尿病肾病(DN)患者出现血清Lp(a)水平显著增高,且与尿微量白蛋白呈正相关关系,提示Lp(a)水平升高可能继发于DN的肾脏损害,随肾脏损害进展而逐步升高。

[ ABSTRACT] Objective： To investigate the clinical significance of changes of serum lipoprotein（a） level in 2 type diabetics nephropathy. Methods： According to testing results of urine albumin measured, 326 cases of diabetes were divided into 3 groups：diabetic group （DM）, early diabetic nephropathy group （EDN） and clinical dia- betic nephropathy group （CDN）. The other 120 healthy persons were as control group. The levels of triglyceride （TG）, total cholesterol （TC）, high density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol （LDL-C） and lipoprotein were tested in all groups. The results of both Lp （a） and urine albumin were determined and anylized with linear correlation. Results： The Lp （a） levels of DM group were higher than that of control group （P〈0.05） ;the Lp （a） levels in EDN group and CDN group were obviously higher than that in DM group;Lp（a） was positive correlation of straight line with urine albumin （ r = 0. 885, P〈 0. 01 ）. Conclusion ： Increased serum Lp （a） may be associated with the progression of EDN. It suggests that the serum Lp （a） levels might reflect indirectly the severity of diabetic nephropathy in 2 type diabetes. The patients with 2 type diabetes complicated diabetic nephropathy （DN） show the higher Lp （a） level of blood serum and positive correlation with the urine micro albumin. It suggests that the increase of Lp （a） level might be secondly to DN damage and Lp （a） level increase gradually following the progresses of renal impairment.