调脂治疗对初诊2型糖尿病患者血糖的影响

Effect of the correction of dyslipidemia on blood glucose in the patients with type 2 diabetes

目的观察伴血脂异常的初诊2型糖尿病调脂治疗对血糖的影响及糖脂变化的关系。方法选初诊2型糖尿病患者104例分别给予二甲双胍或格列美脲治疗12周后,检测BMI、FPG、HbA_1c、TC、TG、HDL、LDL、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)。选择其中血脂仍异常的患者98例,在原降糖药物剂量不变的基础上,根据血脂水平分别给予阿托伐他汀、非诺贝特或阿托伐他汀,与非诺贝特隔日交替治疗8周,治疗后复测上述指标。结果调脂治疗后三组血脂成分明显改善,FPG、HbA_1c均明显下降(P<0.01)。经Bivariate-correlate分析,HbA_1c的下降与TC、TG、LDL的下降呈正相关;HbA_1c的下降与ApoA呈负相关。结论调脂治疗伴有血脂异常的初诊的2型糖尿病患者在改善血脂的同时,还有利于血糖的进一步控制。

Objective To investigate the effect of dyslipidemia correction on the improvement of blood glucose control in the patients with type 2 diabetes. Methods BMI,FPG, HbAlc,TC,TG,HDL, LDL,ApoA, ApoB were measured before and after metformin or glimepiride treatment and after lipid modulation. Among the 104 patient with type 2 diabetes,98 patients with dyslipidemia were selected after 12 weeks of hypoglycemic treatment and divided into three treatment groups： fenofibrate 0.2 QD（FNT）, atorvastatin 10mg QD（ATO） and both FNT plus ATO for 8 weeks. Results While the lipid spectrum were improved, the HbAlc were decreased from 7. 01% to 6.58% and from 7.47% to 6.99% and from 7. 76% to 7.05% in the three groups respectively （P〈0.01）. The levels of FPG were decreased from 7.65 mmol/L to 7.12 mmol/L, [rom 8.30 mmol/L to 7.63 mmol/L and from 8. 99 mmol/L to 8.05 mmol/L （P（0. 01）respectively. By use of Bivariate-eorrelation analysis, the decrease of HbAlc was positively correlated to the decrease of TC, TG and LDL and negatively to the increase of ApoA. Conclusions The lipid modulation could further improve the blood glucose control in the patients of type 2 diabetes with dyslipidemia.