老年2型糖尿病患者高密度脂蛋白亚类与氧化应激和颈动脉粥样硬化的相关性

Relationships of high density lipoprotein subclasses with oxidative stress and carotid atherosclerosis in elderly patients with type 2 diabetes

目的 探讨老年2型糖尿病患者血清高密度脂蛋白（HDL）亚类的分布特点及其与氧化应激和颈动脉粥样硬化的相关性.方法 老年2型糖尿病患者56例,男40例、女16例;老年健康对照者41例,男31例、女10例.分别测定血清HDL亚类、血清8-异前列腺素F2α及颈动脉超声.结果 老年2型糖尿病组HDL3（0.51±0.21）mmol/L,较健康对照组（0.59±0.15）mmol/L降低（t=1.991,P＜0.05）,HDL及HDL2亦较健康对照组降低,分别为（1.07±0.36）mmol/L对（1.18±0.32）mmol/L和（0.56±0.25）mmol/L对（0.64±0.33）mmol/L,但差异无统计学意义（t值分别为1.611和0.614,均为P＞0.05）;HDL3与HbA1c负相关（r=-0.503,P=0.005）;血清8-异前列腺素F2α吸光度A值较健康对照组降低,分别为0.017±0.004和0.021±0.008（t=2.245,P＜0.05）;颈动脉平均内膜-中层厚度（IMT）较健康对照组升高,但差异无统计学意义;颈动脉斑块检出率63.3%,高于对照组的36.0%（x2=4.076,P＜0.05）.结论 老年2型糖尿病患者HDL亚类水平存在异常,小颗粒的HDL3水平下降,氧化应激增加,可能是导致其动脉粥样硬化的原因之一.

Objective To explore the distribution characteristics of high density lipoprotein （HDL） subclasses in elderly patients with type 2 diabetes mellitus （T2DM）, and to evaluate the relationships of them with oxidative stress and carotid atherosclerosis. Methods The serum levels of HDL subclasses and 8-iso-prostaglandin （PG） F2α were assayed, the carotid ultrasound examinations were executed in 56 elderly patients with T2DM （male： 40, female： 16） and 41 elderly healthy controls （male： 31, female： 10）. Results Compared with control group, the serum level of HDL3 was significantly lower in T2DM group [（0.51±0.21） mmol/L vs. （0.59±0.15） mmol/L,t=1.991, P〈 0.05], and the serum levels of HDL and HDL2 were also decreased [（1.07±0.36）mmol/L vs. （1.18±0.32） mmol/L; （0.56±0.25） mmol/L vs. （0.64±0.33） mmol/L], but there were no statistical significances （t= 1.611 and 0.614 both P〉0.05）. The HDL3 was negatively correlated with HbA1C （r=-0.503, P=0.005）. The values of absorbance of serum 8-iso-PG F2αwere significantly decreased in T2DM group than in control group （0.017±0. 004 vs. 0. 021±0. 008,t=2.245, P〈0.05）. The mean carotid intima-media thickness （IMT） was higher in T2DM group,but there was no statistically significance. The detection rate of carotid atherosclerotic plaques was significantly higher in T2DM group than in control group （63.3% vs. 36.0%, x2=4.076, P〈0.05）. Conclusions The low level of small particles HDL3 as well as elevated oxidative stress may contribute to the development of atherosclerosis in elderly patients with T2DM.