2型糖尿病、肥胖、心血管疾病与血脂代谢关系的研究

Study on the Relationship between Metabolism of Serum Lipid and Type 2 Diabetes Mellitus,Obesity and Cardiovascular Di seases

目的：探索社区人群２ 型糖尿病、肥胖和血脂代谢关系以及和心血管疾病的联系。方法：测定１００ 例２型糖尿病病例和正常对照的８项血脂指标，并结合流行病学调查资料分析比较。结果：肥胖与超重组ＴＧ、Ａｐｏ Ｂ值显著大于正常体重组，ＨＤＬ－Ｃ和Ｌｐ（ａ）则相反；ＢＭＩ与ＴＧ、Ａｐｏ Ｂ呈显著正相关，和ＨＤＬ－Ｃ、Ｌｐ（ａ）呈显著负相关；ＷＨＲ与ＬＤＬ－Ｃ、ＴＣ、ＴＧ、Ａｐｏ Ｂ呈显著正相关，与ＨＤＬ－Ｃ显著负相关；超重和肥胖组ＨＤＬ－Ｃ均值显著低于正常体重组。高ＨＤＬ－Ｃ组高血压、冠心病（ＣＡＤ）的比例显著低于低值组，而高Ａｐｏ Ｂ、ＴＣ、ＬＤＬ－Ｃ组高血压比例显著高于低值组。结论：提示糖尿病，特别是肥胖伴糖尿病，其血脂代谢紊乱（包括ＨＤＬ－Ｃ水平降低，ＴＣ、ＬＤＬ－Ｃ、Ａｐｏ Ｅ水平的增高）。

Objective:To explore the alterations of serum lipid metabolism of Type 2 diabetes mellitus(DM) and its relationship with cardiovascular diseases.Methods:A 1∶1 case control study in 100 newly diagnosed cases of Type 2 diabetes mellitus and 100 controls was conducted,8 indices of serum lipid metabolism were measured.Results:The means of TG and apo B in the group of obesity and overweight were significantly higher than those in the normal weight group,and the means of HDL C and Lp(a) were the reverse.BMI was significantly positively correlated with TG and apo B,but negatively correlated with HDL C and Lp(a).WHR was significantly positively correlated with TC,TG,LDL C and apo B,whereas negatively correlated with HDL C.The group with higher TC,LDL C and apo E had a significantly higher proportion of hypertension,and the group with higher HDL C had a significantly lower proportion of hypertension and CAD.Conclusions:This study indicated that the dyslipidemia of type 2 diabetes mellitus(especially with obesity),such as low HDL C,high TG,LDL C and apo E might be a major cause of AS and cardiovascular diseases.