应用TG/HDL-C评估老年2型糖尿病患者小而致密低密度脂蛋白水平的变化情况及相关血脂谱特点

The evaluation of small dense LDL and lipid characteristics in aged type 2 diabetic patients by TG/HDL-C index

目的评估老年2型糖尿病患者小而致密低密度脂蛋白(sdLDL)水平的变化情况及相关血脂谱特点。方法 114例老年2型糖尿病患者根据低密度脂蛋白(LDL-C)和糖化血红蛋白(HbA1c)水平进行分组分层。检测指标主要有体重指数(BMI)、HbA1c、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、LDL-C、载脂蛋白A(Apo-A)、载脂蛋白B(Apo-B)、载脂蛋白E(Apo-E)和脂蛋白a(Lp-a),并应用TG/HDL-C评估sdLDL水平。结果约有1/3的老年2型糖尿病患者存在sdLDL水平的升高。当LDL-C<3.12mmol/L时,sdLDL升高者的BMI、TG、Apo-A、Apo-B、Apo-E明显高于sdLDL水平正常者,HDL-C则明显降低,差异具有统计学意义(P<0.05);但这种亚组间的差异在LDL-C≥3.12mmol/L时则不明显。结论在老年2型糖尿病患者人群中,应用TG/HDL-C可初步筛查出存在sdLDL水平升高的患者,该类患者的血脂谱变化主要表现为TG、ApoA、ApoB和Apo-E水平的升高和HDL-C的降低。

Objective To evaluate the small dense LDL （sdLDL）and lipid characteristics of aged type 2 diabetic patients by TG/HDL-C index. Methods 114 aged type 2 diabetic patients were divided into different subgroups according to the low-density lipoprotein-cholesterol （ LDL-C ） and glycosylated hemoglobin （ HbA1 c） level. The body mass index （ BMI）, HbA1 c, cholesterol （ TC ）, triglyceride （ TG）, high-density lipoprotein-cholesterol （ HDL- C ） , LDL-C, apolipoprotein A （ Apo-A ） , apolipoprotein B （ Apo-B ） , apolipoprotein E （ Apo-E ） and lipoprotein （ Lp-a ） were tested. Results The proportion of patients with high level of sdLDL in aged type 2 diabetic patients was 33.33%. When LDL-C 〈 3. 12 mmol/L,the BMI, TG, Apo-A, Apo-B and Apo-E levels of patients with sdLDL were significantly higher than those of patients without sdLDL and the HDL-C level was significantly lower. However, the difference between the subgroups was not significant when LDL-C 〉 3. 12 mmol/L. Conclusions The aged type 2 diabetic patients with high level of sdLDL could be primarily screened by TG/HDL-C index. The typical lipid change of these patients was increase in TG,ApoA,ApoB and Apo-E level and decrease in HDL-C level.