2型糖尿病患者ApoA_1/ApoB之值与其血管并发症关系分析

Analysis of relationship of ApoA_1/ApoB with the vascular complication in type 2 diabetes mellitus

目的:分析2型糖尿病(T2DM)患者载脂蛋白A1/载脂蛋白B之值(ApoA1/ApoB值)与其血管并发症的关系。方法:226例T2DM患者按照有无血管并发症分为无血管并发症(A组)、有大血管并发症组(B组)、有微血管并发症组(C组)、同时有大血管和微血管并发症组(D组)4组,测定并比较各组空腹血糖(FBG)、糖化血红蛋白(HbA1c)及血脂各项指标,并行多元逐步回归分析。结果:(1)A组收缩压(SBP)、HbA1c、FPG、甘油三酯(TG)、ApoB较B、C、D组明显偏低(P<0.05);(2)A、C组总胆固醇(CH)、低密度脂蛋白(LDL)较B、D组明显降低(P<0.05),而A、C组高密度脂蛋白(HDL)、ApoA1/ApoB值明显高于B、D组(P<0.01),B、C、D组ApoB明显高于A组(P<0.01)。(3)多元逐步回归分析示ApoA1/ApoB值与HDL呈明显正相关(r=0.237,P<0.01),与HbA1c、TG、LDL呈明显负相关(r=-0.393,-0.416,-0.545,P<0.05)。结论:ApoA1与DM微血管病变无相关性,ApoB为DM血管病变的共同致病因子,ApoA1/ApoB值在血管粥样硬化的诊断治疗上较ApoA1、ApoB单项更有价值。

Objective： To understand the relation with the ApoA1/ApoB and the vascular complication in type 2 diabetes mellitus.Methods： 246 cases of type 2 diabetes mellitus were enrolled in the study which were divided into four groups according to their vascular complications.All groups of FPG,HbA1c and blood lipid were measured.The results between different groups were compared and analyzed by multiple regression method.Results：（1） The SBP,FPG,HbA1c,TG and ApoB in B,C and D groups were significantly higher than those in A group（P0.05）;（2） The CH,LDL in B and D group were significantly higher than those in A and C group（P0.05）,but HDL,ApoA1 and ApoA1/ApoB significantly lower than those in A and C group（P0.01）,the ApoB in B,C and D group was significantly higher than that in A group（P0.01）;（3） Analysis using multiple regression method show that the ApoA1/ApoB had a negative correlation with HbA1c,TG and LDL（r=-0.393,-0.416,-0.545,P0.05）,but a positive one with HDL（r=0.237,P0.01）.Conclusion： ApoA1 does not correlate with the microvascular complications,ApoB may be a joint damaging factor to the vascular complications,ApoA1/ApoB may plays a more important role in diagnosing and treating than ApoA1,ApoB themselves.