甘油三酯与高密度脂蛋白胆固醇比值在糖尿病肾病中的价值研究

Diagnostic Value of Serum TG / HDL-C Ratio in Diabetic Nephropathy

目的探讨甘油三酯与高密度脂蛋白胆固醇比值(TG/HDL-C)在糖尿病肾病中的价值。方法随机选取2型糖尿病患者150例,将其分为糖尿病无肾病组(45例)、早期糖尿病肾病组(35例)、临床糖尿病肾病组(42例)和晚期糖尿病肾病组(28例)4组,检测4组患者空腹血糖(FPG)、糖化血红蛋白(HbA1c)、甘油三脂(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、脂蛋白-A(Apro-A),脂蛋白-B(Apro-B),并计算TG/HDL-C比值。结果与糖尿病无肾病组患者比较,各组患者糖尿病肾病HDL-C明显降低,且随着肾脏损害的加重,血清TG、TC、LDL-C、Apro-B、TG/HDL-C逐渐升高,而HDL-C、Apro-A逐渐降低,组间比较差异有统计学意义(P<0.01)。相关分析结果显示,UAER与HDL-C呈负相关(r=-0.558,P=0.027),而与TG/HDL-C比值呈正相关(r=0.638,P=0.015)。结论 HDL-C是糖尿病肾病发生、发展中的重要保护因子,而TG/HDL-C是与其密切相关的危险因素。

Objective To study the diagnostic value of the serum TG/HDL-C ratio in diabetic nephropathy. Methods 150 patients with diabetes mellitus in our hospital were randomly selected and divided into four groups：non-nephropathy group （n=45）, early nephropathy group （n=35）, clinical nephropathy group （n=42） and later nephropathy group （n=42）. Serum levels of triglyceride （TG）, total cholesterol （TC）, low density lipoprotein-eholeste （LDL-C）, high density lipoprotein-choleste （HDL-C）, Apro-A, Apro-B, fasting plasma glucose （FPG） and glycosylated hemoglobin （HbAlc） were measured and the ratio of TG and HDL-C was then calculated. Results The level of HDL-C in the nephropathy group was significantly lower than the non-nephropathy group. And with the increase of kidney damage, the serum levels of TC, TG, LDL-C, Apro-B, and TG/HDL-C were gradually increased, whereas .the levels of HDL-C and Apro-A were gradually reduced （P〈O.O1）. Results form the correlation analysis showed that UAER and HDL-C was negatively correlated （r=0.558, P=0.027）, and the ratio of TG/HDL-C were positively correlated （r=0.638,P=0.015）. Conclusion HDL-C is a protection factor for diabetic nephropathy, and TG/HDL-C ratio may be used as an independent risk factor of diabetic nephropathy.