血脂异常对2型糖尿病肾病的影响

The effects of dyslipidemia on type 2 diabetic nephropathy

目的 探讨脂代谢异常对 2型糖尿病肾病 (DN)的影响。方法 采用病例对照研究方法 ,测定 40例 2型糖尿病肾病患者和 40例无肾病患者血清脂蛋白及载脂蛋白 (Apo) ,空腹胰岛素、血糖及尿白蛋白排泄率 ,并观察 40例糖尿病肾病患者不同时期血脂水平变化。结果 糖尿病肾病组较无肾病组甘油三酯、低密度脂蛋白 胆固醇、空腹胰岛素、血糖水平明显增高 (P <0 0 0 1 ) ,总胆固醇、高密度脂蛋白 胆固醇、载脂蛋白无明显差异 (P >0 0 5 ) ;甘油三酯、低密度脂蛋白 胆固醇与尿白蛋白排泄率、空腹胰岛素、血糖水平呈正相关 (r分别为 0 3 72、0 3 76、0 3 61 ) ;早期糖尿病肾病组血脂高于无肾病组 ,而且随着病程迁延 ,血脂紊乱趋于明显。结论 糖尿病肾病患者脂代谢紊乱的程度明显高于无肾病患者 ,并且在肾病早期就已出现。提示宜早期监测血脂水平 。

Objective To study the effects of the disorder of lipid metabolism on type 2 diabetic nephropathy (DN). Methods Case control was used to determine serum lipoprotein, apolipoproteins (Apo), fasting insulin, plasma glucose and excretory rate of urine albumin in patients with type 2 DN (40 cases), and type 2 diabetes (40 cases), and observe the level of plasma lipids at different times in 40 patients with type 2 DN.Results There was significant difference in triglycerde (TG), low density lipoprotein cholesterol (LDL C), the level of fasting insulin plasma glucose in the two groups ( P <0.001).There was no significant difference in total cholesterol (Tch), high density lipoprotein cholesterol (HDL C), and apolipoprotein (Apo) in the two groups ( P >0.05). There was a positive correlation between LDL C and excretory rate of urine albumin (UAER), and fasting insulin plasma glucose ( r =0.372,0.376, 0.361, P <0.01); the level of plasma lipids in patients with early type 2 DN was higher than that in patients with type 2 diabetes, and with the delay of the cases, metabolic disorder of plasma lipids became obvious. Conclusion The degree of the metabolic disorders of plasma lipids in patients with type 2 DN is greater than that in patients without nephrosis. To prevent and delay the development of type 2 DN, we ought to examine the plasma lipids in those patients as early as possible.