2型糖尿病患者载脂蛋白B和载脂蛋白A-1比值与胰岛素抵抗的相关分析

Correlation between ApoB/ApoA-1 and insulin resistance in patients with type 2-diabetes

目的探讨2型糖尿病(T2DM)患者载脂蛋白B(ApoB)/载脂蛋白A-1(ApoA-1)比值与血清胰岛素抵抗(IR)的关系。方法南平市第一医院2009年4月至2012年12月住院并已确诊为T2DM的患者180例,检测三酰甘油(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、ApoA-1、ApoB、空腹血清葡萄糖(GLU)、空腹血清胰岛素(FINS)、空腹血清c肽(Cp)、糖化血红蛋白(HbA1c)水平,计算ApoB/ApoA-1比值及IR指数(Homa-IR)。根据ApoB/ApoA-1的四分位值将患者分为A、B、C、D 4组,比较4组患者Homa-IR差异。结果与血糖控制良好患者相比,血糖控制不良患者的TC、LDL-C、ApoB、GLU、Homa-IR及ApoB/ApoA-1比值均明显增高,比较差异有统计学意义(P<0.05)。ApoB/ApoA-1比值较高的组Homa IR明显高于ApoB/ApoA-1比值较低的组,比较差异有统计学意义(P<0.01)。结论在T2DM患者中ApoB/ApoA-1比值与IR密切相关,ApoB/ApoA-1比值增高是IR发生的重要标志。

Objective To investigate the relationship between the ratio of apolipoprotein B and apolipoprotein A1 （ApoB/ApoA- 1） and insulin resistance （IR）in patients with type 2-diabetes. Methods The serum samples of 180 type 2-diabetes patients in Nan- ping were collected and detected triglyceride （TG）, cholesterol （TC）, high-density lipoprotein-cholesterol（ HDL-C）, low-density lip- oprotein （LDL-C）, apolipoprotein A1 （ApoA-1）, lipoprotein B （ApoB）, fasting plasma glucose （GLU）, fasting serum insulin （FINS） ,fasting serum c-peptide （Cp） and glycosylated hemoglobin （HbAlc）, then calculated ApoB/ApoA-1 ratio and insulin re- sistance index （Homa-IR）. According to the quarterback numerical of 180 type 2-diabetes patients ApoB/ApoA-l,all the patients were divided into group A,B,C,D. The relationship between the ApoB/ApoA-1 and Homa-IR was analyzed. Results Compared with the good control of glucose group, the levels of TC, LDL-C, ApoB, GLU, Homa-IR and ApoB/ApoA-1 in the poor control of glucose group were significantly increased（P〈0.05）. The IR risk in groups with higher ApoB/ApoA-1 were far higher than that of groups with lower ApoB/ApoA-I（P〈0.01）. Conclusion There was a significant relationship between the ApoB/ApoA-1 and IR in patients with type 2-diabetes,and as the ApoB/ApoA-1 increased,the incidence of IR increased too.