吸烟对20例男性糖尿病患者血脂的影响

Effect of smoking on blood lipids in 200 cases of male patients with diabetes

目的探讨吸烟对糖尿病男性患者脂代谢紊乱的影响。方法选取2014年7月至2015年9月该院收治的糖尿病男性患者200例,依据吸烟情况分为吸烟组(n=88)和不吸烟组(n=112),比较两组患者的脂代谢情况,并对临床资料进行单因素和多因素Logistic回归分析。结果吸烟组患者的总胆固醇、三酰甘油、低密度脂蛋白胆固醇均明显高于不吸烟组,高密度脂蛋白胆固醇明显低于不吸烟组(P<0.05)。吸烟组中血脂异常64例(72.73%),不吸烟组中血脂异常43例(38.39%),差异有统计学意义(P<0.05)。肥胖、腰臀比小于或等于1.0、吸烟、空腹血糖大于5.6mmol/L、餐后2h血糖大于7.8mmol/L、合并其他代谢综合征男性糖尿病患者体内脂代谢异常率明显升高,与脂代谢情况具有一定相关性(P<0.05)。多因素Logistic回归分析结果显示,肥胖、吸烟、合并其他代谢综合征是影响男性糖尿病患者体内脂代谢的独立危险因素(P<0.05)。结论吸烟是影响男性糖尿病患者体内脂代谢异常的独立危险因素,主要通过加重胰岛素抵抗、增加游离脂肪酸水平发挥作用,临床上应鼓励并引导糖尿病患者戒烟,维持脂代谢稳定。

Objective To investigate the influence of smoking on lipid metabolism disorders in male patients with diabetes.Methods Totally 200 male patients with diabetes from July 2014 to September 2015 were selected,according to the smoking condition divided into smoking group（n=88）and non-smoking group（n=112）,the lipid metabolism was compared between the two groups,and the clinical data were analyzed by single factor and multi factor Logistic regression analysis.Results The total cholesterol,triglyceride,low density lipoprotein cholesterol in smoking group were significantly higher than those in non smoking group,high density lipoprotein cholesterol was significantly lower than that of non smoking group（P〈0.05）.There were 88 cases in the smoking group,of which 64 cases of dyslipidemia（72.73%）;there were 88 cases in the non smoking group,of which 43 cases of dyslipidemia（38.39%）,the difference was statistically significant（P〈0.05）.Obesity,waist to hip ratio≤1.0,smoking,fasting glucose〉5.6mmol/L,2hpostprandial blood glucose〉7.8mmol/L,and other metabolic syndrome in male patients with lipid metabolic disorders was significantly increased,which were correlated with lipid metabolism（P〈0.05）.Multivariate Logistic regression analysis showed that obesity,smoking,and other metabolic syndrome were the independent risk factors of lipid metabolism in male patients with diabetes mellitus（P〈0.05）.Conclusion Smoking is an independent risk factor affecting lipid metabolism in the body of a male diabetic patients,mainly through increasing insulin resistance,increasing free fatty acids play a role,should encourage diabetics to quit smoking and to guide clinical practice,maintaining stable lipid metabolism.