2型糖尿病患者正常范围内血清直接胆红素不同水平与血脂异常的相关性及其危险因素分析

Correlation between Serum DBiL Levels and Blood Lipids in Patients with Type 2 Diabetes Mel- iitus

【目的】分析2型糖尿病（T2DM）患者血清正常范围内（0～6．89μmol／L）直接胆红素（DBiL）不同水平与血脂的相关性及血脂异常的相关危险因素。【方法】收集380例T2DM患者的临床资料，记录其DBil及低密度脂蛋白胆固醇（LDL—C）、高密度脂蛋白胆固醇（HDL-C）、三酰甘油（TG）、总胆固醇（TC）水平，并按照DBil水平分为A组（〈2．2μmol／L，n=92）、B组（2．2～2．9μmol／L，n=88）、C组（2．9～3．9μmol／L，n=102）、D组（3．9～6．89μmol／L，n=98）组，分析不同TBil水平与血脂异常的相关性及血脂异常的相关危险因素。【结果】①四组男性、吸烟饮酒、高TC血症、高TG血症、胰岛素治疗比例及谷丙转氨酶（AI。T）、谷草转氨酶（AST）、餐后2h血糖（2hPG）、糖化血红蛋白（HbA1C）、总胆红素（TBil）、DBil、TC、TG、LDL-C水平对比差异有统计学意义（P〈0．05），D组血脂异常率低于A组，其血清TC、TG、LDL-C水平低于A组。②T2DM患者DBil水平与TC、TG、LDL-C呈负相关（P〈0．05），四组中D组血脂异常风险最低。【结论】T2DM患者正常范围内不同DBil水平与血脂异常存在相关性，高DBil水平可降低血脂异常的风险。

[Objective]To analyze the correlation between normal （0-6.89 μmol/l.） serum direct bilirubin （DBiL） levels and blood lipids in patients with type 2 diabetes mellitus （T2DM） and to predict the related risk factors of dyslipidemia. [Methods]The clinical data of 380 cases with T2DM were collected, and the levels of DBil, low-density lipoprotein cholesterol （LDL-C）, high-density lipoprotein cholesterol （HDL-C）, triglyceride （TG） and total cholesterol （TC） were recorded. According to the DBil levels, the subjects were divided into group A （〈 2.2μmol/L, n =92）, group B （2.2-2.9 btmol/L, n =88）, group C （2.9-3.9 tlmol/I., n = 102）, and group D （3.9-6.89 μmol/L, n =98）. The correlation between TBil and serum lipid was analyzed. [Results]The proportions of male patients, smoking and drinking, high TC hyperlipidemia, high TG hyperlipidemia, insulin treatment, and the levels of alanine aminotransferase （AI.T）, aspartate aminotransferase （AST）, postprandial 2h blood glucose （2hPG）, glycosylated hemoglobin （HbAlc）, total bilirubin （TBil）, DBil, TC, TG and LDL-C showed significant differences among the four groups （ P 〈0.05）. The incidence of dyslipidemia and levels of TC, TG and LDL-C in group D were lower than those in group A. The DBil level was negatively correlated with the levels of TC, TG and LDL-C in patients with T2DM （ P 〈0.05）. The risk of dyslipidemia was the lowest in group D among the four groups. [Conclusion]There is a correlation between normal DBil and blood lipids in patients with T2DM, and high DBil can decrease the risk of dyslipidemia.