2型糖尿病患者糖耐量试验期间血脂变化的调查

An investigation on the changes of postprandial blood lipid during the glucose tolerance test in patients with type 2 diabetes mellitus

目的调查2型糖尿病(T2DM)患者OGTT时血脂的变化。方法T2DM组78例,对照组33例。其中,T2DM组按OGTT试验方式分为葡萄糖组25例和馒头组53例;按用药情况分为未用药组26例、仅用降糖药组37例和降糖降脂药组15例;按空腹血脂分为血脂正常组36例和异常组42例。受试者于0、1、2、3h时分别进行静脉采血,在生化分析仪上检测葡萄糖(GLU)、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)、载脂蛋白A1(ApoA1)和载脂蛋白B(ApoB),在化学发光仪上检测胰岛素(INS)。采用SPSS22.0软件进行统计学分析,各时间点间的变化采用ANOVA检验,各组指标间差异采用SNK检验。结果T2DM组和对照组在OGTT期间的GLU和INS的变化均呈现先升高再降低的趋势,其中T2DM组的峰值出现在餐后2h,对照组的峰值出现在餐后1h,而两组OGTT期间血脂指标(TG、TC、HDL-C、LDL-C、ApoA1和ApoB)的变化均无统计学意义(P>0.05)。按OGTT试验方式、用药情况、空腹血脂水平是否异常分组后,4个时间点各项血脂指标的组内比较差异均无统计学意义(P>0.05)。结论OGTT试验方式、用药情况、空腹血脂水平是否异常等对OGTT期间血脂水平的影响不明显。

Objective To investigate the changes of postprandial blood lipid after the glucose tolerance test in type 2 diabetic mellitus(T2DM)patients.Methods A total of 78 T2DM patients and 33 healthy people as control were enrolled in the study.According to the way of glucose tolerance test,T2DM group was divided into 25 cases of glucose meal and 53 cases of steamed bread meal.According to the medication situation,T2DM group was divided into 26 cases of using no drug,37 cases of using hypoglycemic drugs and 15 cases of using both hypoglycemic and lipid-reducing drugs.According to the fasting lipid,T2DM group was divided into 36 cases of normal blood lipids and 42 cases of dyslipidemia.Subjects were bled at 0 h,1 h,2 h and 3 h.Glucose(GLU),triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),apolipoprotein A1(ApoA1)and apolipoprotein B(ApoB)were detected on a biochemical analyzer.Insulin(INS)was detected on a chemiluminescence apparatus.The data was analyzed by the SPSS 22.0 statistical software.The changes between time points were analyzed by ANOVA.The difference between the item of each group was analyzed by SNK.Results In both the T2DM group and the control group,GLU and INS showed a tendency to rise and then fall during the glucose tolerance test.The peak of the T2DM group appeared at 2 h after meal,the peak of the control group appeared at 1 h after meal.However,there was no statistically significant change in serum lipids(TG,TC,HDL-C,LDL-C,ApoA1 and ApoB)in the two groups during the glucose tolerance test(P>0.05).After grouping according to OGTT methods,medication scheme and fasting lipid level,there was no significant difference in the blood lipid indicators among the four time points(P>0.05).Conclusion OGTT methods,medication scheme and blood lipid level have no significant effect on blood lipid levels during OGTT.