血清α-L-岩藻糖苷酶水平与新疆和田地区住院2型糖尿病患者脂代谢的关系

Relationship between serum alpha-L-fucosidase level and lipid metabolism in hospitalized patients with type 2 diabetes mellitus in Hetian area of Xinjiang

目的研究新疆和田地区2型糖尿病患者的脂代谢特点及其与血清α-L-岩藻糖苷酶(AFU)水平的关系.方法纳入2018年1-12月在新疆和田地区人民医院内一科住院的2型糖尿病患者1000例,其中男性456例,女性544例,平均年龄(54.9±11.3)岁.回顾性分析患者血脂代谢特点及其与血清AFU的关系,并分析维吾尔族与汉族患者的差异.结果本组人群平均糖化血红蛋白为(9.4±2.3)%,15.8%的患者达到中华医学会糖尿病学分会推荐的控制目标;低密度脂蛋白-胆固醇的达标率为53.5%,总胆固醇、甘油三酯及高密度脂蛋白-胆固醇(HDL-C)的达标率均在30%左右,两个民族间差异无统计学意义.多元logistic回归模型分析发现,血清总蛋白(OR=1.038,95%CI:1.015~1.062,P=0.001)、空腹静脉血糖(OR=1.051,95%CI:1.023~1.079,P<0.001)、载脂蛋白A1(OR=7.830,95%CI:2.831~21.654,P<0.001)与AFU呈正相关,HDL-C与AFU呈负相关(OR=0.312,95%CI:0.142~0.684,P=0.004).维吾尔族患者AFU水平低于汉族患者,且该作用独立于其他影响因素(OR=6.185,95%CI:3.087~12.392,P<0.001).结论新疆维吾尔族2型糖尿病患者血糖及血脂达标率均不高.AFU与2型糖尿病患者的糖、脂代谢均密切相关,AFU升高是2型糖尿病患者HDL-C下降的危险因素.

Objective To study the characteristics of lipid metabolism and its relationship with ser-um alpha-L-fucosidase ( AFU) level in patients with type 2 diabetes mellitus in Hetian, Xinjiang. Methods A total of 1000 patients with type 2 diabetes were enrolled in the Department of Internal Medicine, The People′s Hospital of Hetian District in Xinjiang from January to December in 2018, including 456 males and 544 females, with an average age of (54. 9 ± 11. 3) years. The characteristics of blood lipid metabolism and its relationship with serum AFU were retrospectively analyzed, and the differences between Uygur and Han patients were analyzed. Results The average glycosylated hemoglobin A1c of this group was ( 9. 4 ± 2. 3)%, with only 15. 8% patients met the target recommended by Chinese Diabetes Society. Only 53. 5%patients achieved the goal of control in low density lipoprotein-cholesterol, and about 30% patients achieved the goal of control in total cholesterol, triglyceride and high density lipoprotein-cholesterol ( HDL-C). There was no statistical difference between Uygur and Han ethnics. Multiple logistic regression analysis showed that serum total protein (OR=1.038, 95% CI: 1. 015-1. 062, P=0.001), fasting plasma blood glucose (OR=1.051, 95% CI: 1.023-1.079, P<0.001), apolipoprotein A1(OR=7.830, 95% CI: 2.831-21. 654, P<0. 001) were positively correlated with AFU, and HDL-C was negatively correlated with AFU (OR=0. 312, 95% CI:0. 142-0. 684, P=0. 004). The level of AFU in Uygur patients was lower than that in Han patients, and the effect was independent of other influencing factors (OR=6. 185, 95% CI:3. 087-12. 392, P<0. 001). Conclusions The percentages of patients obtaining blood glucose and lipid control are not high in type 2 diabetes in Uygur ethnic group in Xinjiang. AFU is closely related to glucose and lipid metabolism in type 2 diabetic patients. Elevated AFU is a risk factor for the decrease of HDL-C in type 2 di-abetic patients.