稳定性冠状动脉粥样硬化性心脏病合并2型糖尿病患者血脂特点及与其炎性因子的关系

Characteristics of lipid in patients with stable coronary atherosclerotic heart disease complicated with type 2 diabetes mellitus and their correlations with inflammatory factors

目的探讨稳定性冠状动脉粥样硬化性心脏病(stable coronary atherosclerotic heart disease,SCAD)合并2型糖尿病(type 2 diabetes mellitus,T2DM)患者血脂的特点及其与炎性因子的关系。方法选取2017年2月至2019年2月在深圳市龙岗中心医院治疗的SCAD患者184例,其中合并T2DM患者64例(观察组),未合并T2DM患者120例(对照组)。检测两组患者空腹及餐后2 h三酰甘油(triacylglycerol,TG)、总胆固醇(total cho⁃lesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein-cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、残粒脂蛋白胆固醇(remnant lipoprotein particles cholesterol,RLP-C),以及白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、高敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)的血清浓度并进行统计学分析。结果观察组和对照组患者空腹及餐后2 h TC、LDL-C、HDL-C浓度比较,差异无统计学意义(P<0.05)。观察组患者餐后2 h TG、RLP-C浓度分别为(2.22±0.90)mmol/L和(0.77±0.15)mmol/L,明显高于对照组,差异有统计学意义(P<0.05)。观察组患者餐后2 h IL-6、TNF-α、hs-CRP浓度分别为(16.02±1.27)pg/mL、(25.30±1.51)pg/mL和(9.43±1.51)pg/mL,明显高于对照组,差异有统计学意义(P<0.05)。观察组患者餐后2 h TG浓度与餐后2 h IL-6、TNF-α和hs-CRP浓度呈正相关(r=0.379、0.180和0.368,P<0.05);观察组患者餐后2 h RLP-C浓度与餐后2 h IL-6、TNF-α和hs-CRP浓度呈正相关(r=0.480、0.381和0.262,P<0.05)。结论SCAD合并T2DM患者餐后TG、RLP-C浓度明显升高,且与患者炎症指标IL-6、TNF-α和hs-CRP呈正相关,值得临床进一步研究。

Objectives To investigate the characteristics of lipid in patients with stable coronary atherosclerotic heart disease(SCAD)and type 2 diabetes mellitus(T2DM)and their correlations with inflammatory factors.Methods Totally 184 patients with SCAD treated in Shenzhen Longgang Central Hospital from February 2017 to February 2019 were selected,including 64 patients with T2DM(observation group)and 120 patients without T2DM(control group).Serum concentrations of triacylglycerol(TG),total cholesterol(TC),low-density lipoprotein-cholesterol(LDL-C),highdensity lipoprotein cholesterol(HDL-C),remnant lipoprotein particles cholesterol(RLP-C),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),high sensitivity C-reactive protein(hs-CRP)were measured and analyzed in both groups at fasting time and 2 hours after meal.Results There were no significant differences in serum concentrations of TC,LDL-C and HDL-Cbetween observation group and control group(P<0.05).Serum concentrations of TG and RLP-Cin observation group at 2 hours after meal were(2.22±0.90)mmol/L and(0.77±0.15)mmol/L,which were significantly higher than those in control group(P<0.05).Serum concentrations of IL-6,TNF-αand hs-CRP in observation group at 2 hours after meal were(16.02±1.27)pg/mL,(25.30±1.51)pg/mL and(9.43±1.51)pg/mL,which were significantly higher than those in control group(P<0.05).TG at 2 hours after treatment in observation group positively correlated with IL-6,TNF-αand hs-CRP(r=0.379,0.180 and 0.368,P<0.05);RLP-C positively correlated with IL-6,TNF-αand hs-CRP at 2 hours after meal in observation group(r=0.480,0.381 and 0.262,P<0.05).Conclusions Postprandial serum concentrations of TG and RLP-C in patients with SCAD and T2DM significantly increase,and positively correlate with inflammatory markers such as IL-6,TNF-and hs-CRP,which are deserved further clinical study.