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目的 探讨糖尿病肾病 (diabetic nephropathy,DN)病人血清脂质代谢异常与肾脏损害间的关系。方法 6 4例 2型糖尿病 (diabetes m ellitus,DM)病人 ,按尿清蛋白排泄率 (urinary album in excretion rate,U AER)分组 ,并设对照组 ,分别测定血清总胆固醇 (total cholesterol,TC)、甘油三脂 (triglycerides,TG)、高密度脂蛋白胆固醇(high density lipoprotein- cholesterol,HDL- C)、低密度脂蛋白胆固醇 (low density lipoprotein- cholesterol,L DL- C)、载脂蛋白 A1(apolipoprotein- A1,Apo- A1)及载脂蛋白 B(apolipoprotein- B,Apo- B) ,比较组间差异及与 U AER的关系 ;同时比较血脂与血糖间的关系。结果 正常清蛋白尿组仅 Apo- A1显著降低 (P <0 .0 1) ;微量清蛋白尿组Apo- A1显著降低 ,Apo- B显著升高 (P <0 .0 5 ) ;临床期 DN组 Apo- A1显著降低 (P <0 .0 5 ) ,Apo- B、TC、L DL- C显著升高 (P <0 .0 5 ,0 .0 1) ,Apo- A1/ Apo- B在 DM三组均显著降低 (P <0 .0 1,0 .0 5 ) ;TG、L DL- C及 Apo- B与UAER呈显著正相关 (P <0 .0 1,0 .0 0 1) ;TC、TG及 L DH- C与血糖呈显著正相关。结论 DN病人存在明显的脂质代谢异常 ,与血糖控制不良有关 ,且随肾脏损害程度加重而加重 ,其中 TG、HDL- C及 Apo- B的
Objective To investigate the relationship between serum lipid metabolism and renal damage in patients with diabetic nephropathy (DN). Methods Sixty-four patients with type 2 diabetes mellitus (DM) were divided into urinary albumin excretion rate (U AER) group and control group. Total cholesterol (TC) , Triglycerides (TG), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (L DL-C), apolipoprotein A1 apolipoprotein-A1, apolipoprotein A1, and apolipoprotein B (Apo-B). The differences between the two groups were compared with UERR. The relationship between serum lipids and blood glucose was also compared. Results Only Apo-A1 in normal albuminuria group was significantly lower (P <0.01); Apo-A1 in microalbuminuria group was significantly lower and Apo-B was significantly higher (P <0.05); clinical stage DN (P <0.05), Apo-B, TC and L-DL-C significantly increased (P <0.05, 0.01) DM significantly decreased in all three groups (P <0.01, 1.05); TG, L DL-C and Apo-B were positively correlated with UAER (P < ; TC, TG and L DH-C were positively correlated with blood glucose. Conclusion DN patients have obvious lipid metabolism abnormalities, which are related to the poor control of blood glucose and aggravate with the degree of renal damage. Among them, TG, HDL-C and Apo-B