目的:探讨老年糖尿病患者脂餐后脂肪代谢变化规律。方法:13例均为贵州省人民医院干医科住院的老年糖尿病患者(年龄≥60岁)。观察老年糖尿病患者空腹与口服脂肪餐(热量为2520kJ/m2体表面积;脂肪、蛋白质及碳水化物提供的能量分别占60%,14%及26%;多不饱和脂肪酸与饱和脂肪酸之比0.1)后2,4,6,8h时段的总胆固醇、三酰甘油、高密度脂蛋白胆固醇(high-densitylipoproteincholes-terol,HDL-C)、低密度脂蛋白胆固醇(low-densitylipoproteincholesterol,LDL-C)、载脂蛋白A1及载脂蛋白B的变化。结果:餐后4h及8h的总胆固醇水平均下降,与空腹时比较,差异均有显著性意义(Z=-2.481,-2.272;P=0.013,0.023)。餐后2,4及6h的三酰甘油升高,与空腹时比较,差异有显著意义(Z=-2.746,-2.621,-3.110;P=0.006,0.009,0.002)。餐后4,6及8h的HDL-C和LDL-C均降低,与空腹时比较,差异均有显著意义(Z=-3.110～-2.293;P=0.002～0.022)。餐后4h和6h的载脂蛋白A1水平降低,餐后8h的载脂蛋白B水平降低,与空腹时比较,差异均有显著意义(Z=-2.724～-2.046;P=0.006～0.041)。结论:老年糖尿病患者脂肪餐后三酰甘油水平明显升高;而脂肪餐后总胆固醇、HDL-C,LDL-C,载脂蛋白A1及载脂蛋白B均有不同程度的下降。 Objective: To investigate the changes of fat metabolism after fat meal in elderly patients with diabetes mellitus. Methods: Thirteen patients were elderly diabetic patients (aged ≥60 years) hospitalized in Guizhou Provincial People’s Hospital. The fasting and oral fat meal (2520kJ / m2 body surface area; 60%, 14% and 26% fat, protein and carbohydrate respectively); the ratio of polyunsaturated fatty acid and saturated fatty acid 0.1% Total cholesterol, triglyceride, high-density lipoprotein cholesterol-low (HDL-C), low-density lipoprotein cholesterol (LDL-C) Changes in protein A1 and apolipoprotein B. Results: The levels of total cholesterol decreased 4h and 8h after meal, which were significantly different from fasting (Z = -2.481, -2.272; P = 0.013,0.023). The levels of triglyceride increased at 2, 4, and 6 h after meal, which were significantly different from fasting (Z = -2.746, -2.621, -3.110; P = 0.006,0.009, 0.002). The levels of HDL-C and LDL-C at 4, 6 and 8 h postprandial decreased after fasting, which were significantly different from fasting (Z = -3.110 ~ -2.293; P = 0.002 ~ 0.022). The level of apolipoprotein A1 decreased at 4h and 6h after meal, and the level of apolipoprotein B decreased 8h after meal. There was significant difference between fasting and postprandial (Z = -2.724 ~ -2.046; P = 0.006 ~ 0.041). Conclusion: The triglyceride level of postprandial fat in elderly patients with diabetes mellitus was significantly increased. However, total cholesterol, HDL-C, LDL-C, apolipoprotein A1 and apolipoprotein B in postprandial adipose tissue decreased to some extent.