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目的探讨新诊断2型糖尿病(T2DM)合并代谢综合征(MS)患者血清低密度脂蛋白胆固醇(LDL-C)/高密度脂蛋白胆固醇(HDL-C)比值变化及其与各临床指标的相关性。方法选择新诊断T2DM患者140例,根据是否合并MS分为MS组73例、非MS组67例,另设立正常对照组73例。所有研究对象均行口服葡萄糖耐量试验(OGTT)及胰岛素释放试验,并检测血糖、胰岛素、血脂等相关生化指标,计算各组LDL-C/HDL-C比值。比较各组临床指标及LDL-C/HDL-C比值水平变化,分析LDL-C/HDL-C比值与各指标的相关性。根据LDL-C/HDL-C水平三分位分组,比较各组MS患病率。结果MS组(3.18±0.85)及非MS组(2.61±0.93)LDL-C/HDL-C均高于对照组(2.26±0.70),且MS组的LDL-C/HDL-C亦高于非MS组,差异有统计学意义(P<0.05)。根据LDL-C/HDL-C水平三分位分组,各组MS患病率分别为11.27%、35.21%、56.34%,随着LDL-C/HDL-C水平升高MS患病率升高(P<0.05)。相关分析显示,LDL-C/HDL-C比值与体质指数(BMI)、腰围(WC)、腰臀比(WHR)、收缩压、舒张压、餐后2h血糖(PPG)、空腹胰岛素(FINS)、餐后2h胰岛素(PSI)、胰岛素抵抗指数(HOMA-IR)、三酰甘油(TG)、血浆总胆固醇(CHOL)、LDL-C呈正相关(P<0.05),与HDL-C呈负相关(P<0.01)。以LDL-C/HDL-C为因变量作多元逐步回归分析,有HDL-C、LDL-C、FINS进入方程(P<0.01)。结论 T2DM合并MS患者LDL-C/HDL-C的比值升高,且高水平LDL-C/HDL-C比值患者的MS患病率高,LDL-C/HDL-C比值较单纯LDL-C浓度能更好地评估MS发生的危险性,为MS的预防和治疗提供更简便、有效的方案。
Objective To investigate the changes of serum LDL-C / HDL-C ratio in patients with newly diagnosed type 2 diabetes mellitus (T2DM) and metabolic syndrome (MS) and their correlations with various clinical parameters Sex. Methods 140 newly diagnosed T2DM patients were selected. According to whether they were combined with MS, 73 cases were divided into MS group, 67 non-MS group and 73 normal control group. All subjects underwent oral glucose tolerance test (OGTT) and insulin release test, and blood glucose, insulin, blood lipids and other biochemical indicators were measured, and the ratio of LDL-C / HDL-C in each group was calculated. The changes of clinical indexes and LDL-C / HDL-C ratio in each group were compared. The correlation between LDL-C / HDL-C ratio and each index was analyzed. According to the level of LDL-C / HDL-C tertile grouping, comparing the prevalence of MS in each group. Results The levels of LDL-C / HDL-C in MS group (3.18 ± 0.85) and non-MS group (2.61 ± 0.93) were significantly higher than those in control group (2.26 ± 0.70) MS group, the difference was statistically significant (P <0.05). According to the level of LDL-C / HDL-C, the prevalence of MS in each group was 11.27%, 35.21% and 56.34% respectively. The prevalence of MS increased with the increase of LDL-C / HDL-C P <0.05). Correlation analysis showed that the ratio of LDL-C / HDL-C to body mass index (BMI), waist circumference (WHR), systolic blood pressure, diastolic blood pressure, postprandial blood glucose at 2h (PPG), fasting insulin (FINS) PSI, HOMA-IR, triglyceride (TG), total cholesterol (CHOL) and LDL-C at postprandial phase (P <0.05), but negatively correlated with HDL- (P <0.01). Multiple regression analysis showed that HDL-C, LDL-C and FINS entered the equation with LDL-C / HDL-C as the dependent variable (P <0.01). Conclusions The ratio of LDL-C / HDL-C in patients with T2DM and MS is increased, and the prevalence of MS in patients with high-level LDL-C / HDL-C is higher than that in patients with simple LDL-C Can better assess the risk of MS and provide a more convenient and effective solution for the prevention and treatment of MS.