Winocour P H, Durrington P N, Bhatnagar D, Mbewu A D, Ishola M, Mackness M, Arrol S
University of Manchester Department of Medicine, Hope Hospital, Salford, UK.
Diabetes Res Clin Pract. 1992 Dec;18(3):173-84. doi: 10.1016/0168-8227(92)90143-f.
The contribution from lipoproteins, blood pressure, albuminuria and demographic variables to coronary heart disease in 90 adult subjects with and 172 without Type 1 diabetes mellitus was examined in order to investigate whether risk factors were of equivalent importance in diabetic and non-diabetic coronary heart disease. Coronary heart disease (CHD) was present in roughly 25% of subjects in each group. In Type 1 diabetes those with CHD had significantly higher levels of systolic blood pressure, albumin excretion, serum creatinine, triglycerides, VLDL cholesterol and C-peptide, and reductions in serum concentrations of HDL and HDL2 cholesterol, in comparison to those without. However, the prevalence of smokers, and concentrations of Lp(a), ApoB and fibrinogen were comparable. Blood pressure and HDL cholesterol were higher in the CHD group with Type 1 diabetes in comparison to the nondiabetic group with CHD, although LDL concentrations and the prevalence of Lp(a) concentrations > 200 mg/l were lower. Logistic regression analysis revealed the strongest independent predictors of CHD in Type 1 diabetes were serum triglycerides, systolic blood pressure, age, serum LDL cholesterol, and the daily insulin dosage, whereas in the non-diabetic control group HDL2 cholesterol, Lp(a), ApoA1 and ApoB, total serum cholesterol and body mass index were additional predictors. CHD in Type 1 diabetes appears to be most closely associated with increasing age and levels of blood pressure and total serum lipids. Apolipoproteins and albuminuria did not seem to be important independent predictors of CHD in Type 1 diabetes, whereas the former were more clearly associated with CHD in non-diabetic controls.
为了研究危险因素在糖尿病和非糖尿病冠心病中是否具有同等重要性，我们对90名患有1型糖尿病的成年受试者和172名未患1型糖尿病的成年受试者进行了研究，以考察脂蛋白、血压、蛋白尿和人口统计学变量对冠心病的影响。每组中约25%的受试者患有冠心病。在1型糖尿病患者中，与未患冠心病的患者相比，患冠心病的患者收缩压、白蛋白排泄、血清肌酐、甘油三酯、极低密度脂蛋白胆固醇和C肽水平显著更高，而高密度脂蛋白和高密度脂蛋白2胆固醇的血清浓度降低。然而，吸烟者的比例以及脂蛋白(a)、载脂蛋白B和纤维蛋白原的浓度相当。与非糖尿病冠心病组相比，1型糖尿病冠心病组的血压和高密度脂蛋白胆固醇更高，尽管低密度脂蛋白浓度和脂蛋白(a)浓度>200mg/l的比例更低。逻辑回归分析显示，1型糖尿病中冠心病最强的独立预测因素是血清甘油三酯、收缩压、年龄、血清低密度脂蛋白胆固醇和每日胰岛素剂量，而在非糖尿病对照组中，高密度脂蛋白2胆固醇、脂蛋白(a)、载脂蛋白A1和载脂蛋白B、总血清胆固醇和体重指数是额外的预测因素。1型糖尿病中的冠心病似乎与年龄增长以及血压和总血脂水平最为密切相关。载脂蛋白和蛋白尿似乎不是1型糖尿病中冠心病的重要独立预测因素，而前者在非糖尿病对照组中与冠心病的关联更为明显。
