Abdel-Gayoum Abdel-Gayoum A
Department of Laboratory, Dammam College of Health Sciences, PO Box 3761, Dammam 31481, Kingdom of Saudi Arabia.
Saudi Med J. 2004 Feb;25(2):207-11.
The study was planned to investigate whether the serum lipid profile in type 2 diabetes mellitus was different between groups of patients classified as having good, satisfactory or poor glycemic controls, depending on their serum fructosamine levels.
The study was carried out in the Department of Laboratory, Dammam College for Health Sciences, Dammam, Kingdom of Saudi Arabia between February 2003 to June 2003. Clinical laboratory data from diagnosed type 2 diabetic patients were used in the study. One hundred and nineteen patient's data were randomly selected, and according to their serum fructosamine levels, the patients were divided into 3 groups: 29 patients classified as patients with good glycemic control (GGC) with serum fructosamine level <250 micromol/L, 44 patients classified as satisfactory glycemic control (SGC) with serum fructosamine level ranging between 250-355 micromol/L and 46 patients classified as poor glycemic control (PGC) with serum fructosamine >355 micromol/L. The fasting serum glucose and various lipids and lipoprotein concentrations of each group were analyzed by one way analysis of variance and regression analysis.
In the PGC group, the serum total cholesterol (6.11+/- 1.56 mmol/l), triglyceride (2.13 +/- 0.71 mmol/L) and very low density lipoprotein-cholesterol (1.09 +/- 0.40 mmol/L) concentrations were significantly higher than that of the SGC (5.59 +/- 0.89, 1.59 +/- 0.38 and 0.86 +/- 0.28 mmol/L,), and the GGC (5.11 +/- 1.06, 1.25 +/- 0.32 and 0.78 +/- 0.29 mmol/L), whereas, those of the SGC were slightly raised, but not statistically significant, compared to the GGC. The high density lipoprotein cholesterol was significantly lower, and the low density lipoprotein cholesterol was elevated in both satisfactory and poorly controlled groups compared to good control group. Significant correlations were evident between the serum fructosamine and glucose concentrations (r=0.79, p<0.0001), and between them as independent parameters and the serum lipid concentrations.
The glycemic control in type 2 diabetes significantly improves diabetic related dyslipidemia, and would be expected to reduce the risk of atherosclerosis. It is also worth mentioning that the serum fructosamine measure gives a good index for the glycemic control, and its value can reflect the profile of serum lipids.
本研究旨在调查根据血清果糖胺水平分类为血糖控制良好、满意或不佳的2型糖尿病患者组之间的血脂谱是否存在差异。
该研究于2003年2月至2003年6月在沙特阿拉伯王国达曼健康科学学院实验室进行。研究使用了已确诊的2型糖尿病患者的临床实验室数据。随机选择119例患者的数据，并根据他们的血清果糖胺水平将患者分为3组：29例血清果糖胺水平<250微摩尔/升的患者被分类为血糖控制良好（GGC）组，44例血清果糖胺水平在250 - 355微摩尔/升之间的患者被分类为血糖控制满意（SGC）组，46例血清果糖胺>355微摩尔/升的患者被分类为血糖控制不佳（PGC）组。通过单因素方差分析和回归分析对每组的空腹血清葡萄糖以及各种脂质和脂蛋白浓度进行分析。
在PGC组中，血清总胆固醇（6.11±1.56毫摩尔/升）、甘油三酯（2.13±0.71毫摩尔/升）和极低密度脂蛋白胆固醇（1.09±0.40毫摩尔/升）浓度显著高于SGC组（5.59±0.89、1.59±0.38和0.86±0.28毫摩尔/升）以及GGC组（5.11±1.06、1.25±0.32和0.78±0.29毫摩尔/升），而SGC组与GGC组相比略有升高，但无统计学意义。与良好控制组相比，满意和控制不佳组的高密度脂蛋白胆固醇显著降低，低密度脂蛋白胆固醇升高。血清果糖胺与葡萄糖浓度之间（r = 0.79，p<0.0001）以及它们作为独立参数与血清脂质浓度之间存在显著相关性。
2型糖尿病中的血糖控制可显著改善糖尿病相关的血脂异常，并有望降低动脉粥样硬化风险。还值得一提的是，血清果糖胺测量为血糖控制提供了一个良好指标，其值可反映血脂谱。
