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血脂谱与1型糖尿病年轻患者的血糖控制相关。

Lipid profile correlates with glycemic control in young patients with type 1 diabetes mellitus.

作者信息

Ladeia Ana Marice, Adan Luis, Couto-Silva Ana Claudia, Hiltner Angela, Guimarães Armênio C

机构信息

Bahian Medical and Public Health School and Science Development Foundation of Bahia, Bahia, Brazil.

出版信息

Prev Cardiol. 2006 Spring;9(2):82-8. doi: 10.1111/j.1520-037x.2006.4019.x.

Abstract

Data on dyslipidemia in type 1 diabetes is scarce. The authors aimed to evaluate the lipid profile in patients with type 1 diabetes and its correlation to glycemic control. Ninety-four subjects (53.2% males), aged 15.4+/-4.7 (3.6-21.9 years), with disease duration of 5.0+/-3.6 years (0.3-17 years) were evaluated for heart rate, blood pressure, height, and weight. Laboratory data included total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TGs), glycemia, glycosylated hemoglobin (HbA1c), creatinine, thyroid-stimulating hormone, antithyroid antibodies, and 24-hour microalbuminuria. Correlations were performed by the Spearman rank correlation test, and the significance level was <0.05. Mean values were TC, 168.6+/-46.6 mg/d; HDL, 43.1+/-15.3 mg/dL; LDL, 110.9+/-40.6 mg/dL; TGs, 78.3+/-48.6 mg/dL; glycemia, 204.6+/-116.7 mg/dL; and HbA1c, 11.2%+/-2.9%. High TC (43.9% vs. 10.7%; p<0.002) and LDL (51.5% vs. 10.7%; p<0.01) were more prevalent in patients 19 years and younger (n=66). HbA1c correlated with TC (r=0.30; p=0.004), LDL (r=0.28; p=0.008), TG (r=0.31; p=0.003), and TG/HDL ratio (r=0.25; p=0.01). Duration of diabetes correlated with LDL (r=0.21; p=0.04) and insulin daily doses with TG (r=0.23; p=0.04) and body mass index expressed as z scores (r=-0.28; p=0.007). There was a high prevalence of hypercholesterolemia (54.6%) in these diabetic patients, and lipid fraction levels were correlated with HbA1c. Good management of diabetes seems to be of paramount importance in controlling dyslipidemia.

摘要

1型糖尿病患者血脂异常的数据较为匮乏。作者旨在评估1型糖尿病患者的血脂谱及其与血糖控制的相关性。对94名受试者(男性占53.2%)进行了评估,他们的年龄为15.4±4.7岁(3.6 - 21.9岁),病程为5.0±3.6年(0.3 - 17年),评估项目包括心率、血压、身高和体重。实验室数据包括总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、甘油三酯(TGs)、血糖、糖化血红蛋白(HbA1c)、肌酐、促甲状腺激素、抗甲状腺抗体以及24小时微量白蛋白尿。采用Spearman等级相关检验进行相关性分析,显著性水平为<0.05。平均值分别为:TC,168.6±46.6mg/d;HDL,43.1±15.3mg/dL;LDL,110.9±40.6mg/dL;TGs,78.3±48.6mg/dL;血糖,204.6±116.7mg/dL;HbA1c,11.2%±2.9%。19岁及以下患者(n = 66)中高TC(43.9%对10.7%;p<0.002)和高LDL(51.5%对10.7%;p<0.01)更为普遍。HbA1c与TC(r = 0.30;p = 0.004)、LDL(r = 0.28;p = 0.008)、TG(r = 0.31;p = 0.003)以及TG/HDL比值(r = 0.25;p = 0.01)相关。糖尿病病程与LDL(r = 0.21;p = 0.04)相关,胰岛素每日剂量与TG(r = 0.23;p = 0.04)以及以z评分表示的体重指数(r = -0.28;p = 0.007)相关。这些糖尿病患者中高胆固醇血症的患病率较高(54.6%),血脂水平与HbA1c相关。糖尿病的良好管理对于控制血脂异常似乎至关重要。

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