Khan H A, Sobki S H, Khan S A
Department of Biochemistry, College of Science, Bld 5, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia.
Clin Exp Med. 2007 Mar;7(1):24-9. doi: 10.1007/s10238-007-0121-3.
Impaired lipid metabolism resulting from uncontrolled hyperglycaemia has been implicated in cardiovascular complications in diabetes patients. The aim of this study was to examine the impact of glycaemic control on the lipid profile of diabetic patients. We also determined the ability of glycated haemoglobin (HbA(1c)) as an indirect marker of dyslipidaemia. A total of 1011 type 2 diabetic patients (males, 574; females, 437; mean age, 59.76 years) were included in this study. Venous blood samples were collected from all the subjects after at least 8 h fasting. The sera were analysed for HbA(1c), fasting blood glucose (FBG), total cholesterol, triglycerides (TG), high-density lipoprotein cholesterol (HDL) and low-density lipoprotein cholesterol (LDL). The levels of HbA(1c), FBG and LDL did not differ significantly between males and females. Female patients showed significantly higher serum cholesterol and HDL but significantly lower TG levels as compared to males. There was a highly significant correlation between HbA(1c) and FBG. Both HbA(1c) and FBG exhibited direct correlations with cholesterol, TG and LDL and inverse correlation with HDL; the magnitude of significance for all these lipid parameters being greater with HbA(1c) than FBG. There was a linear relationship between HbA(1c) and dyslipidaemia. The levels of serum cholesterol and TG were significantly higher and of HDL significantly lower in patients with worse glycaemic control as compared to patients with good glycaemic control. The findings of this study clearly indicate that HbA(1c) is not only a useful biomarker of long-term glycaemic control but also a good predictor of lipid profile. Thus, monitoring of glycaemic control using HbA(1c) could have additional benefits of identifying diabetic patients who are at a greater risk of cardiovascular complications.
血糖控制不佳导致的脂质代谢受损与糖尿病患者的心血管并发症有关。本研究的目的是探讨血糖控制对糖尿病患者血脂谱的影响。我们还确定了糖化血红蛋白(HbA₁c)作为血脂异常间接标志物的能力。本研究共纳入1011例2型糖尿病患者(男性574例,女性437例;平均年龄59.76岁)。所有受试者至少禁食8小时后采集静脉血样本。分析血清中的HbA₁c、空腹血糖(FBG)、总胆固醇、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL)和低密度脂蛋白胆固醇(LDL)。HbA₁c、FBG和LDL水平在男性和女性之间无显著差异。与男性相比,女性患者的血清胆固醇和HDL显著更高,但TG水平显著更低。HbA₁c与FBG之间存在高度显著的相关性。HbA₁c和FBG均与胆固醇、TG和LDL呈正相关,与HDL呈负相关;所有这些脂质参数与HbA₁c的相关性显著程度均高于FBG。HbA₁c与血脂异常之间存在线性关系。与血糖控制良好的患者相比,血糖控制较差的患者血清胆固醇和TG水平显著更高,HDL水平显著更低。本研究结果清楚地表明,HbA₁c不仅是长期血糖控制的有用生物标志物,也是血脂谱的良好预测指标。因此,使用HbA₁c监测血糖控制可能具有额外的益处,即识别出心血管并发症风险更高的糖尿病患者。