Albers John J, Marcovina Santica M, Imperatore Giuseppina, Snively Beverly M, Stafford Jeanette, Fujimoto Wilfred Y, Mayer-Davis Elizabeth J, Petitti Diana B, Pihoker Catherine, Dolan Larry, Dabelea Dana M
Department of Medicine, Northwest Lipid Metabolism and Diabetes Research Laboratories, University of Washington, 401 Queen Anne Avenue North, Seattle, Washington 98109, USA.
J Clin Endocrinol Metab. 2008 Mar;93(3):735-42. doi: 10.1210/jc.2007-2176. Epub 2007 Dec 18.
The objective of the study was to assess the prevalence and determinants of elevated apolipoprotein B (apoB) and dense low-density lipoprotein (LDL) in United States youth with type 1 or type 2 diabetes.
We conducted cross-sectional analyses of apoB concentrations, LDL density, and prevalence of elevated apoB levels and dense LDL from the SEARCH for Diabetes in Youth study, a six-center U.S.-based study of youth with diabetes onset younger than 20 years of age (2657 with type 1 and 345 with type 2).
Among youth with type 1 diabetes, 11% had elevated apoB (>or=100 mg/dl, 1.95 mm/liter), 8% had dense LDL (relative flotation rate<or=0.237), and 12% had elevated LDL-cholesterol (>or=130 mg/dl, 3.36 mm/liter). In contrast, among youth with type 2 diabetes, 36% had elevated apoB, 36% had dense LDL, but only 23% had elevated LDL-cholesterol. Dense LDL and apoB each increased with hemoglobin A1c in both types. Among type 1 diabetics in poor glycemic control (hemoglobin A1c>or=9.5%), 28% had elevated apoB, and 18% had dense LDL, whereas 72% of poorly controlled type 2 diabetics had elevated apoB and 62% had dense LDL.
In youth with type 1 diabetes, elevated apoB and dense LDL were not highly prevalent, whereas elevated apoB and dense LDL were common lipoprotein abnormalities in youth with type 2 diabetes. The prevalence of these risk factors substantially increased with poor glycemic control in both groups, stressing the importance of achieving and maintaining an optimal glucose control.
本研究旨在评估1型或2型糖尿病美国青少年中载脂蛋白B（apoB）升高及致密低密度脂蛋白（LDL）的患病率和决定因素。
我们对青少年糖尿病研究（SEARCH）中apoB浓度、LDL密度、apoB水平升高及致密LDL患病率进行了横断面分析，该研究是一项在美国六个中心开展的针对糖尿病发病年龄小于20岁的青少年的研究（1型糖尿病患者2657例，2型糖尿病患者345例）。
在1型糖尿病青少年中，11%的患者apoB升高（≥100 mg/dl，1.95 mmol/l）, 8%的患者有致密LDL（相对漂浮率≤0.237），12%的患者LDL胆固醇升高（≥130 mg/dl，3.36 mmol/l）。相比之下，在2型糖尿病青少年中，36%的患者apoB升高，36%的患者有致密LDL，但只有23%的患者LDL胆固醇升高。在两种类型的糖尿病中，致密LDL和apoB均随糖化血红蛋白升高而增加。在血糖控制不佳（糖化血红蛋白≥9.5%）的1型糖尿病患者中，28%的患者apoB升高，18%的患者有致密LDL，而在血糖控制不佳的2型糖尿病患者中，72%的患者apoB升高，62%的患者有致密LDL。
在1型糖尿病青少年中，apoB升高和致密LDL并不十分普遍，而在2型糖尿病青少年中，apoB升高和致密LDL是常见的脂蛋白异常。在两组中，这些危险因素的患病率均随着血糖控制不佳而显著增加，强调了实现并维持最佳血糖控制的重要性。
