2 型糖尿病患者的血清 LDL 胆固醇水平低：两种不同患者人群的分析。

Low serum LDL cholesterol in patients with type 2 diabetes: an analysis on two different patient populations.

机构信息

Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria.

出版信息

Int J Cardiol. 2010 Oct 29;144(3):394-8. doi: 10.1016/j.ijcard.2009.04.048. Epub 2009 May 27.

DOI:10.1016/j.ijcard.2009.04.048

PMID:19477539

Abstract

BACKGROUND

Patients with type 2 diabetes (T2DM) typically exhibit a pattern of dyslipidemia with high triglycerides, low HDL cholesterol, and small LDL particles. We aimed at investigating whether also LDL cholesterol levels are altered in diabetic patients.

METHODS

Lipid panels were obtained in a consecutive series of angiographied coronary patients (n=750), and in a large sample of hypertensive outpatients (n=5949).

RESULTS

T2DM patients in the cohort of coronary patients (n=164; 21.9%) had significantly higher triglycerides (203±138 vs. 153±91 mg/dl; p<0.001), lower HDL cholesterol (44±14 vs. 50±14 mg/dl; p<0.001), lower apolipoprotein A1 (140±28 vs. 148±28 mg/dl; p=0.002), lower total cholesterol (211±48 vs. 220±42 mg/dl; p=0.006) and, importantly, lower LDL cholesterol (122±38 vs. 134±35 mg/dl; p<0.001) than non-diabetic subjects. Whereas apolipoprotein B was similar in T2DM patients as in non-diabetic subjects (113±26 vs. 114±25 mg/dl; p=0.648), the LDL cholesterol/apolipoprotein B ratio was significantly lower (1.08±0.24 vs. 1.18±0.21; p<0.001) and LDL particles were significantly smaller (257±7 vs. 259±6 Å; p<0.001) in T2DM patients. Also among the hypertensive subjects, diabetic patients (n=1632; 27.3%) besides higher triglycerides (173±70 vs. 151±65 mg/dl; p<0.001) and lower HDL cholesterol (53±17 vs. 57±19 mg/dl; p<0.001) exhibited lower total cholesterol (216±44 vs. 222±41 mg/dl; p<0.001) and lower LDL cholesterol (127±40 vs. 136±37 mg/dl; p<0.001) than non-diabetic subjects.

CONCLUSIONS

Both among angiographied coronary patients and hypertensive outpatients, LDL cholesterol is significantly lower in T2DM patients than in non-diabetic individuals.

摘要

背景

2 型糖尿病（T2DM）患者通常表现出甘油三酯升高、高密度脂蛋白胆固醇降低和小而密的低密度脂蛋白（LDL）颗粒的血脂异常模式。我们旨在研究糖尿病患者的 LDL 胆固醇水平是否也发生改变。

方法

在连续的冠状动脉造影患者队列（n=750）和大量高血压门诊患者（n=5949）中获得血脂谱。

结果

在冠状动脉造影患者队列中，T2DM 患者（n=164；21.9%）的甘油三酯（203±138 与 153±91mg/dl；p<0.001）、高密度脂蛋白胆固醇（44±14 与 50±14mg/dl；p<0.001）、载脂蛋白 A1（140±28 与 148±28mg/dl；p=0.002）、总胆固醇（211±48 与 220±42mg/dl；p=0.006）明显较低，重要的是 LDL 胆固醇（122±38 与 134±35mg/dl；p<0.001）也明显较低。而 T2DM 患者的载脂蛋白 B 与非糖尿病患者相似（113±26 与 114±25mg/dl；p=0.648），但 LDL 胆固醇/载脂蛋白 B 比值明显较低（1.08±0.24 与 1.18±0.21；p<0.001），LDL 颗粒明显较小（257±7 与 259±6Å；p<0.001）。在高血压患者中，糖尿病患者（n=1632；27.3%）除了甘油三酯（173±70 与 151±65mg/dl；p<0.001）和高密度脂蛋白胆固醇（53±17 与 57±19mg/dl；p<0.001）较低外，总胆固醇（216±44 与 222±41mg/dl；p<0.001）和 LDL 胆固醇（127±40 与 136±37mg/dl；p<0.001）也明显较低。