Lerman-Garber I, Sienra-Pérez J C, Lira-Menéndez L F, Cardoso-Saldaña G, Zamora-González J, Posadas-Romero C
Departamento de Endocrinología, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
Rev Invest Clin. 1990 Oct-Dec;42(4):257-64.
Atherosclerosis is more common and severe in DM. The purpose of this study was to compare the blood lipids profile and the prevalence of different coronary risk factors (CRF) in a mexican population with CHD (coronary heart disease) and DM compared with non DM patients. All had a history of myocardial infarction. Patients with nephropathy or other secondary causes of dyslipidema were excluded. There were two groups of 45 patients, 32 males, 13 females; age was 60 +/- 1 (SEM), body mass index (BMI) 26 +/- 6. Diabetes duration was 10 +/- 1 years. Diabetic individuals referred smoking in 58%, high blood pressure 55%, obesity (IQ greater than 27) 42%. There were no statistical differences with the non DM group. The mean values of total cholesterol, LDL cholesterol and triglycerides were similar in diabetics and non diabetics. HDL cholesterol was significantly lower in diabetic females (p less than 0.01). Hypoalphalipoproteinemia (HDL-C less than or equal to 30 mg/dL) was the most common abnormality in both groups (52% DM vs 38% nonDM) (p less than 0.01) Type IV phenotype was present in 40 vs 29% (NS). Lipid values were not related to BMI, metabolic control or diabetes type of treatment. To conclude, non insulin dependent diabetic patients with CHD have a high prevalence of CRF. Lipid abnormalities, particularly hypoalphalipoproteinemia and hypertriglyceridemia, could be a cause for the increased atherogenic risk, particularly in females.
动脉粥样硬化在糖尿病患者中更为常见且更为严重。本研究的目的是比较患有冠心病（CHD）和糖尿病的墨西哥人群与非糖尿病患者的血脂谱以及不同冠心病危险因素（CRF）的患病率。所有患者均有心肌梗死病史。排除患有肾病或其他继发性血脂异常原因的患者。共有两组，每组45例患者，其中男性32例，女性13例；年龄为60±1（标准误），体重指数（BMI）为26±6。糖尿病病程为10±1年。糖尿病患者中58%有吸烟史，55%有高血压，42%有肥胖（智商大于27）。与非糖尿病组无统计学差异。糖尿病患者和非糖尿病患者的总胆固醇、低密度脂蛋白胆固醇和甘油三酯的平均值相似。糖尿病女性的高密度脂蛋白胆固醇显著降低（p<0.01）。低α脂蛋白血症（高密度脂蛋白胆固醇≤30mg/dL）是两组中最常见的异常情况（糖尿病组为52%，非糖尿病组为38%）（p<0.01）。IV型表型在糖尿病组和非糖尿病组中的比例分别为40%和29%（无统计学差异）。血脂值与BMI、代谢控制或糖尿病治疗类型无关。总之，患有冠心病的非胰岛素依赖型糖尿病患者中冠心病危险因素的患病率较高。血脂异常，尤其是低α脂蛋白血症和高甘油三酯血症，可能是动脉粥样硬化风险增加的原因，尤其是在女性中。
