Eriksson Mats, Zethelius Björn, Eeg-Olofsson Katarina, Nilsson Peter M, Gudbjörnsdottir Soffia, Cederholm Jan, Eliasson Björn
Department of Medicine, Centre for Metabolism and Endocrinology, Karolinska Institute at Karolinska University Hospital, Huddinge, Sweden.
Eur J Cardiovasc Prev Rehabil. 2011 Feb;18(1):97-105. doi: 10.1097/HJR.0b013e32833ba61e.
Type 2 diabetes and diabetic dyslipidemia are high-risk conditions for cardiovascular disease. However, the description of the distribution of blood lipids in diabetic patients has not been based on population-based surveys. The aim of this study was to describe diabetic dyslipidemia in a large unselected sample of patients from the Swedish National Diabetes Register.
Blood lipid profiles and clinical characteristics in 75,048 type 2 diabetic patients (57% men) were studied.
Pronounced hypertriglyceridemia (triglycerides >4.0mmol/l) was seen in 3.4% of the patients. Total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C) and non-HDL-C were generally higher, and LDL-C/HDL-C and Non-HDL-C/HDL-C ratios were lower in women. Mean TC, LDL-C as well as HDL-C values were lower in patients treated with lipid-lowering agents, whereas triglycerides was higher than in the untreated patients. In patients not treated with lipid-lowering agents all blood lipids increased in women and decreased in men (except HDL-C) at higher ages. Patients with LDL-C/HDL-C ratio ≥ 3 were slightly younger, less frequently used lipid-lowering drugs and had not so often a history of coronary heart disease or stroke.
The distribution of blood lipids in this large sample of unselected type 2 diabetic patients challenges the previous conception of diabetic dyslipidemia, and calls for new studies to explain the roles of LDL-C and HDL-C as strong cardiovascular risk factors in type 2 diabetes.
2型糖尿病和糖尿病血脂异常是心血管疾病的高危状况。然而，糖尿病患者血脂分布的描述并非基于人群调查。本研究的目的是描述来自瑞典国家糖尿病登记处的大量未经选择的患者样本中的糖尿病血脂异常情况。
对75048例2型糖尿病患者（57%为男性）的血脂谱和临床特征进行了研究。
3.4%的患者出现明显的高甘油三酯血症（甘油三酯>4.0mmol/L）。女性的总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）和非高密度脂蛋白胆固醇（Non-HDL-C）一般较高，而LDL-C/HDL-C和Non-HDL-C/HDL-C比值较低。接受降脂药物治疗的患者平均TC、LDL-C以及HDL-C值较低，而甘油三酯高于未治疗的患者。在未接受降脂药物治疗的患者中，所有血脂在女性中随年龄增长而升高，在男性中（HDL-C除外）随年龄增长而降低。LDL-C/HDL-C比值≥3的患者年龄稍小，较少使用降脂药物，冠心病或中风病史也不常见。
在这个大量未经选择的2型糖尿病患者样本中血脂的分布挑战了以往对糖尿病血脂异常的认识，并呼吁开展新的研究来解释LDL-C和HDL-C作为2型糖尿病中强大心血管危险因素的作用。
