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2型糖尿病患者血脂异常的模式及预测因素

Pattern and predictors of dyslipidemia in patients with type 2 diabetes mellitus.

作者信息

Karim Md N, Ahmed Kazi R, Bukht Mohammad S, Akter Jesmin, Chowdhury Hasina A, Hossain Sharmin, Anwar Nazneen, Selim Shajada, Chowdhury Shahabul H, Hossain Fawzia, Ali Liaquat

机构信息

Directorate General of Health Services, Bangladesh.

出版信息

Diabetes Metab Syndr. 2013 Apr-Jun;7(2):95-100. doi: 10.1016/j.dsx.2013.02.011. Epub 2013 Mar 27.

DOI:10.1016/j.dsx.2013.02.011
PMID:23680249
Abstract

Dyslipidemia is a major risk factor for macro-vascular complications in patients with type 2 diabetes mellitus (T2DM). Present study explored pattern and predictors of dyslipidemia in Bangladeshi T2DM patients. The cross-sectional study is conducted among 366 consecutive eligible T2DM patients aged >30 years, BIRDEM diabetic hospital, during July-to-December 2010. Physical examination, diabetic profile, lipid profile and serum createnine was performed. Adjusted odds ratio and confidence limit were generated through binary logistic regression. Most frequent form (59.3%) of dyslipidemia is low HDL. Duration of T2DM is significantly correlated with TC (P<0.05), HDL (P<0.05) and LDL (P<0.05) in both male and female. Glycemic control in terms of HbA1c >7% appeared as predictor of dyslipidemia (P<0.01). Duration T2DM is associated with increased risk of having higher TC (P<0.05), LDL (P<0.05) and lower HDL (P<0.01) and does not seem to affect triglyceride (P>0.05). T2DM with comorbid hypertension seems to predict hyper tri-glyceridemia and lower HDL. Both TC-HDL ratio and LDL-HDL ratio appeared as good predictor of all four parameters of dyslipidemia (P<0.01). The characteristic features of diabetic dyslipidemia are low HDL, high triglyceride and LDL cholesterol level. Low HDL level is the most frequent type of abnormality. Poor glycemic control, prolonged duration, coexisting hypertension predicts dyslipidemia in T2DM.

摘要

血脂异常是2型糖尿病(T2DM)患者发生大血管并发症的主要危险因素。本研究探讨了孟加拉国T2DM患者血脂异常的模式及预测因素。2010年7月至12月期间,在BIRDEM糖尿病医院对366例年龄>30岁的连续合格T2DM患者进行了横断面研究。进行了体格检查、糖尿病相关指标、血脂谱和血清肌酐检测。通过二元逻辑回归生成调整后的优势比和置信区间。血脂异常最常见的形式(59.3%)是高密度脂蛋白(HDL)降低。T2DM的病程在男性和女性中均与总胆固醇(TC)(P<0.05)、HDL(P<0.05)和低密度脂蛋白(LDL)(P<0.05)显著相关。糖化血红蛋白(HbA1c)>7%的血糖控制情况是血脂异常的预测因素(P<0.01)。T2DM病程与TC升高(P<0.05)、LDL升高(P<0.05)及HDL降低(P<0.01)风险增加相关,且似乎不影响甘油三酯(P>0.05)。合并高血压的T2DM似乎预示着高甘油三酯血症和HDL降低。TC-HDL比值和LDL-HDL比值均是血脂异常所有四个参数的良好预测指标(P<0.01)。糖尿病血脂异常的特征是HDL降低、甘油三酯和LDL胆固醇水平升高。HDL水平降低是最常见的异常类型。血糖控制不佳、病程延长、并存高血压可预测T2DM患者的血脂异常。

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