Suryabhan L Lokhande, Chandrashekhar M Iyer, Ratnendra R Shinde, Prerna D Nandedkar
Assistant Professor, Department of Biochemistry, Seth G.S. Medical College and K.E.M. Hospital Mumbai, India .
J Clin Diagn Res. 2013 Apr;7(4):627-30. doi: 10.7860/JCDR/2013/4845.2868. Epub 2013 Mar 9.
Type 2 Diabetes Mellitus (Type 2 DM), which is characterized by a relative insulin deficiency or insulin resistance is associated with a cluster of metabolic abnormalities, which includes glucose intolerance, hypertension, a unique dyslipidaemia, a procoagulant state, and an increase in macrovascular diseases. The present study was conducted to assess the significance of postprandial dyslipidaemia with respect to fasting dyslipidaemia, in the pathogenesis of atherosclerotic changes and possible cardiovascular diseases (CVD) and complications. Methods and Statistical Analysis: Fifty diagnosed cases of type 2 DM which were in the age group of 35-65 years, which had a duration of diabetes of more than five years, were included in the study and 50 age and sex matched healthy subjects were taken as the controls. In both the study groups, we measured the serum levels of fasting as well as the postprandial lipid profile, which was comprised of the total Cholesterol (TC), triglycerides (TGs), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and the waist-hip ratio (WHI) as the cardiovascular risk factors. The statistical analysis was done by using the Students unpaired 't'-test.
The results of this study showed significantly increased levels of serum total cholesterol, TGs, LDL-C and VLDL-C in the postprandial state as compared to those in the fasting state (p<0.001) and as compared to those in the fasting and the postprandial states of the controls (p<0.001). The serum HDL-C level was significantly lower in the postprandial state as compared to that in the fasting state (p<0.001). Also, the postprandial and the fasting HDL-C levels were significantly lower as compared to the levels in their respective control groups (p<0.001).
The findings of the present study indicated that the lipid profile, as a cardiovascular risk factor, was significantly elevated in the postprandial state as compared to that in the fasting state and that it was significantly elevated in the postprandial and the fasting states in the Type 2 DM patients as compared to the levels in their respective control groups. This signified a routine estimation of the postprandial lipid profile, rather than the fasting lipid parameters, in the cardiovascular risk assessment in Type 2 DM.
2型糖尿病(2型DM)的特征为相对胰岛素缺乏或胰岛素抵抗,与一系列代谢异常相关,包括葡萄糖耐量异常、高血压、独特的血脂异常、促凝状态以及大血管疾病增加。本研究旨在评估餐后血脂异常相对于空腹血脂异常在动脉粥样硬化改变及可能的心血管疾病(CVD)和并发症发病机制中的意义。
本研究纳入50例年龄在35 - 65岁、糖尿病病程超过5年的2型DM确诊病例,并选取50例年龄和性别匹配的健康受试者作为对照。在两个研究组中,我们测量了空腹及餐后血脂水平,包括总胆固醇(TC)、甘油三酯(TGs)、高密度脂蛋白胆固醇(HDL - C)、低密度脂蛋白胆固醇(LDL - C)以及作为心血管危险因素的腰臀比(WHI)。统计分析采用学生氏非配对“t”检验。
本研究结果显示,与空腹状态相比,餐后状态下血清总胆固醇、TGs、LDL - C和极低密度脂蛋白胆固醇(VLDL - C)水平显著升高(p < 0.001),与对照组的空腹和餐后状态相比也显著升高(p < 0.001)。与空腹状态相比,餐后状态下血清HDL - C水平显著降低(p < 0.001)。此外,与各自对照组水平相比,餐后和空腹HDL - C水平均显著降低(p < 0.001)。
本研究结果表明,作为心血管危险因素的血脂水平在餐后状态相对于空腹状态显著升高,并且2型DM患者的餐后和空腹血脂水平与各自对照组相比显著升高。这意味着在2型DM的心血管风险评估中,常规评估餐后血脂水平而非空腹血脂参数具有重要意义。