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血糖控制对新诊断2型糖尿病患者血脂谱、载脂蛋白B100、载脂蛋白AI及高密度脂蛋白亚类变化影响的研究

[Studies of influences of blood glucose controlling on the changes of lipid profiles, ApoB100, ApoAI and HDL subclass of newly diagnosed type 2 diabetes].

作者信息

Tao Shibing, Tian Li, Fu Mingde, Tian Haoming

机构信息

Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu 610041, China.

出版信息

Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2013 Apr;30(2):368-74.

PMID:23858765
Abstract

This study was aimed to observe if the lipid profiles, apoprotein B100 (ApoB100), ApoAI, high density lipoprotein (HDL) and its subclasses could be improved by controlling the blood glucose. Fifty-three patients with newly diagnosed type 2 diabetic were divided into four groups, diet and exercise group (n = 13), continuous subcutaneous insulin infusion (CSII) group (n = 14), multiple daily insulin injection group (MDI, n = 13), and oral hypoglycaemic agents group (n = 13). Fasting blood glucose (FPG), glycated hemoglobin A1c (HbA1c), lipid profiles, ApoB100, ApoAI and HDL subclasses were measured at beginning and a month later. Forty-three patients finished the testing. The levels of FPG, HbA1c, triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and ApoB100 were decreased significantly (P < 0.05) in all groups, and ApoAI/ApoB100 increased obviously (P < 0.05). Comparatively matured HDL subclasses such as HDL2b were increased (P < 0.05), and comparatively infantile HDL subclasses such as HDL3b were decreased (P < 0.05). Therapy with hyperglycemic agents improved TG, TC, LDL-C, ApoB100, ApoAI/ApoB100, and HDL2b significantly (P < 0.05), but intervention with the diet and exercise group alone did not improve lipid profiles, apolipoproteins, and HDL subclasses (P > 0.05). Meanwhile, therapy with insulin intensive therapy (MDI, CSII) group had the most powerful effect on decreasing ApoB100 concentration (P < 0.05). The results suggested that lipid profiles, apolipoproteins, and quantity and quality of HDL subclasses might be improved by blood glucose controlling.

摘要

本研究旨在观察控制血糖是否能改善血脂谱、载脂蛋白B100(ApoB100)、载脂蛋白AI(ApoAI)、高密度脂蛋白(HDL)及其亚类。53例新诊断的2型糖尿病患者被分为四组,即饮食和运动组(n = 13)、持续皮下胰岛素输注(CSII)组(n = 14)、多次皮下胰岛素注射组(MDI,n = 13)和口服降糖药组(n = 13)。在研究开始时和一个月后测量空腹血糖(FPG)、糖化血红蛋白A1c(HbA1c)、血脂谱、ApoB100、ApoAI和HDL亚类。43例患者完成了检测。所有组的FPG、HbA1c、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和ApoB100水平均显著降低(P < 0.05),且ApoAI/ApoB100明显升高(P < 0.05)。相对成熟的HDL亚类如HDL2b增加(P < 0.05),而相对幼稚的HDL亚类如HDL3b减少(P < 0.05)。降糖药物治疗显著改善了TG、TC、LDL-C、ApoB100、ApoAI/ApoB100和HDL2b(P < 0.05),但仅饮食和运动组干预并未改善血脂谱、载脂蛋白和HDL亚类(P > 0.05)。同时,胰岛素强化治疗组(MDI、CSII)对降低ApoB100浓度的作用最强(P < 0.05)。结果表明,控制血糖可能改善血脂谱、载脂蛋白以及HDL亚类的数量和质量。

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