餐后甘油三酯浓度均值是 2 型糖尿病患者颈动脉粥样硬化的独立危险因素。

Mean postprandial triglyceride concentration is an independent risk factor for carotid atherosclerosis in patients with type 2 diabetes.

机构信息

Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan.

出版信息

Clin Chim Acta. 2014 Mar 20;430:134-9. doi: 10.1016/j.cca.2013.12.022. Epub 2013 Dec 27.

DOI:10.1016/j.cca.2013.12.022

PMID:24373894

Abstract

BACKGROUND

Postprandial hypertriglyceridemia is a risk factor for atherosclerotic disease. However, the postprandial triglyceride (PTG) concentration fluctuates markedly and is poorly reproducible. The aim of this study was to determine whether the mean PTG (mean-PTG) concentration is a risk factor for carotid atherosclerosis in patients with type 2 diabetes.

METHODS

We measured the fasting and postprandial lipid concentrations, and the maximum intima-media thickness (max IMT) of carotid arteries by ultrasound in 115 diabetic patients. A carotid plaque was defined as max IMT of >1.0mm. The mean-PTG concentration was calculated from several PTG concentrations measured on different days during a 1-year follow-up period.

RESULTS

PTG concentrations showed marked intra-individual variability, and ranged from 0.29 to 6.03 mmol/l. Patients with carotid plaques had higher mean-PTG concentrations than those without carotid plaques (1.51 ± 0.57 vs. 1.29 ± 0.47 mmol/l, p=0.025). Neither fasting triglycerides nor one-point PTG concentrations differed between the two groups. Multivariate stepwise logistic regression analysis revealed that the mean-PTG concentration was significantly associated with carotid plaques [OR 1.20 (95% CI, 1.05-1.37), p=0.009], even after adjusting for traditional risk factors including HDL-cholesterol, LDL-cholesterol, age, hypertension, and duration of diabetes.

CONCLUSIONS

The mean-PTG concentration is an independent risk factor for carotid atherosclerosis in patients with type 2 diabetes.

摘要

背景

餐后高甘油三酯血症是动脉粥样硬化疾病的一个危险因素。然而，餐后甘油三酯（PTG）浓度波动显著，且重复性差。本研究旨在确定 2 型糖尿病患者的平均 PTG（mean-PTG）浓度是否是颈动脉粥样硬化的一个危险因素。

方法

我们测量了 115 例糖尿病患者的空腹和餐后血脂浓度以及颈动脉内-中膜厚度（max IMT）。颈动脉斑块定义为 max IMT＞1.0mm。mean-PTG 浓度是通过在 1 年随访期间的不同天数测量的多个 PTG 浓度计算得出的。

结果

PTG 浓度个体内差异显著，范围为 0.29-6.03mmol/L。有颈动脉斑块的患者的 mean-PTG 浓度高于无颈动脉斑块的患者（1.51±0.57 vs. 1.29±0.47mmol/L，p=0.025）。两组患者的空腹甘油三酯或单点 PTG 浓度无差异。多变量逐步逻辑回归分析显示，mean-PTG 浓度与颈动脉斑块显著相关[OR 1.20（95%CI，1.05-1.37），p=0.009]，即使在调整了包括高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、年龄、高血压和糖尿病病程在内的传统危险因素后也是如此。