Calanna S, Scicali R, Di Pino A, Knop F K, Piro S, Rabuazzo A M, Purrello F
Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy.
Diabetes Research Division, Department of Medicine, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Department of Biomedical Sciences, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Nutr Metab Cardiovasc Dis. 2014 Jun;24(6):670-6. doi: 10.1016/j.numecd.2014.01.013. Epub 2014 Jan 29.
We aimed to investigate lipid abnormalities and liver steatosis in patients with HbA1c-defined prediabetes and type 2 diabetes compared to individuals with HbA1c-defined normoglycaemia.
Ninety-one subjects with prediabetes according to HbA1c, i.e. from 5.7 to 6.4% (39-46 mmol/mol), 50 newly diagnosed patients with HbA1c-defined type 2 diabetes (HbA1c ≥6.5% [≥48 mmol/mol]), and 67 controls with HbA1c lower than 5.7% (<39 mmol/mol), were studied. Fasting blood samples for lipid profiles, fatty liver index (FLI), bioimpedance analysis, ultrasound scan of the liver, and BARD (body mass index, aspartate aminotransferase/alanine aminotransferase ratio, diabetes) score for evaluation of liver fibrosis, were performed in all subjects. In comparison to controls, subjects with prediabetes were characterised by: lower apolipoprotein AI and HDL cholesterol levels, higher blood pressure, triglycerides levels and apolipoprotein B/apolipoprotein AI ratio, higher FLI, increased prevalence of and more severe hepatic steatosis, similar BARD score, and higher total body fat mass. In comparison to subjects with diabetes, subjects with prediabetes exhibited: similar blood pressure and apolipoprotein B/apolipoprotein AI ratio, similar FLI, reduced prevalence of and less severe hepatic steatosis, lower BARD score, increased percent fat and lower total body muscle mass. In comparison to controls, subjects with diabetes showed: lower apolipoprotein AI and HDL cholesterol levels, higher blood pressure and triglycerides levels, higher FLI, increased prevalence of and more severe hepatic steatosis, higher BARD score, and higher total body muscle mass. Moreover, HbA1c was correlated with BMI, HOMA-IR, triglycerides, HDL cholesterol, AST, and ALT.
Subjects with HbA1c-defined prediabetes and type 2 diabetes, respectively, are characterised by abnormalities in lipid profile and liver steatosis, thus exhibiting a severe risk profile for cardiovascular and liver diseases.
我们旨在研究糖化血红蛋白（HbA1c）定义的糖尿病前期和2型糖尿病患者与HbA1c定义的血糖正常个体相比的脂质异常和肝脂肪变性情况。
研究了91例根据HbA1c诊断为糖尿病前期的受试者，即HbA1c为5.7%至6.4%（39至46 mmol/mol），50例新诊断的HbA1c定义的2型糖尿病患者（HbA1c≥6.5%[≥48 mmol/mol]），以及67例HbA1c低于5.7%（<39 mmol/mol）的对照者。对所有受试者进行空腹血样检测，以分析血脂谱、脂肪肝指数（FLI）、生物电阻抗分析、肝脏超声扫描，以及用于评估肝纤维化的BARD（体重指数、天冬氨酸转氨酶/丙氨酸转氨酶比值、糖尿病）评分。与对照组相比，糖尿病前期受试者的特征为：载脂蛋白AI和高密度脂蛋白胆固醇水平较低，血压、甘油三酯水平和载脂蛋白B/载脂蛋白AI比值较高，FLI较高，肝脂肪变性的患病率增加且更为严重，BARD评分相似，全身脂肪量较高。与糖尿病患者相比，糖尿病前期受试者表现为：血压和载脂蛋白B/载脂蛋白AI比值相似，FLI相似，肝脂肪变性的患病率降低且程度较轻，BARD评分较低，体脂百分比增加且全身肌肉量较低。与对照组相比，糖尿病患者表现为：载脂蛋白AI和高密度脂蛋白胆固醇水平较低，血压和甘油三酯水平较高，FLI较高，肝脂肪变性的患病率增加且更为严重，BARD评分较高，全身肌肉量较高。此外，HbA1c与体重指数、胰岛素抵抗指数、甘油三酯、高密度脂蛋白胆固醇、天冬氨酸转氨酶和丙氨酸转氨酶相关。
HbA1c定义的糖尿病前期和2型糖尿病患者分别具有脂质谱异常和肝脂肪变性的特征，因此表现出心血管疾病和肝脏疾病的严重风险特征。
