Akanji A O, Agbedana E O, Ugbode C
Department of Medicine, University College Hospital, Ibadan, Nigeria.
Afr J Med Med Sci. 1989 Sep;18(3):229-34.
Plasma lipid profiles--total cholesterol (TC), LDL-cholesterol, HDL-cholesterol, triglycerides and phospholipids--were studied in relation to two parameters of diabetic control (fasting blood sugar (FBS) for short-term control and glycosylated haemoglobin (HBA1C) for long-term control) in 46 diabetic patients (22 insulin-dependent (IDDM) and 24 non-insulin dependent (NIDDM] and 22 non-diabetic control subjects. We confirmed the positive correlation between FBS and HBA1C. All diabetic patients had significantly higher triglyceride levels (P less than 0.05) than controls, which were not influenced by degree of glycaemic control. NIDDM patients tended to have higher than normal TC levels (P less than 0.05). In IDDM, TC level was positively correlated with HBA1C (r = 0.37, P less than 0.05), and negative correlations were established between FBS and HDL-cholesterol (r = -0.46, P less than 0.02) and the HDL-cholesterol:TC ratio (r = -0.49, P less than 0.01), suggesting an increased atherogenic risk with poorer diabetic control. It is concluded that lipoprotein abnormalities exist in Nigerian diabetics, though not as consistently as in Caucasians. The differences may be due to, among other factors, differences in genetic make-up, diet (typical African diet being rich in plant fibre and poor in cholesterogenic nutrients) and aetiology of the diabetic state (tropical diabetes being highly heterogeneous and now thought to be linked to malnutrition).
在46例糖尿病患者(22例胰岛素依赖型糖尿病(IDDM)和24例非胰岛素依赖型糖尿病(NIDDM))及22例非糖尿病对照受试者中,研究了血浆脂质谱——总胆固醇(TC)、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯和磷脂——与糖尿病控制的两个参数(短期控制用空腹血糖(FBS)和长期控制用糖化血红蛋白(HBA1C))之间的关系。我们证实了FBS与HBA1C之间存在正相关。所有糖尿病患者的甘油三酯水平均显著高于对照组(P<0.05),且不受血糖控制程度的影响。NIDDM患者的TC水平往往高于正常水平(P<0.05)。在IDDM中,TC水平与HBA1C呈正相关(r = 0.37,P<0.05),FBS与高密度脂蛋白胆固醇(r = -0.46,P<0.02)以及高密度脂蛋白胆固醇与TC的比值(r = -0.49,P<0.01)之间呈负相关,这表明糖尿病控制越差,动脉粥样硬化风险增加。结论是尼日利亚糖尿病患者存在脂蛋白异常,尽管不如白种人那样一致。这些差异可能是由于多种因素造成的,包括基因构成、饮食(典型的非洲饮食富含植物纤维且胆固醇生成营养素含量低)以及糖尿病状态的病因(热带糖尿病高度异质性,现在认为与营养不良有关)。