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2型糖尿病患者血清直接胆红素与血脂的相关性研究

[A correlation study between serum direct bilirubin and lipid in type 2 diabetic patients].

作者信息

Wang Ru, Yang Guoqing, Lyu Zhaohui, Dou Jingtao, Gu Weijun, Zang Li, Jin Nan, Du Jin, Ouyang Jinzhi, Guo Qinghua, Wang Xianling, Yang Lijuan, Ba Jianming, Mu Yiming

机构信息

Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.

Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China. Email:

出版信息

Zhonghua Nei Ke Za Zhi. 2014 Oct;53(10):783-7.

Abstract

OBJECTIVE

To investigate the association between DBil with normal range and serum lipid in type 2 diabetic patients.

METHODS

A total of 979 subjects with type 2 diabetes admitted to the Department of Endocrinology of Chinese PLA General Hospital from June 2012 to June 2013 were included for the study. Serum DBil, TC, TG, HDL-C and LDL-C levels were collected for the analyses. Subjects were divided into four groups based on the DBil levels: Q1 group (<2.2 µmol/L), Q2 group (2.2-< 2.9 µmol/L), Q3 group (2.9-< 3.9 µmol/L) and Q4 group ( ≥ 3.9 µmol/L) .

RESULTS

(1) TC, TG, LDL-C levels were significantly lower in Q4 group than those in the other three Q groups after adjustment of age, gender, duration of diabetes, BMI, smoking, drinking, glycosylated hemoglobin A1c (HbA1c) , fasting plasma glucose (FPG), medication, ALT, AST and fatty liver. No difference could be viewed in HDL-C level between each group (P = 0.65). (2) Pearson correlation analyses showed that DBil was inversely correlated with TC (r = -0.33, P < 0.01), TG (r = -0.23, P < 0.01), LDL-C (r = -0.18, P < 0.01), and positively correlated with HDL-C level in men (r = 0.14, P < 0.01), respectively. Multiple linear regression analyses showed DBil was an independent impact factor for TC, TG and LDL-C. (3) Compared with Q1 group, the odds ratio (OR) for dyslipidemia was 0.54 (95%CI 0.35-0.82, P < 0.01), 0.56 (95%CI 0.37-0.85, P < 0.01) and 0.44 (95%CI 0.29-0.69, P < 0.01) in Q2, Q3 and Q4 group, respectively, after age, gender, duration of diabetes, BMI, smoking, drinking, HbA1c, FPG, medication, ALT, AST and fatty liver were adjusted. Moreover, the OR for dyslipidemia was much lower in Q4 man subjects with age<55 years , HbA1c ≥ 6.5%, BMI<25 kg/m(2), and with no fatty liver.

CONCLUSION

DBil in normal range was closely associated with lipid profile in type 2 diabetes. It might play a protective effect in dyslipidemia.

摘要

目的

探讨2型糖尿病患者中处于正常范围的直接胆红素(DBil)与血脂之间的关联。

方法

纳入2012年6月至2013年6月在中国人民解放军总医院内分泌科住院的979例2型糖尿病患者进行研究。收集血清DBil、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平进行分析。根据DBil水平将受试者分为四组:Q1组(<2.2 μmol/L)、Q2组(2.2 - <2.9 μmol/L)、Q3组(2.9 - <3.9 μmol/L)和Q4组(≥3.9 μmol/L)。

结果

(1)在调整年龄、性别、糖尿病病程、体重指数(BMI)、吸烟、饮酒、糖化血红蛋白A1c(HbA1c)、空腹血糖(FPG)、用药情况、谷丙转氨酶(ALT)、谷草转氨酶(AST)和脂肪肝后,Q4组的TC、TG、LDL-C水平显著低于其他三个Q组。各组间HDL-C水平无差异(P = 0.65)。(2)Pearson相关性分析显示,DBil与TC(r = -0.33,P < 0.01)、TG(r = -0.23,P < 0.01)、LDL-C(r = -0.18,P < 0.01)呈负相关,在男性中与HDL-C水平呈正相关(r = 0.14,P < 0.01)。多元线性回归分析显示DBil是TC、TG和LDL-C的独立影响因素。(3)在调整年龄、性别、糖尿病病程、BMI、吸烟、饮酒、HbA1c、FPG、用药情况、ALT、AST和脂肪肝后,与Q1组相比,Q2组、Q3组和Q4组血脂异常的比值比(OR)分别为0.54(95%CI 0.35 - 0.82,P < 0.01)、0.56(95%CI 0.37 - 0.85,P < 0.01)和0.44(95%CI 0.29 - 0.69,P < 0.01)。此外,年龄<55岁、HbA1c≥6.5%、BMI<25 kg/m²且无脂肪肝的Q4组男性受试者血脂异常的OR更低。

结论

正常范围内的DBil与2型糖尿病患者的血脂谱密切相关。它可能对血脂异常起保护作用。

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