载脂蛋白 B 与 2 型糖尿病患者的代谢综合征相关，而与低密度脂蛋白胆固醇无关。
Apolipoprotein B Is Related to Metabolic Syndrome Independently of Low Density Lipoprotein Cholesterol in Patients with Type 2 Diabetes.
机构信息
Department of Internal Medicine, Jeju National University Hospital, Jeju, Korea.
Department of Internal Medicine, Jeju National University Hospital; Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.
出版信息
Endocrinol Metab (Seoul). 2015 Jun;30(2):208-15. doi: 10.3803/EnM.2015.30.2.208.
BACKGROUND
Increased low density lipoprotein cholesterol (LDL-C) level and the presence of metabolic syndrome (MetS) are important risk factors for cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM). Recent studies demonstrated apolipoprotein B (apoB), a protein mainly located in LDL-C, was an independent predictor of the development of CVD especially in patients with T2DM. The aim of this study was to investigate the relationship between apoB and MetS in T2DM patients.
METHODS
We analyzed 912 patients with T2DM. Fasting blood samples were taken for glycated hemoglobin, high-sensitivity C-reactive protein, total cholesterol, triglyceride (TG), high density lipoprotein cholesterol, LDL-C, and apoB. MetS was defined by the modified National Cholesterol Education Program Adult Treatment Panel III criteria. We performed a hierarchical regression analysis with apoB as the dependent variable. Age, sex, the number of components of MetS and LDL-C were entered at model 1, the use of lipid-lowering medications at model 2, and the individual components of MetS were added at model 3.
RESULTS
Seventy percent of total subjects had MetS. ApoB level was higher in subjects with than those without MetS (104.5±53.3 mg/dL vs. 87.7±33.7 mg/dL, P<0.01) even after adjusting for LDL-C. ApoB and LDL-C were positively correlated to the number of MetS components. The hierarchical regression analysis showed that the increasing number of MetS components was associated with higher level of apoB at step 1 and step 2 (β=0.120, P<0.001 and β=0.110, P<0.001, respectively). At step 3, TG (β=0.116, P<0.001) and systolic blood pressure (β=0.099, P<0.05) were found to significantly contribute to apoB.
CONCLUSION
In patients with T2DM, apoB is significantly related to MetS independently of LDL-C level. Of the components of MetS, TG, and systolic blood pressure appeared to be determinants of apoB.
背景
在 2 型糖尿病（T2DM）患者中，升高的低密度脂蛋白胆固醇（LDL-C）水平和代谢综合征（MetS）的存在是心血管疾病（CVD）的重要危险因素。最近的研究表明，载脂蛋白 B（apoB），一种主要位于 LDL-C 中的蛋白，是 CVD 发展的独立预测因子，尤其是在 T2DM 患者中。本研究旨在探讨 T2DM 患者中 apoB 与 MetS 的关系。
方法
我们分析了 912 例 T2DM 患者。采集空腹血样检测糖化血红蛋白、高敏 C 反应蛋白、总胆固醇、三酰甘油（TG）、高密度脂蛋白胆固醇、LDL-C 和 apoB。MetS 采用改良的美国国家胆固醇教育计划成人治疗专家组 III 标准定义。我们以 apoB 为因变量进行层次回归分析。模型 1 中纳入年龄、性别、MetS 成分和 LDL-C 的个数，模型 2 中纳入降脂药物的使用，模型 3 中纳入 MetS 的各个成分。
结果
70%的受试者患有 MetS。与无 MetS 的受试者相比，患有 MetS 的受试者的 apoB 水平更高（104.5±53.3 mg/dL 比 87.7±33.7 mg/dL，P<0.01），即使在校正了 LDL-C 后也是如此。apoB 和 LDL-C 与 MetS 成分的数量呈正相关。层次回归分析显示，在第 1 步和第 2 步中，MetS 成分的增加与 apoB 水平的升高相关（β=0.120，P<0.001 和 β=0.110，P<0.001）。在第 3 步中，TG（β=0.116，P<0.001）和收缩压（β=0.099，P<0.05）被发现对 apoB 有显著贡献。
结论
在 T2DM 患者中，apoB 与 MetS 显著相关，与 LDL-C 水平无关。在 MetS 的各个成分中，TG 和收缩压似乎是 apoB 的决定因素。
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