Diabetes Care. 1997 Nov;20(11):1683-7. doi: 10.2337/diacare.20.11.1683.
To compare fasting plasma lipids and lipoproteins in male and female patients at diagnosis of NIDDM and to examine age and sex differences in lipid concentrations.
Cross-sectional study of fasting plasma total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride in 2,139 male and 1,574 female white patients, aged 25-65 years, at diagnosis of NIDDM.
At diagnosis of NIDDM, the mean age +/- SD for men was 52 +/- 9 and 53 +/- 9 years for women; BMI was 28.3 +/- 4.9 and 30.8 +/- 6.7 kg/m2, and fasting plasma glucose was 11.6 +/- 3.6 and 12.4 +/- 3.8 mmol/l, respectively. The mean total and LDL cholesterol were higher in female than in male NIDDM patients, 5.8 +/- 1.2 vs. 5.5 +/- 1.1 and 3.9 +/- 1.1 vs. 3.6 +/- 1.0 mmol/l (both P < 0.001), respectively, while triglyceride levels were similar: geometric mean (1 SD interval) for men and women was 1.8 (1.1-3.1) vs. 1.8 (1.1-2.9) mmol/l. HDL cholesterol was higher in female than in male NIDDM patients, 1.09 +/- 0.2 vs. 1.01 +/- 0.24 mmol/l (P < 0.001); the sex differential for HDL cholesterol was 7% in NIDDM patients compared with 22% in the general population. Data analysis by 5-year age bands showed a significant trend toward lower total cholesterol and triglyceride and higher HDL cholesterol in men diagnosed above the age of 50 years. In female NIDDM patients, lipid concentrations increased with age of diagnosis but reached a plateau above the age of 50 years.
The effect of NIDDM, observed at diagnosis, on plasma lipid and lipoprotein levels is more pronounced in women than in men. This may explain in part why the cardiovascular risk is proportionally higher in female patients.
比较非胰岛素依赖型糖尿病(NIDDM)患者诊断时男性和女性的空腹血脂及脂蛋白水平,并研究血脂浓度的年龄和性别差异。
对2139例年龄在25 - 65岁的男性和1574例女性白人NIDDM患者的空腹血浆总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和甘油三酯进行横断面研究。
NIDDM诊断时,男性的平均年龄±标准差为52±9岁,女性为53±9岁;体重指数分别为28.3±4.9和30.8±6.7kg/m²,空腹血糖分别为11.6±3.6和12.4±3.8mmol/L。女性NIDDM患者的平均总胆固醇和低密度脂蛋白胆固醇高于男性,分别为5.8±1.2与5.5±1.1,以及3.9±1.1与3.6±1.0mmol/L(均P<0.001),而甘油三酯水平相似:男性和女性的几何均值(1个标准差区间)分别为1.8(1.1 - 3.1)与1.8(1.1 - 2.9)mmol/L。女性NIDDM患者的高密度脂蛋白胆固醇高于男性,为1.09±0.2与1.01±0.24mmol/L(P<0.001);NIDDM患者中高密度脂蛋白胆固醇的性别差异为7%,而在普通人群中为22%。按5岁年龄组进行数据分析显示,50岁以上诊断出的男性患者中,总胆固醇和甘油三酯有显著降低趋势,高密度脂蛋白胆固醇有升高趋势。在女性NIDDM患者中,血脂浓度随诊断年龄增加,但在50岁以上达到平台期。
在诊断时观察到的NIDDM对血浆脂质和脂蛋白水平的影响在女性中比在男性中更明显。这可能部分解释了为什么女性患者的心血管风险相对更高。