男性糖尿病足患者与男性2型糖尿病患者脂蛋白a差异研究

目的探讨糖尿病足与2型糖尿病这两个不同阶段中脂蛋白a(Lpa)的差异以及脂蛋白a(Lpa)在糖尿病足病程发展中的作用。方法回顾性分析解放军总参总医院骨内科糖尿病足患者(糖尿病足组)和2型糖尿病患者(2型糖尿病组)各30例,患者均符合WHO(1999年)糖尿病诊断标准。糖尿病足诊断符合国际糖尿病足工作/IDF顾问组发布的诊断标准。比较两组一般情况及生化指标,包括年龄、病程、身高、体重、空腹血糖、糖化血红蛋白、甘油三脂、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白A、载脂蛋白B、载脂蛋白E、游离脂肪酸、脂蛋白a。结果糖尿病足组与2型糖尿病组患者年龄、病程、身高、体重比较差异无统计学意义。生化指标结果显示,糖尿病足组脂蛋白a(Lpa)高于2型糖尿病组,差异具有统计学意义(P<0.05)。游离脂肪酸低于2型糖尿病组,差异具有统计学意义(P<0.05)。两组间空腹血糖、甘油三脂、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白B、载脂蛋白A、载脂蛋白E差异均无统计学意义(P>0.05)。结论糖尿病足患者脂蛋白a水平高于2型糖尿病患者,提示脂蛋白a在动脉粥样硬化或微血管病变的发生中起着相当重要的作用。对于糖尿病足患者的治疗应重视对其脂代谢的治疗。

Study on difference of lipoprotein(a) metabolism between male patients with diabetic foot and type 2 diabetes mellitus

Objective To investigate the difference of lipoprotein a(Lpa) between diabetes foot and type 2 diabetes male patients,and to explore the role of Lpa in the development of diabetic foot.Methods Clinical data of 30 cases of diabetic foot and 30 cases of type 2 diabetes from September 2008 to February 2011 in department of orthopedics in General Hospital of PLA were retrospectively analyzed.The general situation and biochemical parameters,including course of disease,age,height,weight,fasting blood glucose(FBG),glycated hemoglobin(HbA1c),triglyceride(TG),total cholesterol(Chol),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),apolipoprotein A(ApoA),apolipoprotein B(ApoB),apolipoprotein E(ApoE),non-esterified fatty acid(NEFA),Lpa were compared between diabetic foot group and type 2 diabetes group.Results The age,duration,height,weight showed no significant difference between two groups,while Lpa in diabetic foot group was higher than in type 2 diabetes group(P<0.05).NEFA in diabetic foot group was lower than in type 2 diabetes group(P<0.05).FBG,TG,LDL-C,HDL-C,ApoB,ApoB,ApoE were not statistically different between two groups(P>0.05).Conclusion The results suggest that lipoprotein(a)may play a very important role in the occurrence of atherosclerosis or peripheral angiopathy.For patients with diabetic foot,more attentions should be paid to the lipid metabolism.