血清非高密度脂蛋白胆固醇与2型糖尿病患者下肢外周动脉病变的相关性研究

目的分析血清非高密度脂蛋白胆固醇（non—HDL—c）与2型糖尿病患者下肢外周动脉病变（PAD）的相关性。方法采用血管多普勒诊断仪测定233例2型糖尿病住院患者的踝肱指数（ABI）。并将ABI〈0．9者列为PAD组。ABII〉0．9为非PAD组；同时比较两组患者的血糖、血脂（包括non—HDL，C）、C肽、尿白蛋白／肌酐比值和估算肾小球滤过率差异，并探讨与PAD有关的主要危险因素。结果PAD组53例（22．7％）；PAD组LDL—c与non—HDL—C水平均明显高于非PAD组（均P〈0．05或0．01）；在TG≤2．26mmol／L和〉2．26mmol／L时，PAD组的non—HDL—c水平均高于非PAD组（均P〈0．05或O．01）；Logistic回归分析显示：年龄、糖尿病病程、non—HDL—c为2型糖尿病患者出现PAD的主要危险因素。结论non—HDL—c是2型糖尿病伴发PAD的主要危险因素之一，应成为2型糖尿病患者调脂治疗的重要靶点。

Association of serum non-HDL-c levels with peripheral arterial disease of lower extremity in patients with type 2 diabetes mellitus

Objective To investigate the association of non-high density lipoprotein cholesterol （non-HDL-c） with peripheral arterial disease （PAD） of lower limbs in type 2 diabetic patients. Methods Ankle brachial index （ABI） was determined by Doppler ultrasonography in 233 patients with type 2 diabetes mellitus, 53 patients （22.7%） had ABI〈0.9 and were diagnosed as peripheral arterial disease of low.extremity （PAD） and the remaining 180 （ABI I〉0.9） were as non-PAD group. Age, duration of diabetes, smoking history, blood pressure, fasting plasma glucose and 2h postprandial plasma glucose, total cholesterol, triglyceride and low density lipoprotein cholesterol （LDL-c）, non-HDL-c, uric acid, creatinine clearance rate, urinary albumin to crertinine ratio were analyzed. Results Serum LDL-c and non-HDL-c levels were higher in PAD group than those in the non-PAD group（ P 〈 0.05 and P〈0.01 ）. LDL-c was higher in PAD group only when TG≤2.26mmol/L, however, non-HDL-c was increased in all PAD patients no matter its TG levels. Logistic regression analysis showed that aging,longer duration of diabetes and higher non-HDL-c levels were independent risk factors for PAD in type 2 diabetic patients. Conclusion Serum non-HDL-c level,as an independent risk factor for PAD in patients with type 2 diabetes mellitus, may serve a target for lipid-lowering therapy.