2型糖尿病急性时相血清淀粉样蛋白A、高密度脂蛋白胆固醇和动脉粥样硬化的关系

目的 探讨2型糖尿病患者急性时相血清淀粉样蛋白A(SAA)、高密度脂蛋白胆固醇(HDL-C)与动脉粥样硬化的关系.方法 49例2型糖尿病患者根据颈动脉内中膜厚度(IMT)及斑块分为动脉粥样硬化组(37例)和无动脉粥样硬化组(12例).动脉粥样硬化组中又分为治疗组(22例,辛伐他汀治疗12周)和未治疗组(15例).于随访12周后空腹抽血测糖化血红蛋白(HbA1c)、血脂和炎症细胞因子.结果 (1)Spearman相关分析显示体重指数(BMI)和腰围与SAA和白细胞介素(IL)6显著正相关(P＜0.01).SAA与肿瘤坏死因子α(TNF-α)、IL-6比较显著正相关(P＜0.05、(P＜0.01),与超敏C反应蛋白(hsCRP)和脂联素无显著相关性.SAA与TG显著正相关,而与HDL-C和载脂蛋白A-I(ApoA-I)显著负相关(P＜0.01).hsCRP、TNF-α和脂联素与血脂各成分之间没有相关性.(2)治疗前动脉粥样硬化组hsCRP、TNF-α、SAA和IL-6与无动脉粥样硬化组比较,显著升高(P＜0.01),而脂联素水平显著降低(P＜0.01);与无动脉粥样硬化组比较,TG显著高,而HDL-C显著降低(P＜0.05).(3)与治疗前比较,治疗组治疗12周后hsCRP、TNF-α、SAA明显下降(P＜0.01),脂联素明显升高(P＜0.05),TC、TG和低密度脂蛋白胆固醇(LDL-C)显著下降(P＜0.01),HDL-C上升(P＜0.01).结论 2型糖尿病合并动脉粥样硬化患者SAA明显升高.SAA与肥胖和HDL-C显著相关.

Relationship of acute-phase serum amyloid A and high-density lipoprotein cholesterol with atherosclerosis in type 2 diabetes

Objective To study the relationship of acute-phase serum amyloid A(SAA)and high-density lipoprotein cholesterol(HDL-C)with atherosclerosis in type 2 diabetes.Methods Fourty-nine type 2 diabetic patients were divided into group A(with atherosclerosis,37 cases)and group B(without atherosclerosis,12 cases).Of 37cases in group A,22 patients were randomly selected to be given a dose of 40 mg simvastatin treatment for 12-week as group AS,and the remaining 15 patients not to be given simvastatin served as the cont...