2型糖尿病血糖波动水平与脂蛋白a和血尿酸的关系

［摘要］目的: 研究2型糖尿病患者血糖波动水平与脂蛋白a和血尿酸水平的关系。方法: 以50例2型糖尿病伴蛋白尿患者作为观察组，50例2型糖尿病尿微量蛋白阴性患者作为对照组。测定并记录患者一般临床资料、血液生化指标；评估患者血糖浓度波动。分析血糖波动与脂蛋白a和血尿酸水平的关系。结果： 两组平均病程、餐后2小时血糖（2hPG）、三酰甘油、总胆固醇、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、血尿酸、脂蛋白a和尿微量白蛋白（U-mALB）水平差异均有统计学意义（均P＜0.01）；观察组平均血糖波动幅度（MAGE）、最大血糖波动幅度（LAGE）、血糖水平标准差（SDBG）、平均餐后血糖波动幅度（MPPGE）均显著高于对照组（P＜0.01）；U-mALB与脂蛋白α和血尿酸呈显著正相关（r分别为0.886,0.943，均P<0.05），总胆固醇、MAGE与脂蛋白a呈独立正相关（r分别为0.560,0.965，均P<0.05），SDBG和MAGE与血尿酸呈独立正相关（r分别为0.641,0.495，均P<0.05）。 结论： 2型糖尿病血糖波动水平可影响脂蛋白a的表达和血尿酸的水平。

Relationship between blood glucose fluctuation and lipoprotein-a andserum uric acid level in type 2 diabetes mellitus

Objective: To study the relationship between blood glucose fluctuation and serum lipoprotein-a, serum uric acid in type 2 diabetic patients. Methods: Fifty patients of type 2 diabetes mellitus with microalbuminuria were selected as the observation group, fifty patients with type 2 diabetes mellitus without microalbuminuria were selected as the control group.The general clinical data and blood biochemical indexes were measured and recorded. The fluctuations of blood glucose was evaluated. The relationship between blood glucose and lipoprotein a, serum uric acid were analyzed. Results: There were significant differences of the average course of disease, 2 hours plasma glucose (2hPG),triglyceride,total cholesterol（TC）, HDL-C, LDL-C, serum uric acid, lipoprotein-a and U-mALB between the two groups(all P<0.01). The values of mean amplitude of glycemic excursions(MAGE), maximum blood glucose fluctuation(LAGE),blood sugar level standard deviation(SDBG) and average postprandial blood glucose fluctuation range(MMPGE) of the observation group were significantly higher than those of the control group(P<0.01). U-mALB was positively correlated with lipoprotein-a and blood uric acid(r=0.886,0.943 respectively，both P<0.05),TC and MAGE were positively correlated with lipoprotein-a（r=0.560,0.965 respectively，both P<0.05）, and SDBG, MAGE were positively correlated with blood uric acid（r=0.641,0.495 respectively，both P<0.05）. Conclusion: The blood glucose fluctuation level of type 2 diabetes may be associated with the expression of lipoprotein a and the level of uric acid. ［Key words］type 2 diabetes mellitus； blood glucose fluctuation; lipoprotein a; blood uric acid