Lp（a）、apoB/apoA1及HOMA-IR在2型糖尿病与糖耐量受损患者中的变化及意义

目的探讨2型糖尿病（T2DM）、糖耐量受损（IGT）患者脂蛋白（a）Lp（a）]、载脂蛋白A1（apoA1）、载脂蛋白B（apoB）和稳态模型的胰岛素抵抗指数（HOMA-IR）的变化及其相互间的关系和意义。方法测定24例2型糖尿病患者（T2DM组）、22例糖耐量受损患者（IGT组）和36例健康成人（正常对照组）的Lp（a）、apoA1、apoB等血脂指标,同时检测T2DM组和IGT组的空腹血糖、空腹胰岛素并计算HOMA-IR,分析T2DM及IGT患者血脂指标的变化及其与HOMA-IR的关系。结果 T2DM组、IGT组与正常对照组比较Lp（a）、apoB、apoB/apoA1显著升高（P〈0.01）,apoA1显著降低（P〈0.05）;T2DM组与IGT组之间的差异有统计学意义,且两组间apoB、apoB/apoA1与HOMA-IR有显著的相关性（P〈0.05）。结论 Lp（a）、apoB、apoB/apoA1等血脂指标与T2DM的发生发展有关,且apoB、apoB/apoA1与胰岛素抵抗显著相关,在CV危险评估、病情与治疗监测等方面有重要的应用价值。

Relationship and Significance between the Level of Lp（a）,apoA1/apoB and HOMA-IR in Patients with T2DM and IGT

Objective To investigate the relationships between the level of apoB,apoB /apoA1 and HOMA-IR in patients with T2DM and IGT.Methods The levels of serum lipoprotein（a） Lp（a）],apoA1 and apoB were determined.Lipid index was measured in 24 patients with T2DM,22 patients with IGT and 36 cases of NGT.And in IGT and T2DM groups,fasting blood glucose and fasting insulin were measured and analyzed.Results The levels of Lp（a）,apoB and apoB /apoA1 in T2DM and IGT were significantly higher than the NGT（P0.01）.ApoA1 in T2DM and IGT was significantly lower than the NGT（P0.05）.The difference between T2DM and IGT is significant.The levels of apoB,apoB /apoA1 were significantly correlated with HOMA-IR in T2DM and IGT groups（P0.05）.Conclusion The lipid index Lp（a）,apoB and apoB /apoA1 is correlated with T2DM progression.The levels of apoB and apoB /apoA1 are significantly associated with insulin resistance.These values are valuable in CV risk assessment and the monitoring of treatment progress.