老年2型糖尿病血管并发症与脂代谢关系的探讨

目的 探讨老年2型糖尿病患者血管并发症与血脂、载脂蛋白、脂蛋白（a)之间的关系。方法 将老年2型糖尿病患者分为62例无血管并发症组（Ⅱ组）及58例有血管并发症组（I组），对两组病例进行了血清总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL－C）、低密度脂蛋白胆固醇（LDL－C）、载脂蛋白AI（ApoAI)、载脂蛋白B（ApoB)及脂蛋白（a)Lp(a)]的测定。结果 I组与Ⅱ组比较：TC、TG、LDL－C、ApoB、Lp(a)水平均显著增高，而HDL－C和ApoAI明显降低。结论 老年2型糖尿病患者由于体内胰岛素相对不足和胰岛素抵抗，使血脂、载脂蛋白、脂蛋白浓度和组成成分发生变化及功能发生异常，从而促进动脉粥样硬化，伴随着血管并发症的发生。因此，临床上对老年2型糖尿病患者进行调脂治疗是减少血管并发症的重要手段之一。

THE STUDY OF THE RELATIONSHIP BETWEEN OF ELDERLY PATIENTS WTTH NON-INSULIN DEPENDENT DLABETES MELLITUS AND METABOLISM OF SERUM LIPLDS

Objective: To discuss the relationship between levels of serum lipids?apolipoprotein?lipoprotein and blood vessel complications of elderly patients with non-insulin dependent diabetes mellitus(NIDDM).Methods:120 cases of elderly patients with non-insulin dependent diabetes mellitus were divided into two groups:Group one:58 cases with blood vessel complications,Group two:62 cases without blood vessel complications.The levels of total cholesterol(TC)?Triglyceride(TG)?high density lipoprotein cholesterol(HDL-C)?low density lipoprotein cholesterol (LDL-C)?apolipoprotein AI(ApoAI)?apolipoprotein B(ApoB)?lipoprotein(a)in both groups were tested.Results: The levels of TC?TG?LDL-C?Lp(a) in group one were significantly higher than those of group two,while the levels of HDL-C?ApoAI in group one were significantly lower than those of the second group.Conclusion:Becanuse of the relative lack of insulin and insulin resistance in elderly patients with NIDDM,the composition and consistency of serum lipids?apolipoprotein?lipoprotein and their functions have changed,which leads to atherosclerosis and blood vessel complications.It is suggested that adjusting the density of serum lipids is one of the most important means in the treatment of elderly patients with non-insulin dependent diabetes mellitus.