空腹甘油三酯正常的2型糖尿病患者餐后血脂的动态变化

目的探讨空腹甘油三酯正常的2型糖尿病患者脂肪餐后血脂水平的动态变化。方法通过脂肪餐负荷试验对25例空腹甘油三酯正常的2型糖尿病患者和20例健康对照者进行餐后血脂代谢的研究。分别于餐前、餐后2、4、6和8h用酶法测定总胆固醇和甘油三酯,一步法测定高低密度脂蛋白,葡萄糖氧化酶法测定血糖,化学发光免疫分析法测定免疫反应胰岛素,计算曲线下甘油三酯面积和增加面积。结果两组餐后甘油三酯平均值都有所升高,峰值在餐后4h。但糖尿病组餐后8h甘油三酯仍明显高于空腹水平(P<0.05),而对照组在餐后8h甘油三酯已恢复接近空腹水平(P>0.05)。两组的高密度脂蛋白在餐后4h都有一个轻微的低谷出现,但无组间差异(P>0.05)。总胆固醇和低密度脂蛋白在餐后无明显变化。两组曲线下甘油三酯面积和增加面积与餐后4h血清甘油三酯水平的相关性最显著(P<0.05)。结论2型糖尿病患者餐后脂代谢异常发生在空腹血脂异常之前。有必要联合检测空腹与餐后4h的甘油三酯水平来全面反映甘油三酯代谢是否存在异常。

The Dynamic Change of Postprandial Lipid in Patients of Normotriglyceridemic Type 2 Diabete

Aim To study the dynamic change of postprandial lipid after a fat meal in patients of normotriglyceridemic type 2 diabete. Methods Subjects were assigned to two groups:the observed group of 25 fasting normotriglyceridemic type 2 diabetic patients; the healthy control group of 20 normal subjects. Postprandial lipids were measured after a fatty test meal. Results Postprandial TG concentrations of the two groups are all raised. TG peak times were all approximate 4 h in the two groups. TG concentrations at 8 h were significantly higher than fasting TG levels in case group (P<0.05), but were no significantly different in control group (P>0.05). A slight postprandial decrease in HDL-C was observed in both groups with no significant difference between groups nevertheless, and there were no difference between diabetics and controls. Postprandial changes in total cholesterol and LDL cholesterol were weak after the test meal. The correlative coefficients of TG-AUC, TG-IAUC and TG levels at 4 h were the biggest (P<0.05). Conclusions The postprandial dyslipidemia usually appears before fasting dyslipidemia in patients with type 2 diabetes mellitus. It is necessary to measure fasting TG level and 4 hour TG level to see if the triglyceride metabolism is abnormal.