抗氧化型低密度脂蛋白抗体与糖尿病和代谢综合征的相关性

目的通过测定血清抗氧化型低密度脂蛋白抗体（oxLDL Ab），探讨氧化型低密度脂蛋白（Oxidized LDLs）与糖尿病及代谢综合征（MS）的关系。方法糖尿病患者78例（DM组），其中有代谢综合征患者71例为MS组，健康人18例为对照组。测定BMI、腰臀比（WHR）和TG、TC、HDL-C、LDL-C、载脂蛋白A、载脂蛋白B、脂蛋白（a）等血脂指标。酶联免疫吸附法测定血清oxLDL Ab（IgM和IgG型）浓度。硫酸右旋糖苷沉淀法测定HDL亚型。结果初发糖尿病患者、糖尿病患者及代谢综合征患者的血清oxLDL Ab水平明显高于对照组，分别为（30．18±9．85）、（32．17±21．31）、（38．42±23．59）、（24．05±3．32）U／ml，差异有统计学意义（P〈0．05）；随着糖尿病病程的延长，糖尿病患者oxLDL Ab浓度有升高的趋势；经相对危险度估计，高oxLDL Ab浓度的人群患MS的相对危险度是正常浓度人群的2．57倍（95％可信区间1．76～3．75），χ^2=23．51（P=0．000）。结论血清oxLDL Ab浓度与糖尿病及代谢综合征密切相关，糖尿病及MS患者血清oxLDL Ab水平明显升高，且随病程延长有逐步升高的倾向；测定oxLDL Ab浓度，可以用来判断与估计MS的患病危险度。

Relatienship among oxidized-LDLs, type 2 diabetes mellitns and metabolic syndrome

Objective To discuss the relationship among oxidized-LDLs, type 2 diabetes mellitus (DM) and metabolic syndrome(MS). Methods Seventy-eight DM, 71 MS patients and 18 healthy controls were en-rolled. The systolic blood pressure, diastolic blood pressure, BMI, WHR was recorded, serum lipids, such as total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein, apolipoprotein A & B100 and lipoprotein (a) were measured. The serum anti-oxLDL Ab (IgM and IgG) were measured by Immune ELISA. HDL subtype HDL-3 were detected by Dextran sulfate (50000 Dalton) sedimentation. Result The serum anti-oxLDL Ab in MS & DM patients were significantly higher than healthy controls (P < 0.05). The DM patients had higher levels of sub-type HDL-3 than the controls (P < 0.05). Serum anti-oxLDL Ab in DM patients increased gradually. Relative risk of people of high level of serum anti-oxLDL Ab was 2.57 times higher than that in control group (95% CI is 1.76-3.75, P = 0.000). Conclusion Serum anti-oxLDL Ab is closely related with Metabolic Syndrome and increases significantly in DM and MS patients. Serum HDL decreases in diabetic patients but subtype HDL-3 seems to in-crease. Meanwhile, serum anti-oxLDL Ab can be used as one of the laboratory items for diagnosis of MS.