超体质量/肥胖及糖尿病患者血清载脂蛋白B与载脂蛋白A1比值的临床意义

目的 探讨ApoB/ApoA1比值在超体质量、肥胖及2型糖尿病患者的变化情况并进一步研究其临床意义.方法 收集2012年7月～2013年4月来我院进行健康体检的受检者181例,以研究对象的BMI及糖调节状况为依据对其进行分组,A组n=38 (20/18)],该组患者具有正常的糖调节与体质量;B组n=41 (24/17)],该组研究对象均为2型糖尿病患者并且具有正常的体质量;C组n=54(31/23)],该组患者为超体质量/肥胖且具有正常的糖调节;D组n=48 (26/22)],该组患者为超体质量/肥胖的2型糖尿病.对四组患者FPG、血脂、hs-CRP、胰岛素水平进行检测,各组患者的胰岛素敏感性采用HOMA-IR进行评价.结果 ①B、C、D组与A组比较具有较高的ApoB/ApoAl比值(P＜0.05),D组与B、C组比较水平更高(P＜0.05).②ApoB/ApoA1的独立相关因素为年龄、BMI、TG、HDL-C、LDL-C、HOMA-IR(P＜ 0.05).③高ApoB/ApoA1组患者的年龄、BMI、FPG、TG、TC、LDL-C、HS-CRP、HOMA-IR水平与低ApoB/ApoA1组比较均明显较高,高ApoB/ApoA1组患者也具有较高的高血压及代谢综合征的发生率,HDL-C水平明显将低.④高血压及代谢综合征的发生中ApoB/ApoA1为其独立危险因子(P＜0.05).结论 在超体质量、肥胖及糖尿病人群中ApoB/ApoA1比值对其风险评估较为适用.

Study on the clinical significance of overweight/obesity and diabetic pa- tients serum apolipoprotein B and apolipoprotein A1 ratio

Objective To investigate the effect of ApoB/ApoAl ratio in overweight, obese and changes in patients with type 2 diabetes mellitus and study its clinical significance. Methods A total of 181 subjects were collected from July 2012 to April 2013 in our hospital for health examination, BMI and sugar research object＇s regulation grouped accord- ing to group A （n=38, 20/18）, the group of patients with normal glucose regulation and body mass, group B （n--41, 24/17） the study group, all patients with type 2 diabetes mellitus and had normal body weight, group C （n=54,31/23） with normal glucose regulation of the patients were overweight/obesity and, group D （n--48, 26/22）, the patients were overweight/ obese type 2 diabetes mellitus. FPG, hs-CRP, blood lipids, insulin levels, insulin sensitivity of patients in four groups were evaluated by HOMA-IR. Results （1）The ApoB/ApoA1 ratio in group B, C, D group were higher than group A（P 〈 0.05）, The ApoB/ApoA1 ratio in group D were higher than group B ,C （P 〈 0.05 ）. （2）The independent factors asso- ciated with ApoB/ApoA1 were BMI, TG, age, HDL-C, LDL-C, HOMA-IR （P 〈 0.05）. （3）Age, BMI, FPG, TG, TC, LDL-C, HS-CRP, HOMA-IR levels in high ApoB/ApoA1 group were significantly higher than low ApoB/ApoA1 group, the rate of hypertension and the prevalence of metabolic syndrome in high ApoB/ApoA1 group were higher, HDL-C level was lower. （4）Hypertension and metabolic syndrome occurred in ApoB/ApoA1 was the independent dan- gerous factor （P 〈 0.05）. Conclusion ApoB/ApoA1 in overweight, obesity and diabetic population ratio is applied to the risk assessment.