2型糖尿病患者血清载脂蛋白AⅠ、AⅡ、 B100、CⅡ、CⅢ、E含量分析

目的　探讨2型糖尿病患者血清中载脂蛋白(apo)AⅠ、AⅡ、B100、CⅡ、CⅢ、E含量的改变特点。方法　对143例2型糖尿病患者(其中合并冠心病20例，合并高甘油三酯血症66例，合并高胆固醇血症55例)和127例非糖尿病对照进行了空腹12小时后血糖、胰岛素、甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白胆固醇及apoAⅠ、AⅡ、B100、CⅡ、CⅢ、E含量的测定。结果　与非糖尿病对照组相比，男性2型糖尿病患者腰臀比(WHR)、空腹血糖(FBG)及apoCⅡ明显升高(P<0.05)，apoAⅠ、AⅡ明显降低(P<0.05)。女性糖尿病患者较女性非糖尿病者体重指数(BMI)、WHR、FBG、TG水平明显升高(P<0.05)，HDL-C、apoAⅠ、AⅡ水平则明显降低(P<0.01)。在伴有脂质异常血症和冠心病的2型糖尿病患者中，apo(s)与血脂的变化更为明显。2型糖尿病伴高甘油三酯血症的患者较TG正常的糖尿病患者BMI、WHR、空腹胰岛素(INS)、TG、TC、apoB100、CⅡ、CⅢ和E水平明显升高，同时伴HDL-C、apoAⅠ水平降低(P均<0.05)；2型糖尿病伴高胆固醇血症的患者与TC正常的的患者相比，WHR、TG、TC和apoB100、CⅡ、CⅢ、E水平也明显升高(P<0.01)。载脂蛋白的变化与血脂的变化呈明显相关。在2型糖尿病合并冠心病的患者中，BMI、FBG、INS、apoB100、CⅡ、CⅢ和E水平显著升高，HDL-C、apoAⅡ水平则显著降低(P均<0.05)。结论　载脂蛋白异常是2型糖尿病患者的代谢紊乱特征，同时可能是2型糖尿病发生脂代谢紊乱和冠心病的重要原因。

The Abnormal Changes of Apolipoprotein(s) in Patients with Ty pe 2 Diabetes Mellitus

Objective To investigate the changes of the apolipoproteins(apoAⅠ, AⅡ, B100, CⅡ, CⅢ, E) in patients with type 2 diabetes mel litus . Methods The levels of fasting plasma glucose(FBG)，insulin，T G,TC, apoAⅠ, AⅡ, B100, CⅡ, CⅢ, E were all measured in 127 non-diabetic sub jects and 143 type 2 diabetic patients (20 associated with coronary heart disease (CHD) and 66 associated with hypertriglyc eridemia(HTG), 55 associated with hypercholesterolemia).Results In male type 2 diab etic patients, the levels of FBG, WHR and apoCⅡ were significantly higher(P <0.05) and apoAⅠ， AⅡ levels were significantly lower (P<0.05) than thos e in male non -dia betic subjects. In female type 2 diabetic patients, the levels of FBG, BMI, WHR, TG significantly elevated while HDL-C, apoAⅠ, AⅡ levels significantly decrea sed as compared with those in female non-diabetic subjects. In type 2 diabetic gro u p, the levels of WHR, FBG and TG in HTG patients were elevated significantly as compared with th ose without HTG, and the levels of HDL-C, apoAⅠand apoAⅡ were decreased; the l evels of WHR, TG, TC, apoB100, CⅡ, CⅢ, E in patients with HTC were significan tly higher than those whose cholesterol levels were normal. In patients with CHD , the levels of fasting insulin, apoB100, apoCⅡand apoE were significantly high er than those in patients without CHD，and the levels of HDL-C and apoAⅡ were d ecreased significantly. Conclusion Abnormal changes of apo(s) i n type 2 dia betes mellitus may be a cause of type 2 diabetes associated with HTG and CHD.