| 摘要: |
| ［摘要］ 目的 探讨超重及肥胖2型糖尿病（T2DM）患者血浆脂蛋白相关磷脂酶A2（Lp-PLA2）水平及其与颈动脉内膜中层厚度（IMT）的相关性。方法 选择2018-01～2018-08桂林医学院附属医院收治的T2DM患者95例，根据体质量指数（BMI）将其分为单纯T2DM组（BMI<24 kg/m2）56例和超重及肥胖T2DM组（BMI≥24 kg/m2）39例。比较两组空腹血糖（FBG）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、空腹胰岛素（FINS）、胰岛素抵抗指数（IRI）、糖化血红蛋白（HbA1c）、颈动脉IMT和Lp-PLA2。分析Lp-PLA2与颈动脉IMT的相关性。结果 与单纯T2DM组相比，超重及肥胖T2DM组的FINS、IRI、TC、LDL-C、Lp-PLA2及颈动脉IMT水平较高，HDL-C水平较低，差异有统计学意义（P<0.05）。两组FBG、HbA1c、TG比较差异无统计学意义（P>0.05）。T2DM患者血浆Lp-PLA2水平与颈动脉IMT水平呈正相关（r=0.388,P=0.000）。单纯T2DM组和超重及肥胖T2DM组血浆Lp-PLA2水平与颈动脉IMT水平均呈正相关（r=0.292,P=0.029；r=0.470,P=0.003）。多元线性回归分析结果显示，较高水平的BMI、LDL-C及Lp-PLA2是影响颈动脉IMT增厚的主要危险因素（P<0.05）。结论 超重及肥胖T2DM患者的血浆Lp-PLA2水平较高，且Lp-PLA2水平与颈动脉IMT呈正相关，检测该指标可能有利于临床医师及早发现、干预糖尿病大血管病变的发生。 |
| 关键词: 2型糖尿病 脂蛋白相关磷脂酶A2 颈动脉内膜中层厚度 超重 肥胖 |
| DOI：10.3969/j.issn.1674-3806.2021.05.08 |
| 分类号:R 587.1 |
| 基金项目:广西卫健委科研课题（编号：Z20180408） |
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| A study on the correlation between plasma lipoprotein-associated phospholipase A2 level and carotid intima-media thickness in overweight and obese patients with type 2 diabetes mellitus |
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XUN Jing-qiong, KANG Sheng, TANG Min-juan, et al.
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Department of Endocrinology, Affiliated Hospital of Guilin Medical University, Guangxi 541000, China
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| Abstract: |
| ［Abstract］ Objective To investigate the plasma lipoprotein-associated phospholipase A2(Lp-PLA2) level in overweight and obese patients with type 2 diabetes mellitus(T2DM), and its correlation with carotid intima-media thickness(IMT). Methods Ninety-five T2DM patients who were admitted to the Affiliated Hospital of Guilin Medical University from January 2018 to August 2018 were selected. They were divided into simple T2DM group(BMI<24 kg/m2, n=56) and overweight and obese T2DM group(BMI≥24 kg/m2, n=39) according to their different values of Body Mass Index(BMI). The levels of fasting blood-glucose(FBG), total cholesterol(TC), triglyceride(TG), high density lipoprotein-cholesterol(HDL-C), low density lipoprotein-cholesterol(LDL-C), fasting insulin(FINS), insulin resistance index(IRI), glycated haemoglobin A1c(HbA1c), carotid IMT and Lp-PLA2 were compared between the two groups. The correlation between Lp-PLA2 and carotid IMT was analyzed. Results The levels of FINS, IRI, TC, LDL-C, Lp-PLA2 and carotid IMT in the overweight and obese T2DM group were significantly higher than those in the simple T2DM group, while the level of HDL-C in the overweight and obese T2DM group was significantly lower than that in the simple T2DM group(P<0.05). There were no statistically significant differences between the two groups in the levels of FBG, HbA1c and TG(P>0.05). There was a positive correlation between plasma Lp-PLA2 level and carotid IMT level in the T2DM patients(r=0.388, P=0.000). There were positive correlations between plasma Lp-PLA2 level and carotid IMT level in the simple T2DM group and the overweight and obese T2DM group(r=0.292, P=0.029; r=0.470, P=0.003). The results of multiple linear regression analysis showed that higher levels of BMI, LDL-C and Lp-PLA2 were the main risk factors affecting carotid IMT thickening(P<0.05). Conclusion Overweight and obese T2DM patients have higher levels of plasma Lp-PLA2, and the level of Lp-PLA2 is positively correlated with carotid IMT. The detection of this index may be beneficial to clinicians for early detection and intervention of diabetic macrovascular disease. |
| Key words: Type 2 diabetes mellitus(T2DM) Lipoprotein-associated phospholipase A2(Lp-PLA2) Carotid intima-media thickness(IMT) Overweight Obesity |
