[1]余安运,刘夏炎,宋 煜,等.血清脂蛋白(a)和同型半胱氨酸(HCY) 与2型糖尿病胰岛素抵抗的临床研究[J].现代检验医学杂志,2016,31(03):65-68.[doi:10.3969/j.issn.1671-7414.2016.03.018]
　YU An-yun,LIU Xia-yan,SONG Yu,et al.Clinical Study of Serum Lipoprotein(a) and Homocysteine with Type 2 Diabetes Mellitus and Insulin Resistance[J].Journal of Modern Laboratory Medicine,2016,31(03):65-68.[doi:10.3969/j.issn.1671-7414.2016.03.018]
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血清脂蛋白(a)和同型半胱氨酸(HCY) 与2型糖尿病胰岛素抵抗的临床研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第31卷
期数:
2016年03期
页码:
65-68
栏目:
论著
出版日期:
2016-06-15

文章信息/Info

Title:
Clinical Study of Serum Lipoprotein(a) and Homocysteine with Type 2 Diabetes Mellitus and Insulin Resistance
文章编号:
1671-7414(2016)03-065-04
作者:
余安运; 刘夏炎; 宋 煜; 于佩方
陕西省康复医院检验科,西安 710065
Author(s):
YU An-yun; LIU Xia-yan; SONG Yu; YU Pei-fang
Department of Clinical Laboratory,Shaanxi Kangfu Hospital,Xi'an 710065,China
关键词:
脂蛋白(a);  同型半胱氨酸;  2型糖尿病;  胰岛素抵抗
分类号:
R587.1; R446.112
DOI:
10.3969/j.issn.1671-7414.2016.03.018
文献标志码:
A
摘要:
目的 分析血清脂蛋白(a)[Lp(a)]和同型半胱氨酸(HCY)在2型糖尿病(T2DM)中的水平,探讨它们与胰岛素抵抗(IR)之间的关系。方法选取2012年5月～2015年12月陕西省康复医院住院并确诊为T2DM的患者108例作为病例组,病例组按照有无肾病并发症分为单纯糖尿病(SDM)组48例和糖尿病肾病(DN)组60例。同期选择67例健康体检者作为正常对照组(NC组)。收集所有研究对象一般资料并采集他们的全血及血清标本,测定以下指标:糖化血红蛋白(HbA1c)、低密度脂蛋白胆固醇(LDL-C)、尿素氮(BUN)、血肌酐(SCr)、胱抑素C(CysC)、Lp(a)和HCY水平; 对SDM组和DN组的研究者同时测定空腹血糖(FPG)、空腹胰岛素(FINS)和胰岛素抵抗指数(HOMA-IR); 比较各组间上述指标的差异以及分析Lp(a)和HCY与IR间的关系。结果 ①三组间比较仅在体重上:NC组60.1±10.34 kg,SDM组67.2±11.38 kg和DN组68.8±1.35 kg,差异有统计学意义(F=0.457,P=0.035)。②NC组、SDM组、DN组三组间比较,HbA1c(F=3.421,P=0.013),LDL-C(F=2.963,P=0.041),BUN(F=4.637,P=0.031),SCr(F=2.369,P=0.024),CysC(F=3.697,P=0.011),Lp(a)(F=1.236,P=0.021),HCY(F=4.317,P=0.027),差异均有统计学意义。③SDM组FPG,FINS和HOMA-IR分别是5.99±0.94 mmol/L,61.11±28.46 pmol/L和2.93±1.97。DN组FPG,FLNS和HOMA-IR分别是9.01±2.23 mmol/L,98.56±62.14 pmol/L和4.34±2.74。两组间比较FPG,FINS,HOMA-IR(t=0.47,0.55,0.69,均P=0.024),差异均有统计学意义。④Lp(a),HCY与HOMA-IR呈正相关,相关系数分别为r=0.761,0.840; P=0.044,0.021。结论 血清Lp(a)和HCY水平在DN患者中表达增高,与IR有一定相关性,同时检测血清Lp(a)和HCY对DN的早期发现有重要意义。
Abstract:
Objective To analyze the levels of serum lipoprotein(a)[Lp(a)] and homocysteine(CHY)in type 2 diabetes mellitus(T2DM)patients and todetermine the relationship between them and diabetic insulin resistance.Methods A total of 108 patients with T2DM and 50 healthy volunteers(control group)were studied.T2DM group according to the presence of kidney disease complications could be divided into simple diabetes group(SDM)in 48 patients with diabetic nephropathy(DN)group of 60 cases.Collectedpatients general data and determined two groups of glycosylated hemoglobin(HbA1c),low density lipoprotein(LDL),urea nitrogen(BUN),serum creatinine(SCr),urinary inhibition C(CysC),Lp(a)and HCY levels; Compared differences between groups and how they related to T2DM kidney disease,and the relationship between insulin resistance.Results ①Compared between three groups only the weight(NC group 60.1±10.34 kg,SDM group 67.2±11.38 kg,DN group 68.8±1.35 kg),the difference was statistically significant(F=0.457,P=0.035).②compared between the three groups,the levels ofHbA1c(F=3.421,P=0.013),LDL-C(F=2.963,P=0.041),BUN(F=4.637,P=0.031),SCr(F=2.369,P=0.024),CysC(F=3.697,P=0.011),Lp(a)(F=1.236,P=0.021),HCY(F=4.317,P=0.027)were increasedsignificantly.③FPG,FINS and HOMA-IR in SDM group were 5.99±0.94 mmol/L,61.11±28.46 pmol/L and 2.93±1.97 respectively,FPG,FINS and HOMA-IR in DNgroup were 9.01±2.23 mmol/L,98.56±62.14 pmol/L and 4.34±2.74 respectively.Compared between the two groups,FPG(t=0.47,P=0.017),FINS(t=0.55,P=0.039),HOMA-IR(t=0.69,P=0.024)differences were statistical significance.④The Lp(a),HCY were significantly positive correlation with HOMA-IR(r=0.761,P=0.044; r=0.840,P=0.021).Conclusion Lp(a)and HCY levels in serum associated with diabeticnephropathy,and insulin resistance.And the detection of serum Lp(a)and HCY has important significance for early detection of diabetic nephropathy.

参考文献/References:

[1] Wada J,Makino H.Inflammation and the pathogenesis of diabetic nephropathy[J].Clin Sci,2013,124(3/4):139-152.
[2] 谢艳红,匡金石,李艾红.2型糖尿病患者血糖控制水平对血脂及脂蛋白的影响[J].现代检验医学杂志,2013,20(1):92-94. Xie YH,Kuang JS,Li AH.Effect of the serum lipid and apolipoprotein profiles on glycemic control in patients with type 2 diabetes mellitus[J].Journal of Modern Laboratory Medicine,2013,20(1):92-94.
[3] Umahara T,Uchihara T,Yamada S,et al.Differential expression of oxidized/native lipoprotein(a)and plasminogen in human carotid and cerebral artery plaques[J].Atherosclerosis,2011,215(2):392-398.
[4] 陈 涛,王中心,黄丽华,等.初诊2型糖尿病合并高血压患者血清脂联素和改良稳态模型评估法计算的胰岛素抵抗指数的变化及相关性[J].中华高血压杂志,2015,23(5):452-456. Chen T,Wang ZX,Huang LH,et al.The changes and relationship of serum adiponectin and homeostasis model assessment-2 of insulin resistance in newly-diagnosed type 2 diabetic patients accompanied with hypertension[J].Chinese Journal of Hypertension,2015,23(5):452-456.
[5] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华糖尿病杂志,2014,88(7):26-89. Diabetes branch of the Chinese Medical Association.Chinese type 2 diabetes prevention and control guide(2013 Edition)[J].Chinese Journal of Diabetes,2014,88(7):26-89.
[6] 郑姜钦,马 坤,吕绍光.2型糖尿病中医辨证与胰岛素抵抗的关系[J].中华中医药杂志,2010,25(8):1318-1320. Zheng JQ,Ma K,L(¨overu)SG.Relationship between TCM syndrome differentiation and insulin resistance of type 2 diabetes[J].China Journal of Traditional Chinese Medicine and Pharmacy,2010,25(8):1318-1320.
[7] 郭 玫,李红梅,刘 瑛.对新诊断2型糖尿病患者合并脂代谢异常及非酒精性脂肪肝的探讨[J].中国糖尿病杂志2013,21(3):229-231. Guo M,Li HM,Lui Y.Study on the newly T2DM patients with lipometabolism disturbance and fatty liver[J].Chinese Journal of Diabetes,2013,21(3):229-231.
[8] Toro R,Segura E,Nunez-Cortes JM,et al.Relationship between lipoprotein(a)and micro/macro complications in type 2 diabetes mellitus:a forgotten target[J].Journal of Genatric Cardiology,2015,12(2):93-99.
[9] Zhang Y,Li S,Xu RX,et al.Systemic inflammatory markers are closely associated with atherogenic lipoprotein subfractions in patients undergoing coronary angiography[J].Mediators Inflamm,2015(2015):235742.
[10] Bellentani S,Marino M.Epidemiology and natural history of non-alcoholic fatty liver disease(NAFLD)[J].Ann Hepatol,2009,8(suppl 1):S4-S8.
[11] Kaur S,Singh P,Indu V,et al.Fibrinogen,Lp(a),microalbuminuria andleft ventricular mass index:cardiovascaular disease risk factors in diabetes[J].Indian J Clin Biochem,2012,27(1):94-96.
[12] 王 莹,王 懿,李卓成.糖尿病肾病患者BNP,HCY和cTnI的变化与其发生心血管疾病的关系[J].国际检验医学杂志,2011,32(5):555-559. Wang Y,Wang Y,Li ZC.The relationship between the changes of BNP,HCY and cTnI in patients with diabetic&nephropathy and their cardiovascular diseases[J].Internations Journal of Laboratory Medicine,2011,32(5):555-559.

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备注/Memo

备注/Memo:
基金项目:陕西省科技攻关项目[批准号2008K16-6(7)]。 作者简介:余安运(1962-),男,本科,副主任技师,主要从事生化及临床实验诊断的研究,E-mail:13991968072@163.com。
更新日期/Last Update: 2016-06-25