摘要
目的:分析乙型肝炎肝硬化合并糖尿病患者糖脂代谢的特点及其与Child分级的关系。方法:检测肝硬化合并2型糖尿病糖尿病组(A组)、2型糖尿病无肝硬化组(B组)患者的血脂(Tch、TG、HDLC、LDL-C、apoA、apoB)、空腹血糖(FBG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1C)、C肽及餐后2 h C肽水平.同时探讨其与Child分级的关系。结果:(1)A组患者FPG、空腹C肽、餐后2 h C肽水平均高于B组(P<0.05)。(2)A组患者HDL-C、LDL-C、apoA、apoB水平均低于B组(P<0.05)。随着肝功能child分级的上升,A组患者HDL-C、LDL-C、apoA、apoB水平进一步下降,尤以apoB及HDL-C最为显著。结论:肝硬化合并2型糖尿病患者存在较严重的胰岛素抵抗,其脂代谢紊乱主要以HDL-C、apoB显著降低为特点.下降程度与肝功能child分级有关。
Objective：To determine the characteristics of glucose and lipid metabolism in patients with hepatitis B-associated liver cirrhosis who had diabetes mellitus and to link with the Child stage. Methods： Patients with type 2 diabetes were alloeated to concomitant liver cirrhosis group （ group A） and cirrhosis-free group （group B ） and tested for blood lipids （total cholesterol [ TCh ], total glycerol [ TG ], low-density lipoprotein-eholesterol [ LDL-C ], high-density lipoprotein-eholesterol [ HDL-C], apoA and apoB）, fasting blood glucose （FBG） , postprandial 2h blood glucose （2hPG）, glycosylated hemoglobin （HbA1 C） , fasting C peptide and postprandial 2 h C peptide, thus allowing to determine their correlation with Child Stage. Results： Group A had high levels of FPG, fasting C peptide and postprandial 2h C peptide （ all P 〈 0.05 ） yet lower levels of HDL- C, LDL-C, apoA and apoB （ all P 〈 0.05 ）. The increased Child stage was associated with reduced levels of LDL-C, apoA, HDL-C and apoB, particularly the latter two indices, in group A. Conclusion： Insulin resistance is remarkable in patients with liver cirrhosis and concomitant type 2 diabetes mellitus who are characterized by aberrant lipid metabolism （ i. e. HDL-C and apoB） , the reduction of which is correlated with Child stage.
出处
《广州医学院学报》
2013年第1期23-25,共3页
Academic Journal of Guangzhou Medical College
关键词
肝硬化
2型糖尿病
血脂异常
预后
liver cirrhosis
type 2 diabetes
aberrant blood lipid
prognosis
