摘要
目的分析在2型糖尿病（T2DM）患者血脂风险评估中非高密度脂蛋白胆固醇（non—HDLC）和载脂蛋白B（ApoB）的一致性。方法选取2013年1月至2014年1月于首都医科大学附属北京朝阳医院内分泌科就诊的460例无心脑血管疾病病史的初诊T2DM患者为研究对象，记录身高、体重，计算体质指数（BMI），测定血脂等相关指标，分析ApoB和non—HDLC的相关性；依据美国糖尿病协会／美国心脏病学会（ADA／ACC）、美国血脂协会（NLA）针对糖尿病患者提出的血脂目标值，采用Kappa分析和线性回归分析T2DM患者低密度脂蛋白胆固醇fLDL—C）、non—HDLC、ApoB达标的一致性情况。结果对所有人选的糖尿病患者ApoB和non-HDLC水平进行相关性分析显示，二者间具有相关性（r=0．68，P〈0．001）。对114例糖尿病合并高甘油二三酯（TG）血症f〉200mg／d1）患者分析显示，ApoB和non．HDLC呈显著正相关（r：0．86，P〈0．001）。此外，在ApoB〈90mg／dl的T2DM患者中，40％不能同时满足non—HDLC〈130ms／dl的目标值；16．9％患者ApoB〈80mg／dl，而non．HDLC≥100mg／dl；12％患者non—HDLC〈100mg／dl，而ApoB≥80mg／dl；4．4％的患者ApoB〈70mg／dl，而non—HDLC〉100mg／dl；24％的患者non—HDLC〈100mg／dl，而ApoB≥70mg／dl。结论在临床实际中，糖尿病患者的non—HDLC和ApoB水平具有较好的相关性，一定程度上可替代ApoB作为评价糖尿病患者血脂异常导致心血管风险的参考指标。
Objective To assess the concordance rate of lipid risk between non-high density lipoprotein cholesterol （non-HDLC） and apolipoproteinB （ApoB） targets in patients with diabetes. Methods A total of 460 patients from Beijing Chaoyang hospital with newly diagnosed type 2 diabetes without history of cardio-cerehral vascular disease were enrolled in this study during the period from Jan 2013 to Jan 2014. Body height, body weight, body mass index （BMI） and blood lipid were measured.Data from 460 determinations of low density lipoprotein cholesterol（LDL-C）, non-HDLC and Apo B in patients were analyzed. To evaluate the relation between Non-HDLC and Apo B in patients with diabetes with triglyceride （TG） 200-499 mg/dl. Rates of discordance were calculated, based on the currently recommended LDL-C, non-HDLC, and Apo-B goals acknowledged by the American Diabetes Association （ADA） and American Collegeof Cardiology （ACC） panel. Data was analyzed by linear regression and Kappa analysis to show the concordance of LDL-C, non-HDLC and Apo B in T2DM patients. Results In patients with diabetes and hypertriglyceridemia, a positive relationship exists between non-HDLC and Apo-B observed by correlated analysis（r=0.86, P〈0.001）, whereas a weak eorrelation among the overall diabetes. In patients with non- HDLC goal of〈130 mg/dl, there was a diseordance with Apo-B level goal of〈90 mg/dl in 40% of samples. In patients with non-HDLC goal of〈100 mg/dl, 12% of samples had Apo B〉80 and 16.9% had Apo B〈 80 mg/dl. Using the Apo B goal of〈70 mg/dl, these numbers were 24% and 4.4% respectively. Conclusions In practice, non-HDLC and ApoB have an obvious correlation in diabetes patients. To some extent, these two parameters have the equivalence in assessment of cardiovascular risks in diabetes with dyslipidemia.
出处
《中华糖尿病杂志》
CAS
CSCD
2015年第7期442-446,共5页
CHINESE JOURNAL OF DIABETES MELLITUS
基金
国家自然科学基金项目（81270369）
首都临床特色基金（Z131107002213024）
北京市自然科学基金（1142001）
通信作者：王广,Email：drwg6688@aliyun.com
关键词
载脂蛋白B
非高密度脂蛋白胆固醇
糖尿病
2型
Apolipoprotein-B
Non-high density lipoprotein cholesterol
Diabetes mellitus,type 2
