文章摘要
周学玲,张紫晨,邱雪婷,王 敏,孙 敏.初诊2型糖尿病患者脂蛋白相关磷脂酶A2与胰岛素抵抗的相关性研究[J].南京医科大学学报,2020,(5):681~686
初诊2型糖尿病患者脂蛋白相关磷脂酶A2与胰岛素抵抗的相关性研究
Correlation between levels of lipoprotein associated phospholipase A2 and insulin resistance in newly diagnosed type 2 diabetes mellitus
投稿时间:2019-12-03  
DOI:10.7655/NYDXBNS20200512
中文关键词: 初诊断2型糖尿病  脂蛋白相关磷脂酶A2  胰岛素抵抗
英文关键词: newly diagnosed T2DM  Lp⁃PLA2  insulin resistance
基金项目:国家重点研发计划资助(2018YFC1314800,2018YFC1314805)
作者单位
周学玲 南京医科大学第一附属医院内分泌科江苏 南京 210029马鞍山市人民医院内分泌科安徽 马鞍山 243000 
张紫晨 南京医科大学第一附属医院内分泌科江苏 南京 210029 
邱雪婷 南京医科大学第一附属医院内分泌科江苏 南京 210029 
王 敏 南京医科大学第一附属医院内分泌科江苏 南京 210029 
孙 敏 南京医科大学第一附属医院内分泌科江苏 南京 210029 
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中文摘要:
      目的:探讨初诊断2型糖尿病(T2DM)患者血浆脂蛋白相关磷脂酶A2(Lp?PLA2)水平与胰岛素抵抗的关系。方法:选取219例初诊断T2DM 患者,测定血浆Lp?PLA2、总胆固醇、甘油三酯、高密度脂蛋白胆固醇(HDL?C)、低密度脂蛋白胆固醇(LDL?C)、糖化血红蛋白(HbA1c)、空腹血糖和空腹胰岛素等指标,于口服葡萄糖耐量试验(OGTT)或馒头餐试验后检测30 min、120 min血糖和胰岛素。以Lp?PLA2水平分为正常组(<200 ng/mL)和高值组(≥200 ng/mL),分析两组胰岛素抵抗水平及二者的相关性。结果:初诊断T2DM患者Lp?PLA2高值组比正常组HOMA?IR值显著增高(P<0.05),而Matsuda ISI显著降低(P<0.05)。相关分析进一步提示Lp?PLA2水平与HOMA?IR呈正相关(P<0.05),与Matsuda ISI呈负相关(P<0.05)。多元线性回归分析结果显示,血浆Lp?PLA2是影响T2DM患者HOMA?IR 和Matsuda ISI的重要因素(P<0.05)。结论:Lp?PLA2与T2DM胰岛素抵抗密切相关。Lp?PLA2作为简单易行的指标,除了作为T2DM心血管风险预测因素外,还可以反映糖尿病患者胰岛素抵抗程度,可作为T2DM重要的评估监测指标。
英文摘要:
      Objective:To explore the relationship between lipoprotein?associated phospholipase A2(Lp?PLA2)and insulin resistance in newly diagnosed type 2 diabetes mellitus. Methods:A total of 219 newly diagnosed T2DM patients were selected. Lp?PLA2 levels,total cholesterol(TC),triacyl glycerin(TG),high?density lipoprotein cholesterol(HDL?C),low density lipoprotein cholesterol(LDL?C),glycosylated hemoglobin(HbA1c),fasting plasma glucose and fasting plasma insulin were measured,respectively.Postprandial venous blood samples were collected at 30 and 120minutes after OGTT to test glucose and insulin levels. The patients were divided into normal group(<200 ng/mL)and high group(≥200 ng/mL)according to Lp?PLA2 level,to analyze the level of insulin resistance between the two groups and their correlation. Results:HOMA?IR in T2DM patients with high Lp?PLA2 level was significantly higher than those with normal Lp?PLA2(P<0.05),while Matsuda ISI was significantly lower(P<0.05).With the increase of Lp?PLA2 level in newly diagnosed T2DM patients,HOMA?IR significantly increased(P<0.05)and Matsuda ISI significantly decreased(P<0.05). Correlation analysis showed that the Lp?PLA2 levels were positively correlated with HOMA?IR(P<0.05)and negatively correlated with Matsuda ISI(P<0.05). Regression analysis showed that Lp?PLA2 was an important predictor for HOMA?IR and Matsuda ISI(P<0.05). Conclusion:Lp?PLA2 level is closely related to T2DM insulin resistance. Lp?PLA2,as a simple and feasible indicator,can be useful for evaluating both cardiovascular risk and insulin sensitivity in T2DM.
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