首都医科大学学报 ›› 2011, Vol. 32 ›› Issue (5): 609-613.doi: 10.3969/j.issn.1006-7795.2011.05.005

• 糖尿病基础研究与临床实践 • 上一篇    下一篇

2型糖尿病HDL2b的变化特点及对预测冠心病风险的意义

马亚红1,2, 冼勋德3, 杨俊芬2, 甄亚平4, 刘国庆3, 杨金奎1   

  1. 1. 首都医科大学附属北京同仁医院内分泌科,北京 100730;2. 北京市普仁医院内分泌科,北京 100062;3. 北京大学心血管研究所 教育部分子心血管学重点实验室,北京 100029;4. 首都医科大学临床检验中心,北京 100069
  • 收稿日期:2011-07-21 修回日期:1900-01-01 出版日期:2011-10-21 发布日期:2011-10-21
  • 通讯作者: 杨金奎

Characteristics of HDL2b changes and their significance in prediction of risks for coronary artery disease in type 2 diabetic patients

MA Ya-hong1,2, XIAN Xun-de3, YANG Jun-fen2, ZHEN Ya-ping4, LIU Guo-qing3, YANG Jin-kui1   

  1. 1. Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China;2. Department of Endocrinology, Beijing Puren Hospital, Beijing 100062, China;3. Institute of Cardiovascular Sciences, Peking University and Key Laboratory of Cardiovascular Sciences, China Administration of Education, Beijing 100029, China;4. Clinical Laboratory Center, Capital Medical University, Beijing 100069, China
  • Received:2011-07-21 Revised:1900-01-01 Online:2011-10-21 Published:2011-10-21

摘要: 目的 探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清高密度脂蛋白(high-density lipoprotein ,HDL)亚组分HDL2b的变化特点及对预测冠状动脉粥样硬化性心脏病(coronary heart disease,CHD)风险的意义。方法 采用病例对照研究的方法观察41例T2DM患者及41例空腹血糖正常(normal fasting glucose,NFG)对照者,病例均来自于北京市顺义区南法信镇35~74岁自然人群,2组研究对象的年龄、性别、体质量指数(body mass index,BMI)、腰围、臀围、血压均匹配,采用微流芯片(microfluidic chip)技术测定空腹血清HDL、HDL2b、HDL2b/HDL比率,并对10年CHD发生风险(10-year CHD risk)进行评估。结果 T2DM组患者空腹血糖(fasting plasma glucose,FPG)、稳态模型胰岛素敏感指数(homeostasis model for insulin resistance,HOMA-IS)、胰岛素抵抗指数(homeostasis model assessment-insulin resistant index,HOMA-IR)、三酰甘油(triglycerides,TG)、血清总胆固醇(total cholesterol,TC)、10年CHD发生风险均显著高于对照组(P<0.05),HDL、HDL2b、HDL2b/HDL比率显著低于对照组(P<0.01),HDL2b与FBG、空腹胰岛素(fasting insulin,FINS)、TG、TC、HOMA-IR、10年CHD发生风险呈负相关,HDL2b与FBG及10年CHD发生风险相关性优于HDL。结论 T2DM患者HDL2b显著降低,10年CHD发生风险显著上升,与HDL相比,HDL2b预测CHD发生风险更加敏感。

关键词: 2型糖尿病, 高密度脂蛋白亚组分, 微流芯片法, 冠状动脉粥样硬化性心脏病风险

Abstract: Objective To investigate the characteristics of plasma high-density lipoprotein(HDL) subfraction HDL2b changes and their significance in prediction of risks for coronary heart disease(CHD) in patients with type 2 diabetes mellitus(T2DM). Methods Totally 41 T2DM patients and 41 controls with normal fasting glucose matched in age, gender, body mass index(BMI), circumference of waist, circumference of hip, and blood pressure were enrolled. The controls were from a normal population aged 35~74 year-old from Nanfaxin, a town in Shunyi District, Beijing. A microfluidic chip method was adopted to measure total HDL, HDL2b and the ratio of HDL2b/HDL, and the 10-year CHD risk was evaluated. Results T2DM patients had higher fasting plasma glucose(FPG), Homeostasis model for insulin resistance(HOMA-IS), homeostasis model assessment-insulin resistant index(HOMA-IR), triglycerides(TG), total cholesterol(TC) and 10 year CHD risk than the controls(P<0.05), while HDL, HDL2b and the ratio of HDL2b/HDL were lower in the T2DM patients(P<0.01). HDL2b was found to be negatively correlated with FBG, fasting insulin(FINS), TC, TG, HOMA-IR and 10 year CHD risk. The relationship of FBG and 10-year CHD risk with HDL2b was stronger than with HDL. Conclusion T2DM patients have significantly lower HDL2b levels, higher 10-year CHD risk. HDL2b is therefore a more sensitive predictor than HDL.

Key words: type 2 diabetes mellitus, high-density lipoprotein subfractions, microfluidic chip, coronary heart disease risk

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