[1]谭璐 闫彩凤 曾纯 陈晴 宫祎慧.成人隐匿性自身免疫性糖尿病患者的脂代谢 特点及其与颈动脉粥样硬化的关系[J].国际内分泌代谢杂志,2019,39(03):160-164.[doi:10.3760/cma.j.issn.1673-4157.2019.03.004]
　Tan Lu,Yan Caifeng,Zeng Chun,et al.Lipid metabolism and its association with carotid atherosclerosis in patients with latent autoimmune diabetes mellitus in adults[J].International Journal of Endocrinology and Metabolism,2019,39(03):160-164.[doi:10.3760/cma.j.issn.1673-4157.2019.03.004]
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成人隐匿性自身免疫性糖尿病患者的脂代谢 特点及其与颈动脉粥样硬化的关系()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
39
期数:
2019年03期
页码:
160-164
栏目:
论著
出版日期:
2019-05-20

文章信息/Info

Title:
Lipid metabolism and its association with carotid atherosclerosis in patients with latent autoimmune diabetes mellitus in adults
作者:
谭璐1; 2 闫彩凤2 曾纯1 陈晴2 宫祎慧2
1中南大学湘雅二医院国家代谢疾病研究中心,长沙 410000; 2江苏省苏北人民医院内分泌科,扬州 225001
Author(s):
Tan Lu1; 2;  Yan Caifeng2;  Zeng Chun1;  Chen Qing2;  Gong Yihui2
1Clinical Research Center for Metabolic Diseases of the Second Xiangya Hospital of Central South University, Changsha 410000, China; 2Department of Endocrinology, the Northern Jiangsu People's Hospital, Yangzhou 225001, China
关键词:
成人隐匿性自身免疫性糖尿病;  颈动脉斑块;  动脉粥样硬化;  脂质蓄积指数
Keywords:
Latent autoimmune diabetes in adults;  Carotid plaque;  Atherosclerosis;  Lipid accumulation index
DOI:
10.3760/cma.j.issn.1673-4157.2019.03.004
摘要:
目的 探讨起病两年内成人隐匿性自身免疫性糖尿病(LADA)患者的脂代谢及其与颈动脉粥样硬化的相关性。方法 纳入起病两年内的LADA患者(LADA组)38例、典型1型糖尿病患者(TT1DM组)50例以及非糖尿病患者(NDM组)50名,测定各受试者的血脂、颈部血管超声、血糖、身高、体重、腰围、臀围等指标,利用单因素方差分析比较3组间各脂代谢指标差异并找出其与颈动脉斑块的相关性,最后利用受试者工作特征(ROC)曲线判断各体脂分布指标对颈动脉斑块的预测能力。结果 3组间比较,LADA组体重指数、高密度脂蛋白-胆固醇(HDL-C)水平高于TT1DM组、低于NDM组(F=9.322、3.190,P均<0.05),但甘油三酯水平则明显高于其他两组(F=3.213,P<0.05); 校正HbA1c、空腹血糖、2 h血糖后,LADA组颈动脉斑块与甘油三酯(r=0.387,P=0.036)、甘油三酯/HDL-C(r=0.393,P=0.027)和脂质蓄积指数(LAP)(r=0.397,P=0.021)均呈正相关,与HDL-C呈负相关(r=-0.384,P=0.037)。LAP、甘油三酯、甘油三酯/HDL-C和腰臀比对LADA患者颈动脉斑块的曲线下面积(AUC)值有统计学意义,其中LAP的AUC值(0.707,95% CI:0.441～0.906,P=0.031)最大。结论 LADA患者的脂代谢特点是甘油三酯水平升高、HDL-C水平降低; 甘油三酯是LADA患者动脉粥样硬化的危险因素,HDL-C则是保护因素; LAP能有效预测LADA患者颈动脉粥样硬化。
Abstract:
Objective To explore the characteristics of lipid metabolism and its correlation with carotid atherosclerosis in patients with latent autoimmune diabetes in adults(LADA)within 2 years of onset.Methods A total of 38 patients with LADA(LADA group), 50 patients with typical type 1 diabetes mellitus(TT1DM group)within 2 years of onset and 50 individules without diabetes mellitus(NDM group)were enrolled. Blood lipid, carotid artery ultrasound, blood glucose, height, weight, waist circumference and hip circumference were measured. Differences of blood lipids were compared by ANOVA-analysis among three groups, and the correlation between each lipid index and carotid plaque formation were studied. Finally, the predictive value of body fat distribution index in the formation of carotid plaque was estimated by receiver operating characteristic(ROC)curve.Results Body mass index and high density lipoprotein-cholesterol(HDL-C)in LADA group were significantly lower than those in NDM group and higher than those in TT1DM group(F=9.322, 3.190, all P<0.05), while triglyceride(TG)was significantly higher in LADA group than that of the other two groups(F=3.213, P<0.05). After adjusted with HbA1c, fasting glucose and 2 h postprandial glucose, the carotid plaque were positively correlated with TG(r=0.387, P=0.036), TG/HDL-C(r=0.393, P=0.027)and lipid accumulation index(LAP)(r=0.397, P=0.021), but negatively correlated with HDL-C(r=-0.384, P=0.037)in LADA group. LAP, TG, TG/HDL-C and waist hip ratio(WHR)were significant predictors of carotid plaque, and LAP had the largest area under the curve of ROC(0.707, 95% CI: 0.441-0.906, P=0.031)in patients with LADA.Conclusions Lipid metabolism in patients with LADA are mainly characterized by increase of TG and decrease of HDL-C. TG is a risk factor of atherosclerosis in patients with LADA, and HDL-C is a protective factor. LAP is able to predict the formation of carotid atherosclerosis in patients with LADA.

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备注/Memo

备注/Memo:
通信作者:闫彩凤,Email:yancaifeng@126.com
基金项目:国家代谢疾病研究中心课题(2015BAI12B12)
Corresponding author: Yan Caifeng, Email: yancaifeng@126.com
Fund program:Clinical Research Center for Metabolic Diseases Subject(2015BAI12B12)
更新日期/Last Update: 2019-05-20