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目的探讨2型糖尿病(T2DM)、糖耐量受损(IGT)患者脂蛋白(a)[Lp(a)]、载脂蛋白A1(apoA1)、载脂蛋白B(apoB)和稳态模型的胰岛素抵抗指数(HOMA-IR)的变化及其相互间的关系和意义。方法测定24例2型糖尿病患者(T2DM组)、22例糖耐量受损患者(IGT组)和36例健康成人(正常对照组)的Lp(a)、apoA1、apoB等血脂指标,同时检测T2DM组和IGT组的空腹血糖、空腹胰岛素并计算HOMA-IR,分析T2DM及IGT患者血脂指标的变化及其与HOMA-IR的关系。结果 T2DM组、IGT组与正常对照组比较Lp(a)、apoB、apoB/apoA1显著升高(P<0.01),apoA1显著降低(P<0.05);T2DM组与IGT组之间的差异有统计学意义,且两组间apoB、apoB/apoA1与HOMA-IR有显著的相关性(P<0.05)。结论 Lp(a)、apoB、apoB/apoA1等血脂指标与T2DM的发生发展有关,且apoB、apoB/apoA1与胰岛素抵抗显著相关,在CV危险评估、病情与治疗监测等方面有重要的应用价值。
Objective To investigate the changes of lipoprotein (a) [Lp (a)], apolipoprotein A1 (apoA1), apolipoprotein B (apoB) and insulin homeostasis model in type 2 diabetic patients and impaired glucose tolerance (IGT) Resistance index (HOMA-IR) changes and their mutual relations and significance. Methods Serum lipids of Lp (a), apoA1 and apoB in 24 type 2 diabetic patients (T2DM group), 22 patients with impaired glucose tolerance (IGT group) and 36 healthy adults (normal control group) Fasting blood glucose and fasting insulin in patients with IGT, IGT and HOMA-IR were calculated. The changes of serum lipids and the relationship with HOMA-IR in T2DM and IGT patients were analyzed. Results Compared with the normal control group, the levels of Lp (a), apoB and apoB / apoA1 in T2DM group and IGT group were significantly increased (P <0.01) and apoA1 was significantly decreased (P <0.05). There was statistical difference between T2DM group and IGT group Significance, and there was a significant correlation between apoB, apoB / apoA1 and HOMA-IR (P <0.05). Conclusions Serum lipids such as Lp (a), apoB and apoB / apoA1 are related to the occurrence and development of T2DM. And apoB, apoB / apoA1 are significantly associated with insulin resistance and have important value in risk assessment of CV, disease and treatment monitoring.