老年2型糖尿病和冠心病患者高密度脂蛋白与高密度脂蛋白中血清淀粉样蛋白A含量改变的相关性

目的研究老年2型糖尿病(T2DM)和冠心病(CHD)患者高密度脂蛋白(HDL)与HDL中血清淀粉样蛋白(SA)A含量变化的相关性。方法选取老年T2DM、CHD患者54例,T2DM组18例,CHD组19例,T2DM+CHD组17例,另抽选15名老年健康人员作为健康参考组,统计调查各组临床特征及血脂、血糖指标,检测HDL中SAA水平,各组细胞间黏附分子(ICAM)-1、血管细胞黏附分子(VCAM)-1、人急性单核细胞白血病细胞株(THP-1细胞)黏附能力变化。结果各组年龄、体重指数(BMI)、性别、总胆固醇(TC)差异无统计学意义(P0.05);各组高血压、吸烟、三酰甘油(TG)、HDL、血糖与CHD组差异有统计学意义(P0.05)。HDL中SAA指标,各组差异有统计学意义(P0.05);ICAM-1表达各组差异有统计学意义(P0.05);VCAM-1表达检测在T2DM+CHD组最高,与其他组差异有统计学意义,T2DM组与CHD组VCAM-1表达略有上升,与健康参考组对比差异无统计学意义(P0.05);THP-1表达检测T2DM+CHD组最高,T2DM组与CHD组次之,各组差异有统计学意义(P0.05)。HDL中SAA与ICAM-1表达正相关;THP-1细胞黏附呈负相关;与VCAM-1表达无明显相关性。结论 HDL受病理因素转变可造成HDL原有生物反应机制受限,SAA含量越多,HDL抑制黏附能力越弱。     

糖尿病冠心病患者心肌细胞中磷脂酰基转移酶1水平的变化及影响因素分析

目的检测磷脂酰基转移酶1(ALCAT1)的mRNA及蛋白质水平在冠心病(CHD)合并T2DM患者心肌细胞中的变化,并探讨其影响因素。方法选取河南省人民医院行心脏手术的风湿性心脏病(RHD)、RHD合并T2DM(RHD+T2DM)、单纯CHD及CHD合并T2DM(CHD+T2DM)患者共131例。手术中取右心耳米粒大小组织,PCR检测ALCAT1的mRNA表达水平;Western blot检测AL—CAT1的蛋白表达水平。结果 (1)4组SBP、DBP、TC、LDL-C、HDL-C、TG、FPG、HbA在c、血肌酐(Scr)及心脏射血分数(EF)等指标比较,差异有统计学意义(P0.05);(2)ALCAT1的mRNA水平在4组间比较,差异有统计学意义[(0.029±0.005)vs(0.041±0.004)vs(0.036±0.006)vs(0.053±0.004),P0.05]。ALCAT1的蛋白表达呈相似趋势(P0.05);(3)ALCAT1的mRNA水平与年龄、SBP、DBP、TC、LDL-C、TG、FPG、HbA在c、Scr水平呈正相关,与HDL—C及EF呈负相关(P0.05)。结论 CHD患者心肌细胞中ALCAT1的mRNA及蛋白水平较RHD患者高,并发糖尿病的患者比不伴发糖尿病者高,间接提示了CHD及糖尿病会加重心肌细胞中心磷脂的病理重构,并引起线粒体的功能障碍。     

血清脂联素在2型糖尿病合并冠心病中的临床价值

目的检测2型糖尿病合并冠心病患者血清脂联素并研究其临床价值。方法选择2型糖尿病合并冠心病患者(T2DM+CHD组)和正常健康人(CON组)为研究对象,检测并比较两组研究对象血清脂联素和常规生化指标差异,分析T2DM+CHD组患者血清脂联素与Gensini积分的相关性。结果 T2DM+CHD组2型糖尿病合并冠心病患者FBG、TC、TG、LDL和LP(a)均显著高于CON组正常健康人,而HDL和脂联素均显著低于CON组正常健康人,差异均具有统计学意义(P0.05)。将T2DM+CHD组2型糖尿病合并冠心病患者血清脂联素与Gensini积分进行相关性分析,表明脂联素和Gensini积分呈负相关(均rs=-0.533,P=0.031)。脂联素水平越低表示Gensini积分越高,冠状动脉病变越严重。结论血清脂联素与2型糖尿病合并冠心病发病紧密相关,可能在2型糖尿病合并冠心病病情及预后评估中具有一定临床价值。     

可溶性P-选择素和CD40L与2型糖尿病合并冠心病的相关性

目的 探讨可溶性P选择素(sP-Selectin)和CD40L与2型糖尿病(T2DM)合并冠心病之间的关系.方法 将87例T2DM患者分为40例T2DM合并冠心病(T2DM+ CHD)组和47例单纯T2DM组,选择同期正常健康人32例(年龄、性别与T2DM组相匹配)作为正常对照组,采用双抗夹心酶联免疫吸附检测sP-Selectin和CD40的水平,并作相关分析.结果 T2DM组的P-Selectin、CD40L显著高于正常对照组(P＜0.05).T2DM+ CHD组sP-Selectin、CD40L高于T2DM组(P＜0.05),T2DM+ CHD组的CD40L与体重指数(BMI)、收缩压(SBP)、甘油三酯(TG)、空腹血糖(FPG)、低密度脂蛋白(LDL)、sP-Selectin正相关(r=0.53,0.52,0.66,0.58,0.46,0.618,P＜0.05),与HDL呈负相关(相关系数r=-0.40,P＜0.05).结论 sP-Selectin、CD40L与T2DM并冠心病之间存在密切的相关性,在T2DM并冠心病的发生、发展中起着重要作用,测定sP-Selectin、CD40L可能作为T2DM并冠心病的预测因子.     

老年冠心病合并糖尿病患者血脂及尿酸水平

目的探讨老年冠心病(CHD)合并糖尿病(DM)患者与单纯CHD患者之间的血脂及尿酸(UA)水平差异。方法 2013年2月至2014年2月对在某医院接受诊断与治疗的≥60岁CHD患者按照是否合并2型糖尿病(T2DM)进行分组研究,比较CHD组和CHD+DM组在血脂及UA水平方面的差异,探讨老年人群中CHD合并DM患者与其血脂及UA水平之间的关系。结果 CHD组和CHD合并DM组患者年龄、性别、体重指数(BMI)、收缩压、舒张压及高血压发生率等方面比较均无明显差异(P0.05)。而CHD并DM组的吸烟例数明显低于CHD组(P0.05)。CHD并DM组患者的甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、UA均高于CHD组(P0.05)。结论治疗合并T2DM的老年CHD患者时,除应控制血糖外,还应加强调脂治疗和控制UA水平。     

老年2型糖尿病合并冠心病患者尿微量白蛋白与心功能的关系

目的探讨老年2型糖尿病(T2DM)并冠心病(CHD)患者尿微量白蛋白(MALB)与心功能的关系。方法将252例患者分为T2DM+CHD组(67例)、CHD组(68例)和T2DM组(67例),同时选择本院同期健康体检者50例作为对照组。测定所有研究对象的左心房直径(LA)、左心室后壁厚度(LVPW)及左室射血分数(LVEF)及MALB、血糖、胰岛素C肽(空腹+餐后2 h)、血脂、糖化血红蛋白(HbA1c)等指标。结果T2DM+CHD组的血脂(TC、LDL、HDL)、血糖、胰岛素和C肽与对照组和CHD组比较,差异有统计学意义(P<0.05);T2DM+CHD组的LA和LVEF与其余三组比较,差异有统计学意义(P<0.05),LVPW显著高于对照组和T2DM组(P<0.05);T2DM+CHD组中MALB与LVPW、LA呈正相关(r=0.356、0.326,P<0.05),与LVEF呈负相关(r=-0.447,P<0.05)。结论老年T2DM+CHD患者MALB水平与心功能具有相关性,高水平MALB可导致心功能的减退。     

冠心病合并2型糖尿病患者临床和冠脉病变特点分析

目的探讨冠心病(CHD)合并2型糖尿病(DM)患者的临床和冠脉病变特点。方法136例冠心病患者,合并2型糖尿病者为DM组(67例),不伴糖尿病者为非DM组(69例),比较两组患者的临床和冠脉造影资料。结果DM组症状不典型者、合并高血压、心肌梗死、心力衰竭者均明显高于非DM组(P0.05);三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、脂蛋白(a)[LP(a)]水平DM组高于非DM组(P0.05);而HDL水平则明显降低(P0.05);DM组冠脉病变三支、弥漫性、闭塞性病变也明显高于非DM组。结论冠心病合并2型糖尿病患者临床有冠脉病变复杂特点。     

冠心病合并2型糖尿病与血浆Omentin-1及IL-6、hs-CRP的相关性

目的探讨血浆网膜素-1（Omentin-1）水平与冠心病（CHD）合并2型糖尿病（T2DM）炎性反应的关系,以及炎性反应蛋白和炎性因子在合并糖尿病中的相关性及意义。方法选取住院和门诊CHD患者60例,分为CHD组（28例）和CHD合并T2DM组（32例）。同期选取我院健康体检者26例作为正常对照组（NC组）。采用ELISA法检测血浆Omentin-1、IL-6和hs-CRP水平,进行对比分析。结果 CHD组、CHD合并T2DM组血浆Omentin-1水平均明显低于NC组,IL-6、hs-CRP水平均明显高于NC组;CHD合并T2DM组血浆Omentin-1水平显著低于CHD组,IL-6、hs-CRP水平均明显高于CHD组。CHD合并T2DM组外周血Omentin-1水平与IL-6、hs-CRP水平呈显著负相关（r=-0.353,P〈0.05;r=-0.581,P〈0.01）;hs-CRP与IL-6呈显著正相关（r=0.279,P〈0.05）。结论 CHD患者体内存在Omentin-1和IL-6,hs-CRP的异常表达,合并T2DM患者更为显著,且三者具有显著相关性。Omentin-1及IL-6、hs-CRP可能参与了CHD合并T2DM的发生、发展,此为早期干预CHD合并T2DM提供了理论依据。     

补体C1q肿瘤坏死因子相关蛋白1与脂联素水平的关系

目的探讨健康老年人、2型糖尿病(T2DM)老年患者、T2DM合并冠心病(CHD)老年患者及CHD老年患者补体C1q肿瘤坏死因子(TNF)相关蛋白1(CTRP1)与脂联素(ADPN)水平及其关系。方法采用酶联免疫法(ELISA)测定各组患者血清CTRP1及ADPN的水平。将患者分为对照组(n=42);T2DM组(n=30);并发症组(n=32);CHD组(n=31);定义对照组、CHD组为非糖尿病(DM)组;T2DM组、并发症组为DM组。结果 DM组血清CTRP1水平明显高于非DM组。DM组CTRP1水平与ADPN水平呈负相关关系。结论 CTRP1与T2DM有关。本实验结果支持目前关于CTRP1为ADPN有效补充的观点。     

内皮一氧化氮合酶基因5''''-侧翼区T-786→C突变与2型糖尿病并发冠心病的关系

目的研究血管内皮一氧化氮合酶(eNOS)基因5'-侧翼区T-786→C突变与2型糖尿病(T2DM)并发冠心病(CHD)的关系.方法选择T2DM患者186例,其中65例并发CHD;选择正常人63例作为对照.采用PCR/ASO杂交技术检测T-786→C突变. 结果与对照组相比,T2DM伴CHD组TC基因型及C等位基因频率明显增高(P＜0.05).与T2DM不伴CHD组相比,T2DM伴CHD组C等位基因频率明显增高(P＜0.05).在T2DM患者中,与TT组比较,TC组HbA1 c明显增高.多元logistic回归分析显示,年龄、血压、病程、LDL-C、脂蛋白(a)、HbA1c、C等位基因与CHD呈正相关(P＜0.01).结论eNOS基因5'-侧翼区T-786→C突变增高T2DM患者并发CHD的危险性.     

2型糖尿病并发高血压患者内皮功能的血浆生物指标的变化

目的探讨2型糖尿病患者并发高血压时内皮细胞损伤或功能紊乱的血浆生物指标的变化。方法测定31例糖尿病并发高血压患者、35例单纯糖尿病患者和32例正常人血压、空腹血糖、血浆甘油三酯、胆固醇、血栓调节蛋白(Tm)、一氧化氮(NO)、vW因子水平。统计学方法用t检验和直线相关分析。结果2型糖尿病并发高血压患者收缩压、舒张压、空腹血糖、血浆甘油三酯、胆固醇、Tm和vW因子高于正常人(P<0.01),NO低于正常人(P<0.01)。单纯糖尿病患者空腹血糖、血浆甘油三酯、胆固醇、Tm和vW因子高于正常人(P<0.01或P<0.05)。糖尿病并发高血压患者收缩压、舒张压、血浆甘油三酯、胆固醇、Tm和vW因子高于单纯糖尿病患者(P<0.01或P<0.05),NO低于单纯糖尿病患者(P<0.01)。2型糖尿病患者Tm与收缩压、舒张压、甘油三酯、胆固醇和vW因子呈正相关(r=0.353、r=0.324、r=0.257、r=0.265、r=0.404,P<0.01或P<0.05),vW因子与收缩压、舒张压、甘油三酯和胆固醇呈正相关(r=0.329、r=0.289、r=0.254、r=0.256,P<0.01或P<0.05),NO与收缩压、舒张压、Tm及vW因子呈负相关(r=-0.432、r=-0.402、r=-0.415、r=-0.467,P<0.01)。结论2型糖尿病合并高血压患者存在内皮细胞损伤或功能紊乱,其高血压的发生发展可能与血管内皮细胞的损伤或功能紊乱相关。     

高血压合并2型糖尿病患者的动脉弹性与内皮功能

目的探讨高血压合并2型糖尿病对动脉功能的影响。方法研究对象137例根据标准分为正常对照组、原发性高血压(EH)组、高血压合并2型糖尿病(EH 2DM)组,各组分别测定一氧化氮(NO)、一氧化氮合酶(NOS)、颈股脉搏波传导速度(cfPWV)及血流介导的血管舒张功能(FMD)和反应性充血(RH)。结果与对照组比较,EH 2DM组和EH组NO、FMD、RH值明显降低,cfPWV明显升高(P<0.01);与EH组比较,EH 2DM组的FMD、RH降低(P<0.05)。相关分析结果显示收缩压、舒张压、血糖、cfPWV与FMD负相关(r=-0.507,P=0.001;r=-0.404,P=0.001;r=-0.373,P=0.001;r=-0.270,P=0.001);NO与FMD正相关(r=0.256,P=0.002)。结论EH 2DM患者血管内皮功能和大动脉弹性进一步减退。     

糖代谢异常对冠心病相关血清微小RNA表达的影响

目的检测相关血清微小RNA(miRNA)在冠心病及糖尿病合并冠心病患者中的表达水平,探讨糖代谢异常对冠心病相关血清miR-126、miR-146表达的影响。方法选择患者48例,分别为对照组15例,冠心病组17例,糖尿病合并冠心病组(合并组)16例。采用TaqMan探针实时定量PCR技术,检测各组血清miR-126、miR-146;采用TaqMan实时荧光定量PCR对血清中靶miRNA丰度进行定量。结果与对照组比较,冠心病组及合并组患者miR-126基因表达明显上调(P<0.05),而miR-146基因表达虽有下调趋势,但差异无统计学意义(P>0.05)。Spearman相关分析显示,CT miR-126与空腹血糖、餐后2h血糖水平呈负相关(r=-0.686,P=0.002;r=-0.723,P=0.001)。结论糖代谢异常对冠心病相关血清miR-126的表达产生影响,从而在一定程度上为miR-126成为糖尿病大血管病变的血清学检测指标提供理论依据。     

2型糖尿病合并冠心病患者血小板表面CD62P和CD40L的表达水平

目的 探讨2型糖尿病合并冠心病患者血小板表面CD62P和CD40L的表达水平及其和血清高敏C反应蛋白的关系.方法 选择单纯冠心病患者34例、单纯2型糖尿病患者33例、2型糖尿病合并冠心病患者30例及对照者30例,采用流式细胞术分别检测血小板表面CD62P和CD40L的表达水平,并与血清高敏C反应蛋白作相关分析.结果 2型糖尿病合并冠心病组血小板CD62P、CD40L和高敏C反应蛋白水平较对照组、单纯冠心病组及单纯2型糖尿病组显著升高(P<0.01),血小板CD62P和CD40L与血清高敏C反应蛋白水平呈正相关(r分别为0.343和0.495,P均<0.05).结论 2型糖尿病合并冠心病患者的血小板表面CD62P和CD40L表达水平明显升高,并与血清高敏C反应蛋白明显正相关.血小板表面CD62P和CD40L的表达水平可能是预示糖尿病患者合并冠状动脉粥样硬化的重要指标.     

Altered high-density lipoprotein composition is associated with risk for complications in type 2 diabetes mellitus in South Asian descendants: A cross-sectional,case-control study on lipoprotein subclass profiling

Background

Composition of high-density lipoproteins (HDL) is emerging as an important determinant in the development of microvascular complications in type 2 diabetes mellitus (T2DM). Dutch South Asian (DSA) individuals with T2DM display an increased risk of microvascular complications compared with Dutch white Caucasian (DwC) individuals with T2DM. In this study, we aimed to investigate whether changes in HDL composition associate with increased microvascular risk in this ethnic group and lead to new lipoprotein biomarkers.

Materials and Methods

Using ¹H nuclear magnetic resonance spectroscopy and Bruker IVDr Lipoprotein Subclass Analysis (B.I.LISA) software, plasma lipoprotein changes were determined in 51 healthy individuals (30 DwC, 21 DSA) and 92 individuals with T2DM (45 DwC, 47 DSA) in a cross-sectional, case-control study. Differential HDL subfractions were investigated using multinomial logistic regression analyses, adjusting for possible confounders including BMI and diabetes duration.

Results

We identified HDL compositional differences between healthy and diabetic individuals in both ethnic groups. Specifically, levels of apolipoprotein A2 and HDL-4 subfractions were lower in DSA compared with DwC with T2DM. Apolipoprotein A2 and HDL-4 subfractions also negatively correlated with waist circumference, waist-to-hip ratio, haemoglobin A1c, glucose levels and disease duration in DSA with T2DM, and associated with increased incidence of microvascular complications.

Conclusion

While HDL composition differed between controls and T2DM in both ethnic groups, the lower levels of lipid content in the smallest HDL subclass (HDL-4) in DSA with T2DM appeared to be more clinically relevant, with higher odds of having diabetes-related pan-microvascular complications such as retinopathy and neuropathy. These typical differences in HDL could be used as ethnicity-specific T2DM biomarkers.     

中国北方汉族人2型糖尿病合并冠心病与KIF6基因Trp719Arg多态性的相关性

目的探讨中国北方汉族人群KIF6基因Trp719Arg多态性基因型和等位基因频率分布特点,及与2型糖尿病(DM)合并冠心病(CHD)的关联性。方法采用病例对照研究设计,应用聚合酶链反应限制性片段长度多态性(PCR-RFLP)技术分析了对照组(152例)、DM组(97例)、DM+CHD组(76例)KIF6基因Trp719Arg多态性;比较组间基因型和等位基因频率分布差异,研究基因多态性对血糖、血脂水平的影响。结果中国北方汉族人群Trp719Arg多态性TT、TC、CC基因型频率分别为0.281、0.499与0.220。T、C等位基因频率分别为0.531与0.469。KIF6基因Trp719Arg多态性基因型和等位基因频率组间分布差异无统计学意义(均为P>0.05)。KIF6基因Trp719Arg多态性对血糖、血脂水平无显著影响。Logistic回归分析显示,高血压、年龄(≥60岁)、低HDL-C水平(<1.04 mmol/L)是DM+CHD的独立危险因素(OR分别为2.850、12.977和4.006,均为P<0.05),C等位基因与DM+CHD的发生无统计学相关性。结论 KIF6基因Trp719Arg多态性可能不是我国北方汉族人群DM+CHD的独立危险因素。     

Triglyceride-rich lipoproteins are associated with hypertension in preeclampsia

Disorders of the lipoprotein metabolism are a major cause of endothelial dysfunction that may result in hypertension and proteinuria, clinical hallmarks of preeclampsia (PE). Lipoproteins and low-density lipoprotein (LDL) subfractions were investigated in 15 women with severe PE and compared with 23 women with a normal course of pregnancy. Compared with normal pregnancy, in PE apolipoprotein (apo)B in very low-density lipoprotein was increased by 76% (P = 0.008), and the triglyceride content of intermediate dense lipoproteins (IDL) was increased by 51% (P < 0.001); cholesterol and apoB in LDL were decreased by 26% (P = 0.005) and 23% (P = 0.016), respectively. Although not significant, the LDL profile was dominated by the most buoyant LDL-1. ApoB in the most dense LDL (dLDL), namely LDL-5 and LDL-6, was significantly decreased by 49% (P < 0.001) and 55% (P < 0.001), respectively. Diastolic blood pressure was positively correlated with the triglyceride content of IDL (r = 6.31; P < 0.001 and r = 0.352; P = 0.033 by partial correlation controlling for the presence or absence of PE) and negatively correlated with the concentration of apoB in dLDL (r = -0.500; P = 0.002). In addition, IDL triglycerides correlated negatively with infant birth weight percentile (r = -0.373; P = 0.027) and positively with proteinuria (r = 0.430; P = 0.014). Low birth weight was associated with high IDL triglycerides and low rather than high concentrations of dLDL. Triglyceride-rich remnants are known to cause endothelial dysfunction. Because the triglyceride content of IDL was positively correlated with elevated blood pressure and proteinuria, triglyceride-rich remnant lipoproteins might contribute to the pathophysiology of PE.     

Eosinophil count is positively correlated with coronary artery calcification

Recent studies suggested that allergic disorders and increased eosinophil count were associated with atherosclerosis. The purpose of this study was to assess the relationship between eosinophil count and coronary artery calcification (CAC). We performed a cross-sectional study in 1363 consecutive participants with clinical suspicion of coronary heart disease (CHD). We evaluated the relationships between CAC score determined by multislice CT and peripheral eosinophil count as well as major cardiovascular risk factors, including age, body mass index, smoking status, hypertension, dyslipidemia, diabetes mellitus (DM), high-sensitivity C-reactive protein and estimated glomerular filtration rate (eGFR). Sex (P=0.0004), hypertension (P=0.0002), dyslipidemia (P=0.0004) and DM (P=0.0061) were associated with log(CAC+1), respectively. Positive correlations were found between log(CAC+1), and age (r=0.325, P<0.0001) and eosinophil count (r=0.165, P<0.0001). Negative correlations were found between log(CAC+1) and eGFR (r=-0.166, P<0.0001). Multivariate linear regression analysis demonstrated that age (β=0.314, P<0.0001), sex (β=0.124, P<0.0001), hypertension (β=0.084, P=0.0008), DM (β=0.108, P<0.0001), eGFR (β=-0.079, P=0.0021) and eosinophil count (β=0.147, P<0.0001) were independent determinants of log(CAC+1). In conclusion, eosinophil count correlated positively with CAC in participants with clinical suspicion of CHD.     

Diabetes mellitus has an additional effect on coronary artery disease

We investigated whether plasma levels of adiponectin in patients with both coronary artery disease (CAD) and diabetes mellitus (DM) are lower than in patients with CAD alone. We examined plasma adiponectin levels in 113 patients, 82 with CAD (40 of whom had both CAD and type 2 DM) and 31 normal controls. We found differences in plasma adiponectin levels between CAD patients with and without DM (7.8 +/- 4.75 versus 12.1 +/- 6.87 microg/mL, P = 0.002), between patients with CAD and controls (10.0 +/- 6.27 versus 15.3 +/- 5.38 microg/mL, P < 0.0001), and between men and women (10.2 +/- 6.41 versus 13.1 +/- 6.22 microg/mL, P = 0.017). Plasma adiponectin levels were correlated negatively with body mass index, triglyceride, total cholesterol, hemoglobin A1c, and fibrinogen levels (r = -0.456, P < 0.0001; r = -0.355, P < 0.0001; r = -0.286, P = 0.002; r = -0.299, P < 0.0001; r = -0.400, P < 0.0001, respectively), but were not significantly correlated with high sensitivity C-reactive protein or low density lipoprotein levels (r = -0.088, P = 0.352; r = -0.167, P = 0.077, respectively). Plasma adiponectin levels correlated positively with high density lipoprotein levels (r = 0.410, P < 0.0001). Our study demonstrates that plasma adiponectin levels in patients with both CAD and DM are lower than in patients with CAD alone. We speculate that people who have very low plasma adiponectin levels may be at increased risk of developing both CAD and DM.     

老年2型糖尿病患者高密度脂蛋白亚类与氧化应激和颈动脉粥样硬化的相关性

目的 探讨老年2型糖尿病患者血清高密度脂蛋白(HDL)亚类的分布特点及其与氧化应激和颈动脉粥样硬化的相关性.方法 老年2型糖尿病患者56例,男40例、女16例;老年健康对照者41例,男31例、女10例.分别测定血清HDL亚类、血清8-异前列腺素F2α及颈动脉超声.结果 老年2型糖尿病组HDL3(0.51±0.21)mmol/L,较健康对照组(0.59±0.15)mmol/L降低(t=1.991,P＜0.05),HDL及HDL2亦较健康对照组降低,分别为(1.07±0.36)mmol/L对(1.18±0.32)mmol/L和(0.56±0.25)mmol/L对(0.64±0.33)mmol/L,但差异无统计学意义(t值分别为1.611和0.614,均为P＞0.05);HDL3与HbA1c负相关(r=-0.503,P=0.005);血清8-异前列腺素F2α吸光度A值较健康对照组降低,分别为0.017±0.004和0.021±0.008(t=2.245,P＜0.05);颈动脉平均内膜-中层厚度(IMT)较健康对照组升高,但差异无统计学意义;颈动脉斑块检出率63.3%,高于对照组的36.0%(x2=4.076,P＜0.05).结论 老年2型糖尿病患者HDL亚类水平存在异常,小颗粒的HDL3水平下降,氧化应激增加,可能是导致其动脉粥样硬化的原因之一.