老年糖尿病脂餐后脂代谢变化规律的进一步研究

目的探讨老年糖尿病脂餐后脂代谢变化规律。方法测定30例老年糖尿病患者空腹与脂肪餐后2、4、6、8h的总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白A1（ApoA1）及载脂蛋白B（ApoB），并与10例健康老人及10例老年单纯高脂血症患者作对照。结果①老年糖尿病组空腹及餐后2、4、6、8h5个时点的HDL-C及ApoA，明显低于对照组（P〈0．05），其他脂代谢指标各时点组间差异均无显著性。②老年糖尿病组空腹及餐后2、4、6、8h等5个时点的TC明显低于高脂血症组（P〈0．05）；老年糖尿病组空腹及餐后2、4、8h4个时点的TG明显低于高脂血症组（P〈0．05）；老年糖尿病组餐后4、6、8h3个时点的LDL-C明显低于高脂血症组（P〈0．05）；老年糖尿病组空腹及餐后2、4、6、8h5个时点的HDL-C与高脂血症组比较，差异均无显著性；老年糖尿病组餐后2、4、6h3个时点的ApoA，明显低于高脂血症组（P〈0．05）；老年糖尿病组空腹及餐后2、4、6、8h5个时点的ApoB明显低于高脂血症组（P〈0．05）。⑧老年糖尿病组HDL-C．曲线下面积（AUC）及ApoA1-AUC明显小于对照组（P〈0．05）；老年糖尿病组LDL-C-AUC及ApoA1-AUC明显小于高脂血症组（P〈0．05）。结论HDL-C及ApoA1下降是老年糖尿病患者空腹及餐后脂代谢紊乱的主要特征。3组人群空腹血脂指标高低决定餐后血脂的变化，与是否患有糖尿病无关。

Further research on fat metabolism after fatty meal in elderly patients with diabetes

Objective To investigate the fat metabolism after fatty meal in elderly patients with diabetes. Methods In 30 elderly patients with diabetics,the total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),apolipoprotein A_1(ApoA_1)and apolipoprotein B(ApoB)were determined on an empty stomach and 2,4,6,8 hours after fatty meal.Then these data were compared with those of 10 healthy subjects and 10 elderly patients with hyperlipemia respectively. Results Compared with the control group,HDL-C and ApoA_1 on an empty stomach and 2,4,6,8 hours after fatty meal were significantly lower in the elderly patients with diabeties.Compared with the hyperlipemia group,TC,ApoA_1 and ApoB of the elderly patients with diabetes were significantly lower(P<0.05) .The area under curve of HDL-C(HDL-C-AUC)and ApoA_1-AUC of the elderly patients with diabetics were significantly smaller than those of the control group and those of the hyperlipemia group(P<0.05). Conclusions Decreased HDL-C and ApoA_1 are the main features of the dysfunction of fatty metabolism in the elderly patients with diabetes.