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2型糖尿病患者的脂蛋白 a 浓度和载脂蛋白 a 分型 |
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史虹莉 方京冲 杨秀芳 沈稚舟 朱禧星
【摘要】 目的 研究2型糖尿病患者的脂蛋白(a)〔Lp(a)〕浓度和载脂蛋白(a)〔apo(a)〕的多态性以及与糖尿病慢性并发症的关系。方法 本研究用改良的Utermann和Guo方法对40名非糖尿病对照和176名2型糖尿病患者进行apo(a)分型检测，观察其与Lp(a)浓度以及微血管和大血管并发症之间的关系，包括肾脏病变、视网膜病变、神经病变、高血压、冠心病、脑梗塞。结果 40名非糖尿病对照之apo(a)分型：S3S2、S4和S4S2的发生频率分别为20%、70%和10%，血清Lp(a)水平为(0.08±0.07)mg/L。而2型糖尿病患者S2、S3、S3S2、S4、S4S2和S4S3的发生频率分别为18.18%、20.45%、17.05%、34.09%、4.55%和5.68%，Lp(a)浓度为(0.13±0.11)mg/L，明显高于非糖尿病对照。与不伴有并发症的糖尿病患者比较，除糖尿病视网膜病变，伴肾脏病变、神经病变、高血压、冠心病、脑梗塞患者之apo(a)分型分布频率有显著差异。与S2基因表现型患者比较，S4表现型患者之空腹血糖、餐后2小时血糖和糖基化血红蛋白水平明显降低。不同基因表现型患者之Lp(a)浓度和尿白蛋白/肌酐水平具有明显差异，S2者最高，S3者其次，S4者最低。结论 2型糖尿病患者和非糖尿病对照之apo(a)基因表现型分布频率不同，同样伴有与不伴有微血管和大血管并发症的糖尿病患者之分布频率亦不同，可能与白蛋白尿和胰岛素抵抗有关。
【关键词】 糖尿病，2型 脂蛋白(a) 载脂蛋白(a)
Lipoprotein(a) concentration and apolipoprotein(a) phenotype in type 2 diabetic subjects
SHI Hongli,FANG Jingchong,YANG Xiufang,et al.Diabetes Research Department,Huashan Hospital,Shanghai Medical University,200040
【Abstract】 Objective To investigate the lipoprotein(a) concentration and apolipoprotein(a) 〔apo(a)〕 polymorphism in type 2 diabetic patients and its relationship to complications. Methods Apo(a) phenotypes were tested with modified Utermann and Guo method in 40 non-diabetic controls and 176 type 2 diabetic subjects and the association between apo(a) phenotypes and micro- and macrovascular complications including nephropathy, neuropathy, retinopathy, hypertension, coronary heart disease and cerebral infarction was analyzed. Results Among the 40 non-diabetic controls, the frequencies of S3S2, S4 and S4S2 were 20%, 70% and 10% respectively and the serum Lp(a) level was (0.08±0.07)mg/L. While the frequencies of S2, S3, S3S2, S4, S4S2, S4S3 were 18.18%, 20.45%, 17.05%, 34.09%, 4.55% and 5.68% respectively in the diabetics and the Lp(a) concentration was (0.13±0.11)mg/L, significantly higher in the diabetics than the non-diabetic controls. Compared with the diabetics without complicati[1] [2] 下一页
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