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目的比较和评估老年2型糖尿病和非糖尿病患者小而致密LDL(sdLDL)水平的变化情况及相关血脂谱特点。方法共有132例老年2型糖尿病和137例老年非糖尿病患者符合入组条件。检测指标主要有糖化血红蛋白(HbA1c)、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-ch)、低密度脂蛋白胆固醇(LDL-ch)、载脂蛋白A(Apo-A)、载脂蛋白B(Apo-B)、载脂蛋白E(Apo-E)和脂蛋白a(Lp-a),并应用TG/HDL-ch评估sdLDL水平。结果老年2型糖尿病患者除HDL-ch明显低于老年非糖尿病患者外,血脂谱中其余各项指标的组间比较无显著性差异。分别有34.10%和27.00%的老年2型糖尿病和老年非糖尿病患者存在sdLDL水平的升高。当sdLDL水平正常时,老年2型糖尿病患者的血脂谱改变表现为HDL-ch明显低于老年非糖尿病患者(P<0.05);但这一差异在sdLDL水平升高时则不明显。结论老年2型糖尿病患者的血脂谱改变主要表现为高密度脂蛋白胆固醇的降低。应用TG/HDL-ch可初步筛查出存在小而致密LDL水平升高的患者。
Objective To compare and evaluate the changes of small and dense LDL (sdLDL) in elderly patients with type 2 diabetes mellitus and non-diabetic patients and the related lipid profiles. Methods A total of 132 elderly patients with type 2 diabetes and 137 elderly non-diabetic patients were eligible. The main indexes of detection were HbA1c, TC, TG, HDL-ch, LDL-ch, apolipoprotein A (Apo -A), apolipoprotein B (Apo-B), apolipoprotein E (Apo-E), and lipoprotein a (Lp-a) were measured and sdLDL levels were assessed using TG / HDL-ch. Results In elderly patients with type 2 diabetes mellitus, HDL-ch was significantly lower than those in non-diabetic elderly patients. There was no significant difference between the two groups in other parameters. There were 34.10% and 27.00% of elderly patients with type 2 diabetes and elderly non-diabetic patients there sdLDL levels increased. When the sdLDL level is normal, the serum lipid profile of elderly patients with type 2 diabetes is significantly lower than that of elderly non-diabetic patients (P <0.05). However, this difference is not obvious when sdLDL levels rise. Conclusion The changes of blood lipid profile in elderly patients with type 2 diabetes mainly reflect the decrease of high density lipoprotein cholesterol. Application of TG / HDL-ch can be initially screened for the presence of small and dense LDL levels in patients.