小而密低密度脂蛋白胆固醇与 2 型糖尿病微血管病变 的相关性分析
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Correlation analysis for small dense LDL cholesterol and microangiopathy in type 2 diabetes mellitus
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    摘要:目的 探讨小而密低密度脂蛋白胆固醇(sdLDLC)与 2 型糖尿病微血管病变之间的关系。方法 (1)检索 PubMed、The Cochrane Library、EMbase、CNKI、VIP、万方数据库及 CBM 等数据库,收集 sdLDLC 与 2 型糖尿病微血管病变相关的文献,检索 时限为建库至 2021 年7 月,提取相关数据,并用stata16.0 软件进行分析。(2)收集武汉大学中南医院2019 年3 月至2021 年2 月确诊的 305 例 2 型糖尿病(T2DM)患者,其中单纯 T2DM 患者(对照组)119 例,T2DM 微血管病变患者(病例组)186 例。测 定所有患者的血清 sdLDLC 及其他相关临床代谢指标,采用 SPSS26.0 软件对收集的数据进行处理与分析。结果 (1)本次 Meta 分析共纳入 6 篇病例对照研究,1 597 例患者符合纳入标准,单纯 T2DM 患者(对照组)642 例,T2DM 微血管病变患者(病 例组)955 例。Meta 分析结果显示,与对照组比较,病例组患者的血清 sdLDLC 水平明显升高,差异具有统计学意义(SMD = 0.56,95%CI:0.33~ 0.78,P<0.001)。Begg′s 检验和 Egger′s 检验结果显示各项研究间无明显的发表偏倚,敏感度分析认为本次 Meta 分析结果具有稳定性与可靠性。(2)回顾性分析 305 例 T2DM 患者,对照组和病例组患者的 sdLDLC、TC、TG、Lp(a)、 FPG、Cr 及 TBil 存在差异,其中病例组患者的 sdLDLC 水平显著高于对照组(P<0.001);而性别、年龄、HDLC 及 LDLC 差异 无统计学意义(P>0.05)。多因素 Logistic 回归分析结果显示 sdLDLC 是 T2DM 患者并发微血管病变的独立危险因素(P< 0.01)。结论 糖尿病微血管病变患者 sdLDLC 水平明显高于单纯 T2DM 患者,sdLDLC 可能是糖尿病微血管病变的危险因素。

    Abstract:

    Abstract:Objective To investigate the relationship between small dense low density lipoprotein cholesterol (sdLDLC)and microan giopathy in type 2 diabetes mellitus. Methods (1)The relevant literatures on sdLDLC and microangiopathy in type 2 diabetes melli tus (T2DM)were searched from PubMed,Cochrane Library,Embase,CNKI,VIP,Wanfang and CBM databases. The retrieval time limit was from the inception of the databases to July 2021. The correlative data were extracted and Metaanalysis was performed by STA TA software version 16 .(2)The data of 305 patients with T2DM in Zhongnan Hospital of Wuhan University from March 2019 to Febru ary 2021 were collected,including 119 patients with simple T2DM (control group)and 186 patients with microvascular disorders (case group). The levels of serum sdLDLC and other related clinical metabolic indicators were measured. The collected data were processed and analyzed by using SPSS software version 26. Results (1)A total of 6 casecontrol studies were included in this metaanalysis, and 1 597 patients met the inclusion criteria,including 642 patients with simple T2DM (control group)and 955 patients with microan giopathy (case group). Metaanalysis showed that the serum sdLDLC levels in the case group increased with statistically significant difference compared with the control group (SMD= 0.56,95%CI:0.33-0.78,P<0.001). The results of Begg′s test and Egger′s test showed that there was no significant publication bias among the studies,and sensitivity analysis suggested that the results of this Meta analysis were stable and reliable. (2)A retrospective analysis for 305 T2DM patients showed that there were statistical differences in sdLDLC,total cholesterol (TC),serum triglyceride (TG),Lipoprotein(a)[Lp(a)],fasting plasma glucose (FPG),creatinine (Cr)and total bilirubin (TBil)between control group and case group,and the sdLDLC levels in case group were significantly higher than those of control group (P<0.001),but no statistically significant difference was found in gender,age,HDLC and LDLC (P> 0.05). Multivariate logistic regression analysis showed that sdLDLC was an independent risk factor for diabetic microangiopathy in T2DM patients (P<0.01). Conclusion The level of serum sdLDLC in the patients with diabetic microangiopathy was significantly higher than that in simple T2DM patients,and sdLDLC may be a risk factor for diabetic microangiopathy.

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漆道西,郑芳.小而密低密度脂蛋白胆固醇与 2 型糖尿病微血管病变 的相关性分析[J].临床检验杂志,2022,(07):510-515

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  • 收稿日期:2022-01-14
  • 最后修改日期:2022-08-17
  • 录用日期:2022-06-17
  • 在线发布日期: 2022-09-26
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