摘要:目的 探讨小而密低密度脂蛋白胆固醇(sdLDLC)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 sdLDLC 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 sdLDLC 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 sdLDLC 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 sdLDLC、TC、TG、Lp(a)、 FPG、Cr 及 TBil 存在差异,其中病例组患者的 sdLDLC 水平显著高于对照组(P<0.001);而性别、年龄、HDLC 及 LDLC 差异 无统计学意义(P>0.05)。多因素 Logistic 回归分析结果显示 sdLDLC 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 sdLDLC 水平明显高于单纯 T2DM 患者,sdLDLC 可能是糖尿病微血管病变的危险因素。
Abstract:Objective To investigate the relationship between small dense low density lipoprotein cholesterol (sdLDLC)and microan giopathy in type 2 diabetes mellitus. Methods (1)The relevant literatures on sdLDLC 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 Metaanalysis 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 sdLDLC 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 casecontrol studies were included in this metaanalysis, and 1 597 patients met the inclusion criteria,including 642 patients with simple T2DM (control group)and 955 patients with microan giopathy (case group). Metaanalysis showed that the serum sdLDLC 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 sdLDLC,total cholesterol (TC),serum triglyceride (TG),Lipoprotein(a)[Lp(a)],fasting plasma glucose (FPG),creatinine (Cr)and total bilirubin (TBil)between control group and case group,and the sdLDLC 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,HDLC and LDLC (P> 0.05). Multivariate logistic regression analysis showed that sdLDLC was an independent risk factor for diabetic microangiopathy in T2DM patients (P<0.01). Conclusion The level of serum sdLDLC in the patients with diabetic microangiopathy was significantly higher than that in simple T2DM patients,and sdLDLC may be a risk factor for diabetic microangiopathy.
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