糖耐量减退患者餐后三酰甘油及动脉粥样硬化相关性.doc

糖耐量减退患者餐后三酰甘油及动脉粥样硬化相关性 　 作者：杨玲 陈军建 王东 徐萍 【摘要】 目的： 探讨空腹三酰甘油（TG）正常(TGlt;1.7 mmol/L)的糖耐量减退（IGT）患者脂肪餐后TG水平的动态变化及其对动脉粥样硬化形成的影响。方法： 选择健康志愿者31例作为对照组（NC组）, 45例IGT患者为糖耐量减退组（IGT组），通过脂肪餐负荷试验对两组进行餐后TG代谢的研究。按脂肪餐后4 h TG水平将IGT组分为餐后正常组（PNTG组）和餐后增高组（PHTG组）, 使用彩超仪检测所有受试者颈动脉内膜厚度（CIMT）从而进行相关分析。结果： 对照组和IGT组餐后TG都有所升高,峰值在餐后4 h。IGT组曲线下三酰甘油面积（TGAUC）和餐后4 h TG水平的相关性最显著(Plt;0.05)。PHTG组、PNTG组和对照组CIMT分别为(1.02±0.43) mm,(0.71 ±0.20)mm和(0.73±0.22) mm，颈动脉斑块发生率分别为81.4 %，50.6 %和45.3 %，PHTG组均明显高于对照组和PNTG组,差异具有显著性统计学意义(Plt;0.05)。以CIMT为因变量,其他指标为自变量,进行多元线性相关分析,发现CIMT与体质量指数（BMI）、年龄（AGE）、收缩压（SBP），TGAUC，TG4 h呈正相关,相关系数分别为0.348，0.311，0.352，0.497，0.482，Plt;0.05。结论： IGT患者餐后4 h的TG水平异常先于空腹TG异常，其增高与动脉粥样硬化有相关性，故应常规检测IGT患者的餐后TG和CIMT。 【关键词】 糖耐量减退； 餐后血脂； 口服脂肪餐负荷试验； 颈动脉内膜中层厚度 ［Abstract］ Objective: To study the dynamic change of postprandial lipid after a fat meal in patients of normotriglyceridemic IGT， and the relationship between the level of postprandial lipoprotein and the carotid intima media thickness(CIMT) in patients of IGT.Methods： In 45 IGT patients and 31 healthy subjects, postprandial lipids were measured after a fatty test meal, 45 subjects of IGT were divided into two groups: the PHTG and PNTG.The CIMT was measured using echography, and 31 normal subjects served as controls. Results： Postprandial TG levels was obviously higher than fasting levels(Plt;0.05).The TG level reached its peak value at 4 h.The TG peak of IGT were both significantly higher than that of the control group(Plt;0.05).The absolute value of CIMT in PHTG was significantly higher than that of the control group(Plt;0.05). No significantly different was found between the control group and PNTG(Pgt;0.05).CIMT were positively related to the body mass index(BMI), age, SBP，TGAUC，TG4h(0.348，0.311，0.352，0.497，0.482。Plt;0.05). Conclusion： The postprandial dyslipidemia usually appeared before fasting dyslipidemia in patients with IGT， Postprandial dylipemia led to cause atherosclerosis.The carotid intima media thickness and postprand