2型糖尿病脂代谢紊乱及胰岛素抵抗与视网膜病变的关系

测定了80例2型糖尿病和30例正常对照组的血脂谱、空腹血糖（FBG）、糖化血红蛋白（HbAlc）、空腹胰岛素（FISN）、胰岛素敏感指数（ISI）等指标并进行比较分析，将糖尿病患者分为：非糖尿病视网膜病变组（NDR）、背景期DR（BDR）及增殖期DR（PDR）。结果表明：与正常对照组比较，糖尿病各组HbAlc、FINS、FBG、甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白（LDL）、载脂蛋白-B（Apol-B）、载脂蛋白-A／B显著升高（P〈0．05或0．01），ISI、高密度脂蛋白（HDL-C）则明显降低（P〈0．05或0．01），各组之间载脂蛋白-Al（Apol-Al）含量无显著性差异（P〉0．05）；糖尿病各组间进行两两比较，TG、HbAlc在NDR组、BDR组、PDR组中逐渐升高，ISI则依次降低（P〈0．05），BDR组、PDR组FINS明显高于NDR组（P〈0．05）．但PDR组和BDR组之间差异无显著性（P〉0．05），各糖尿病组间的FBG、TC、LDL、Apol-B、Apol-A／B无显著性差异（P〉0．05）。说明脂代谢紊乱及胰岛素抵抗可能与2型糖尿病视网膜病变关系密切。

The Relationship Between Dyslipidemia, Insulin Resistance in Type 2 Diabetes Mellitus and Diabetic Retinopathy

The content of serum lipid,FBG,FISN,HbAlc were measured in 30 nomal cotrol subjects and 80 patients with type 2 diabetics mellitus who were divided into diabetic retinopathy group(PDR),background-diabetic retinopathy group(BDR),non-diabetic retinopathy group(NDR).Insulin resistance index(ISI) were also determined.These data were analysed by SPSS for windows of 11.0.Result:The mean levels of HbAlc,FINS,FBG,total triglyceride(TG),total cholestrerol(TC),low-density lipoprotein(LDL),apoprotein-B(Apol-B),Apol-A/B was significantly higher in diabetic group than those in cotrol group(P<0.01,0.05).ISI,high-density lipoprotein(HDL-C) were significantly lower in diabetic group than those in cotrol group(P<0.01,0.05),Apol-A1 in the two groups was similar(P>0.05).The content of TG,HbAlc was increased one by one(P<0.05) in NDR,BDR,PDR,the value of ISI was deceased by turns(P<0.05),FISN in the PDR,BDR was higher than those in NDR(P<0.05),but there was no differences between PDR groups and BDR groups(P>0.05),FBG,TC,LDL,Apol-B,Apol-A/B among the three diabetic groups were similar(P>0.05).Conclusion:Both abnomal metabolism of serum lipid and lipoprotein and insulin resistance probably play a significant function in the patients with diabetic retinopathy.