范培云，姚勇利**，刘佳佳，李亚楠，罗　玮，周　环

(1.青海省人民医院糖尿病科；2.青海大学；3.北京第二炮兵总院医学影像科)



高甘油三脂血症-腰围表型与超敏C反应蛋白在糖尿病下肢血管病变中的临床意义*

范培云1，姚勇利**1，刘佳佳2，李亚楠1，罗玮1，周环3

(1.青海省人民医院糖尿病科；2.青海大学；3.北京第二炮兵总院医学影像科)

摘要目的探讨2型糖尿病患者高甘油三脂血症-腰围表型(HTWP)及超敏C反应蛋白(hs-CRP)在下肢血管病变中的意义。方法将66例2型糖尿病患者分成两组：糖尿病合并下肢血管病变组(30例)和无血管病变组(36例)。同时根据甘油三脂及腰围分为高甘油三脂血症-腰围表型组(HTWP组，28例)和非高甘油三脂血症-腰围表型组(非HTWP组，38例)，并检测患者糖化血红蛋白(HbA1c)、超敏c反应蛋白(hs-CRP)及血脂。结果(1)HTWP组下肢血管病变发生率明显高于非HTWP组，且病变程度更重；(2)下肢血管病变组患者的hs-CRP、TG、LDL-C及体重指数、腰围显著高于无血管病变组，HDL-C明显低于无血管病变组。结论高甘油三脂血症-腰围表型、hs-CRP可作为指标用于糖尿病下肢血管病变的诊断。

关键词高甘油三脂血症-腰围表型2型糖尿病超敏C反应蛋白下肢血管病变

THE CLININAL SIGNIFICANCE OF THE

HYPERTRIGLYCERIDEMIC WAIST PHENOTYPE(HTWP)

AND HIGH-SENSITIVITY C-CREACTIVE PROTEIN(hs-CRP)

IN TYPE 2 DIABETES WITH THE

LOWER LIMB VASCULAR LESION*

Fan Peiyun1，Yao Yongli**1，Liu Jiajia2，Li Yanan1，Luo Wei1，Zhou Huan3

(1.Qinghai Provincial People′s Hospital；2.Qinghai University；

3.Department of Medical Imaging，Beijing General Hospital of Second artillery Force)

Abstract ObjectiveTo investigate the hypertriglyceridemic waist phenotype(HTWP)and high-sensitivity C-reactive protein(hs-CRP)in type 2 diabetes with the lower limb vascular lesion.Method A total of 66 patients were divided into T2DM complicated with lower limb vascular lesion group(group A，n=30)，patients with T2DM group(group B，n=36)，at the same time，according to the waist and triglyceride(TG)，the patients were subdivided into HTWP group and non- HTWP group.Level of serum HbA1C，blood lipid and hs-CRP in four groups were determined and compared.Result 1)The incidence and degree of lower limb vascular lesion in HTWP group were significantly higher than that of in the non- HTWP group，2)The level of hs-CRP，BMI，waist diameter，TC，TG and LDL-C in group A were significantly higher than those in the group B，The level of HDL-C in group A are significantly lower than that in the group B.Conslusion The hypertriglyceridemic waist phenotype(HTWP)and high-sensitivity C-reactive protein(hs-CRP)may have a certain clinical value for the diagnosis of the lower limb vascular lesion in type 2 diabetes.

KeywordsHypertriglyceridemic waist phenotypeType 2 diabetesHigh-sensitivityC-reactive proteinLower limb vascular lesion.

高甘油三脂血症-腰围表型与超敏C反应蛋白是否有助于早期评价糖尿病下肢血管病变的患病风险，目前国内报道角度不一且结果有异。

高甘油三脂一腰围表型(HTWP)首先是由Lemieux等[1]提出的。当甘油三脂TG≥1.7 mmoL/L，同时腰围≥ 90CM即可被认为是筛查代谢综合症的一种简单而且准确性较高的指标，可用于评估2型糖尿病和缺血性心脏病的患病风险。……