| Objective :Most individuals consume 3 or more meals daily and because triglycerides may take 8–12 h to return to fasting concentrations after eating, most of the day is spent in the postprandial state. So the fasting serum lipid may not reflect exactly physiological condition. Determination of postprandial lipids increasing attention. At present a number of studies show that postprandial triglyceride levels and atherosclerosis are closely related.Type 2 diabetes are common diseases, the prevalence rate with the aging population and lifestyle changes to increase, and its complications ,in particularly, atherosclerosis as the main pathological features of macrovascular disease in diabetic patients is one of the main reasons cause the death of disability.The lipid levels of coronary heart disease with diabetes mellitus in patients, particularly postprandial lipid levels are needed more study.We measured blood lipids concentrations 4 h after the administration of calibrated fat loads in patients with coronary heart disease(CHD),and CHD patients with type 2 diabetes.Compare the results of fasting and nonfasting state between the two groups.Methods: Choose from October, 2008 to February,2009 in the Second Hospital affiliated Hebei Medical University inpatient of CHD patients with type 2 diabetes mellitus: 21 cases, patients with CHD alone: 30 cases. Diagnosis of coronary heart disease: a history of previous myocardial infarction(MI) or have coronary angiography has confirmed that specific coronary stenosis. Diabetes diagnosis in accordance with the diagnostic criteria of WHO1999.All of the patients were excluded from the thyroid, liver, kidney, pancreatic disease, exclusion of chronic wasting disease and malignant neoplasms , without undesirable and diarrhea history, fasting TG<5mmol/L,without taking lipid lowing drugs, and postmenopausal women didn't take estrogen .we measured the concentration of lipids in fasting serum and 4 hours after a standard fat test meal (600kcal/m2 body surface area, and the fat, protein and carbohydrate provideed energy respectively is 60% , 14% and 26%. The ratio of polyunsaturated fatty acids and saturated fatty acids is 0.1).Statistical analysis: Measurements data to use the mean value±standard deviation. The statistical method between the two groups compares uses T-test, count data using chi-square test. The main data were tested for normality and homogeneity of variance test.P<0.05 has significance for difference.carries on the statistical analysis using statistical analysis software SPSS16.0.Results: The fasting total cholesterol (TC), triglyceride(TG), levels of CHD patients with type 2 diabetes were 4.73± 0.97mmol /L, 1.72±0.69 mmol/L, significantly higher than that in CHD group ,which were 4.23±0.77mmol /L , 1.30±0.67 mmol/L(P<0.05),with statistical difference. low-density lipoprotein cholesterol(LDL-C),ApolipoproteinB(ApoB) levels wree 2.82±0.84mmol /L, 1.00±0.26 mg / dl, higher than the simple CHD group ,which were 2.39±0.71 mmol /L ,0.89±0.22 mg/dl (P> 0.05), no statistical difference. The high-density lipoprotein cholesterol (HDL-C) level of CHD patients with type 2 diabetes was 1.10±0.22 mmol/L, significantly lower than that in patients with CHD alone,which is 1.23±0.18 mmol /L (P <0.05), ApolipoproteinA(ApoA) was 1.20±0.18 mg / dl ,lower than the simple group of CHD ,which is 1.23±0.23 mg / dl (P> 0.05). Postprandial TG concentration at 4 hours of coronary heart disease with diabetes mellitus group was 4.46±1.30 mmol / L, significantly greater than the simple CHD group, 3.34±1.45mmol /L (P <0.01). 4-hour postprandial serum TG concentration and fasting plasma TG concentration difference (△TG) levels in coronary heart disease with diabetes mellitus group was 2.74±1.20 mmol /L, significantly greater than the simple CHD group, 2.04±1.12 mmol / L (P <0.05 ).Conclusions:Fasting blood lipid disorder in CHD patients with diabetes mellitus is more serious than that in patients with CHD alone, especially with TG increased, HDL-C lowed. postprandial triglyceride levels in patients CHD with diabetes are more pronounced fluctuation than that in patients with CHD alone. |
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