| Objective:At present,there are many studies on the blood lipid metabolism of diabetic patients at home and abroad,but there are few studies on the blood lipid metabolism of Tibetan T2 DM patients in the plateau region,and different opinions are held.In the center on the plateau Tibetan population blood lipid metabolism research based on the review and meta-analysis of different elevation in plateau area Tibetan blood lipid metabolism characteristics of T2 DM patients and the diet,living habits and other relevant factors of clinical research,to explore the related factors influencing the blood lipid metabolism under different altitude has particularity,for the Tibetan plateau area in patients with type 2 diabetes prevention of dyslipidemia with clinical data.Methods:Sixty Tibetan patients with type 2 diabetes who visited the endocrinology department of the affiliated hospital of Qinghai university and 60 Tibetan patients with type 2 diabetes who visited the internal medicine department of BaYi hospital were randomly selected from November 2017 to November 2018.According to the altitude,the patients were divided into medium altitude group(average altitude is 2000m)(n=60)and high altitude group(average altitude is 4000m)(n=60).General data and biochemical indexes were collected,and face-to-face questionnaire survey was used to investigate patients' dietary habits and physical activity.The levels of blood lipid and other indexes were compared between the two groups and the correlation analysis of blood lipid metabolism was conducted.SPSS23.0 software was used for data analysis.Results: 1.Detection rate of Tibetan T2 DM patients combined with dyslipidemia : 42 Tibetan T2 DM patients with different degrees of dyslipidemia in the high altitude group,accounting for 70.00%.A total of 45 cases(75.00%)of Tibetan T2 DM patients with different degrees of dyslipidemia were found in the medium altitude group.2.There were no statistically significant differences between the two groups in gender,disease course,height,weight,BMI,waist circumference,smoking history and drinking history(P>0.05),while there were statistically significant differences in age and education level(P< 0.05).3.There were differences in TG and HDL-C between the two groups,and the differences were statistically significant(P< 0.05).TG of the high-altitude group was lower than that of the medium-altitude group,and HDL-C of the high-altitude group was higher than that of the medium-altitude group.There was no significant difference in TC and LDL-C between the two groups(P>0.05).4.There were differences in FPG,HOMA-IR,HOMA-?,RBC,HGB,HCT,BUN and Scr between the two groups(P< 0.05).FPG,RBC,HGB,HCT,BUN,Scr in the high altitude group was higher than that in the medium altitude group.There was no significant difference in HbAlc,FINS,UA between the two groups(P>0.05).5.Compare the meat intake,physical activity differences between the two groups has no statistical significance(P>0.05).Intake of coarse grains(mainly highland barley),refined grains(mainly flour and rice),dairy(yogurt)and vegetables,movement form and the intensity of labor were difference which statistically significant between the two groups(P< 0.05).The differences were significant except for intake of yogurt and vegetable(P< 0.001).6.Single factor analysis of the influence of various indicators on blood lipid metabolism in Tibetan patients at different altitudes:In the moderate elevation group,TG had a correlation with FINS,HOMA-IR,meat intake and vegetable intake(P<0.05).Among them,there was a negative correlation with vegetable intake(r=-0.320)and a positive correlation with other indicators.No significant correlation was found between HDL-C,TC and LDL-C.In the high altitude group,TG was correlated with highland barley intake,rice and flour intake,meat intake and vegetable intake(P<0.05).Among them,there is a positive correlation with rice and flour intake(r=0.362)and meat intake(r=0.312),while there is a negative correlation with barley intake(r=-0.322)and vegetable intake(r=-0.394).TC was positively correlated with HbAlc(r=0.270)(P< 0.05).LDL-C is positively correlated with HbAlc(r=0.261),and negatively correlated with highland barley intake(r=-0.272)and yogurt intake(r=-0.258)(P< 0.05).7.Multivariate regression analysis on the influence of Tibetan T2 DM patients withdifferent altitudes showed that vegetable intake was negatively correlated with TG in both groups(P<0.01),and vegetable intake was the main influencing factor of TG in moderate altitude group and high altitude group.Conclusion: 1.The main manifestations of dyslipidemia in Tibetan T2 DM patients in the plateau area are: high TG and low HDL-C.TG level decreased and HDL-C level increased with elevation.2.The dyslipidemia of T2 DM patients in Tibetan areas at high and moderate altitudes is related to their dietary habits to some extent.TG and LDL-c of T2 DM patients in Tibetan areas at high elevations are affected by dietary habits,while TG is the only one affected by dietary habits in Tibetan T2 DM patients in moderate elevations.Among them,vegetable intake was the main influencing factor,and the lower vegetable intake was,the higher blood TG was.3.Abnormal blood lipids in Tibetan T2 DM patients in the plateau area are closely related to insulin resistance and glycosylated hemoglobin.4.Environment may be a factor affecting T2 DM in Tibetan patients at different altitudes. |
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