lOURNAL OF 108 - CUNICAL MEDICINE AND PHARMACY VoL12-N'1/201
Roi loan lipid mau & benli nhan dai thao duong typ 2 c(
bien chung than
Dyslipidemia in patients with type II diabetes with renal complications
Dang Thi Viet Ha*, Nguyin Van Thanh*, B 8 Gia Tuyin*, 'Trudng Dai Ape YHd Ng Trin H6ng Nghf* "Benh vifn Trung ucmg Qudn loi 101
T o m t a t
Muc tliu:T\ro h i l u dac d i l m rdi loan lipid m^u d nhiJng benh nhan dai t h i o d u d n g typ 2 cd bien chdng than va cac y l u t d lien quan. B6l tUOng vd phuong phdp: 60 benh nhan dai thao dudng t y p 2 cd b i l n chUng than. Nghi§n cUu md ta eat ngang. Ket qud: 31 benh nhan nam (51,7%), 29 benh nhan nCf (48,3%). Tuoi trung binh: 59,2 ± 9,7. Cholesterol TP d nhdm tuoi > 70 I I cao nhat, triglycerld cao nhSt d nhdm tuoi 50 - 59, LDL-C cao nhat d nhdm tuoi 39 - 49. 50% tang cholesterol TP, 41,7% benh n h l n cd tang triglyceride, 46,6% benh nhSn cd tang LDL-C v l 43,3% benh nhan cd g l i m HDL-C. 31,7% rdi loan 1 thanh phan lipid; 20% benh nhan cd tang cholesterol TP va triglycerld, 23,3% benh n h l n tang cholesterol TP va LDL-C, 13,3% bSnh nhan cd tang c l cholesterol TP, triglycerld va LDL-C. Cd sU k h i c biet ndng dp cholesterol TP, HDL-C, LDL-C d cac nhdm cd MAU va protein nieu khac nhau. LDL-C tUdng quan nghjch vdi ure, albumin, IMLCT (r = -0,29; -0,3; -0,38, p<0,05). Cholesterol TP t u d n g quan thuan vdi HbAI C (r = 0,29, p<0,05). Ket luan: 31,7% benh nhan cd rdi loan ehl 1 t h I n h p h i n lipid m l u , 43,3% rdi loan 2 thanh phan lipid; 13,3% rdi foan 3 t h I n h phan lipid. Cd mdi tUdng quan nghjch giijfa DL-C vdi ure, albumin, IVILCT vS tUdng quan thuan giijfa cholesterol TP vdi HbAI C cd >? nghTa t h d n g ke (p<0,05).
Til khoa: Da\ t h I o dudng typ 2, rdi loan lipid mau, bien chUng t h i n . Summary
Objective: Learn the characteristics of dyslipidemia in patients with type 2 diabetes with renal complications and related fectors. Subject and method: 60 patients with type 2 diabetes mellitus with renal complications. Cross-sectional descriptive study on 60 patients. Result: 31 male patients (51.7%), 29 female patients (48.3%). Average age: 59.2 ± 97. Highest cholesterol total in the age group > 70, highest triglycerides in the age group 50 - 59, LDL-C was highest in the age group 39 - 49.50% Increased cholesterol;
41.7% hypertriglyceridemia; 46.6% increased in LDL-C; 43.3% decreased in HDL-C. 31.7% of patient had a disorder of blood lipid 1 components; 20% of patients with high cholesterol total and triglycerides, 233% of patients with high cholesterol total and LDL-C 13.3% of patients increased in both cholesterol total, triglyceride and LDL-C. There were differences in the levels of total cholesterol, HDL-C, LDL-C in the groups with different levels of urinary protein. LDL-C Inversely eonelated with urea, albumin, GRF (r=-0.29; -0.3; -0.38, p<0.05). Cholesterol total positive correlated with HbAI C (r = 0.29, p<0.05). Conclusion: 31.7% of patients with disorders of only one lipid components, 43.3% lipid disorders 2 components; 13.3% lipid disorders 3 components. There was a negative coneiation between LDL-C with urea, albumin, GRF and a positive correlation between total cholesterol with HbAI C statistically significant (p<0.05).
Keywords: Diabetes type 2, dyslipidemia, renal complications.
Ngay nk4n bai: 28/11/2016, ngay chap nhdn dang: 03/01/2017
flgudiphan hoi: Dgng Thi VielHa. Email: [email protected] - TrudngBai hftc YHd Not
TAP CHf Y DUOC LAM SANG 108 Tap 12-56 1/2017
1. Dat vlin 64
Dai thao ducfng (BTD) la m6t benh man tfnh hay gap nh^t trong cac b§nh 1^ chuyen hoa va nSi tiet.
Ngay tii khi dupe chin doan b#nh nh^n (BN) £>TD dac biet la fiTB typ 2 c6 the da co cac bi^n chufng vi mach gay ton thuong den vong mac, ton thaong than kinh ngoai bien hoac than kinh thyc vat, dac biet la ton thuang than. Bien chiJng than chiem khoSng 20% cac trudng hap DTB typ 2 va t^ 1^ bi^n chCifng than chiem SO - 60% tdng so cac bien chiing mach mau do DTO [1 ]. Hau qua cOa tdn thuong than cudi cCing la benh thSn giai doan cudi ph^i chay dieu tri thay the va la mot trong nhiJng nguyen nhSn hang dau gay tCf vong 12]. Nguyen nhan hang dau gay tCf vong d nhCfng benh nhan benh than man tinh noi chung va b§nh than do DTO noi rieng la do cac bien chiifng tim mach. NhUng y^u to nguy ca cQa WSi mach phai ke den nhu tang dUdng huyet, tang
huyet ap khong dUpc kiem soat tdt, rdi loan lipid huyet thanh [3], [4]... Theo nhOfng thdng ke trong nU6c v^ nude ngoai deu cho thay tan suat DTD va benh than do DTD ngay cang gia tang. VI v$y d^nh gia day dD va dieu trj scfm cac yeu td nguy co 6 nh&ng b$nh nh^n nay la het sUc can thiet, trong do CO rdi loan lipid mau. Da co nhi^u nghien ciiru Idn tai nude ngoai ve rdi loan lipid mau 6 benh nhan DTD, cac nghien c i ^ ve rdi !oan lipid mau trong nude ehu yeu d nhOfng BN DTD chua co bien chUng than hoac nhijfng BN benh than man tinh khong do DTD.
Nham gop phin danh gia mot trong nhufng yeu td nguy ca tim mach d nhufng benh nhan DTD typ 2 co bien chijng than chUng tdi nghien cUu de tai nay v6i muc tieu Tim hiiu ddc diem roi loan lipid mdu dnhCtng b$nh nhdn ddithdo dudng typ 2 c6 bien chUng than vd cdc yeu toliin quan tai Khoa Than - Hit nieu Binh vien Bach Mai.
2. Ddi tupng va phiTcmg phap 2.1. Doi tuang
Tieu chuan chpn benh nhan: Benh nhSn dai thao dudng typ 2 co microalbumin nieu (MAU) duong tinh va cac benh nhan dii thao dudng typ 2 CO protein nieu s 300mg/24h va/hoac suy than man, dieu tn npi tru tai Khoa Than Tiet nieu Benh vien Bach Mai.
Tieu chuan loai trd
Benh nhSn dai thao dudng typ 1, DTD thuf phat, DTD thai nghen, DTD k&m benh ly th$n rieng bi#t khdng do DTD, dang co benh i^ c^p tfnh (nhiem khuan huyet, hdn me do chuyin hoa hoac do cac nguyen nhan kh^c), dang co cac benh \^ npi khoa khac kem theo (xo gan, nghien rupu, benh ly npi tiet kha).
2.2. PhifOngphdp
Phuong phap: Nghien ciJu md ta cat ngang.
Cac budc tien hanh: Kham leim sang. Xet nghiem te bao mau ngoai vi, dudng mau luc doi, ure, creatinin, acid uric, protein, albumin, cholesterol TP, triglycerld, HDL-C, LDL-C, HbAIC, PTH. Xet nghiem nude tieu: Tong phan tfch nUdc tieu, te b^o nieu. Djnh lupng protein nieu 24h hoac xet nghiem IVIAU neu protenin nidu 24h Sm tfnh. Sieu am than, si^u am tim, soi day mat.
Tiiu chudn dp dung
Benh nhan dupe chan doan co benh ly than neu CO 1 trong 2 tieu chuan: 1) MAU ti^ 30 - 300mg/24h:
Tdn thUdng than giai doan sdm; 2) Protein nieu >
300mg/24h c6/khdng kem theo suy glim chUc nang than: Ton thUPng than giai doan mupn.
MUc Ipc cau than dUdc tinh theo cong thUc Cockroft- Gau It:
(k = 1 vdi nam, k = 0,85 vdi nO)
Gidi han binh thudng cita cac thanh phan lipoprotein huyet thanh theo Hdi Tim mach Vi$t Nam (1998) [45]. Danh gi^ nguy CO gay xo viJa mach mau theo ATP III (2001) [50].
[140 - Tu6i (nam)]x Trong iucfng cd the (kg) x k M L a (ml/phtit) = ^ -^ -^
0,814 X N6ng 36 creatinin mau (nmol/i)
Phan dp tang huyet ap theo tieu chuan cCia JNC VII (2012). Giai doan benh than man tinh theo Hdi Than hpc Hoa ky 2002.
2.3. Xit iy so liiu
Theo phan mem SPSS 16.0. Sii dung cac thu$t
toan thdng ke tfnh gia tn trung binh, dp l^ch chuan,
so sanh hai hoac nhieu gia trj trung binh, he sd
tuong quan tuyen tfnh va lap phuong trinh tUdng
quan tuy^n tinh. Su khac biet co y nghTa thdng ke
vdi p<0,05.
lOURNAL OF 108- CLINICAL MEDICINE AND PHAR»/IACY Vol.l2-N°l/201
3. Ket q u i
3.1. Dac diem chung c&a nhdm nghien ciJfu Nghien ciJu g o m 60 b e n h n h a n . 31 b e n h n h a n nam c h i e m t i le 51,7%, 29 b 6 n h n h a n nO c h i e m t i 1648,3%.
Ve t h d i g i a n p h a t hien d a i t h S o d i / d n g : T J le BN phat hiSn BTD < 5 nam 14 36,6%. T i l 5 - 1 0 nam va >
10 nam eCing chi^m t j le 31,7%.
Bang 1 . PhSn bo cFoi tiTtfng nghien c i ^ theo nhom t u 6 l
Nhdn xet: N h o m t u 6 i gap nhieu nhat la 50 - 5 (36,6%). Tuoi t r u n g b i n h cOa doi t u o n g n g h i e n c f t j I 59,2 + 9,7 t u o i (thap nhat [i 39 t u o i , eao nhat I
86tu6i).
Bang 2 . M o t so bien c h l ^ g cua ddi t h a o dudng
Do tuoi 3 9 - 4 9 5 0 - 5 9 6 0 - 6 9 a 70 Tong
Sob§nhnhan 9 22 19 10 60
T J I S % 15,0 36,6 31,7 16,7 100
Bi^n chdng Viem day than l<inh Tang huyet ap Benh 1;? vong mac Tai bi^n mach mau nao BucthOy tinh t h e Benh ij? ban chan Benh mach vanh
S d b e n h n h S n 35 24 10 9 8 2 1
T J I « % 58,3 40,0 16,7 15,0 13,3 3,3 1,7 Nhdn xet: C^c b i ^ n chUng hay g a p la viem dSj t h i n kinh ngoai bien (58,3%), t a n g huyet ap (40%) b§nh v o n g mac (16,7%). Cac bien cht^ng khac co the g a p la tai bien mach m a u nao, due thCiy t i n h the benh iy ban chSn va b e n h mach vanh.
3.2. Ket qud xit nghiem lipid mdu
Bdng 3. Ket quS xet nghiem lipid m a u theo nhom tuoi
Do tuoi 3 9 - 4 9 (n = 9) 5 0 - 5 9 ( n = 22) 6 0 - 6 9 ( n = 19)
> 7 0 ( n = 10) P
Lipid mau (mmol/l) Cholesterol TP
6,22 ±2,38 5,45 ± 2,43 5,50 ±2,67 7,37 ±3,95
>0,05
Triglycerid 2,57 ±1,25 2,86 ± 2,49 1,94 ± 0 , 7 8 2,40 ±1,60
>0,05
HDL-C 1,20 ± 0 , 3 7 1,07 ± 0 , 5 1 1,01 ± 0 , 3 9 1,14±0,61
>0,05
LDL-C 4,21 ±2,19 3,18±1,99 3,35 ±1,91 3,60 ±1,37
>0,05
Nhdn x4t: Khdng cd sU khac bi§t ve ndng dp lipid h u y ^ t t h a n h giUa cac n h o m t u o i (p>0,05).
Bdng 4 . Ty le rdi loan lipid m a u Thcinh phan
Cholesterol TP (TO (mmol/l)
Triglycerld (rG)(mmol/l)
X ± S D
5,8 + 2,72
2,48 ±0,26
Phan loai Binh t h u d n g
Tang nhe Tang cao Binh thudng
Tang nhe Tang cao Tang rat cao
SoBN 30
9 21 35 18 6 1
T 9 1 e % 50,0 15,0 35,0 58,3 30,0 10,0 1,7
Tdng
100%
100%
TAPCHlYDUgcUlMSANGlOS TSpl2 -S61/2017
B i n g 4 . (tiep theo) Thanh phSn
HDL-C(mmol/l)
LDL-C(mmol/l)
X ± S D 1,07 ± 0 , 4 6
3,41 ±0,25
Phan loai Binh thudng
GlSm Tang Binh t h u d n g
Tang nhe Tang cao
SoBN 32 26 2 32 8 20
T J I e % 53,4 43,3 3,3 53,4 13,3 33,3
l o n g
100%
100%
Nhdn xit: Tang cholesterol TP: 50%. 41,7% BN cd tang triglyceride. 46,6% BN c6 tang LDL-C va 43,3% BN CO giam HDL-C.
BSng 5. Dac di^m roi loan lipid mau
N
Dac diem roi loan Khong co r6l loan lipid mdu Roi loan chi 1 t h I n h phan lipid mau Tang cholesterol TP va triglycerid Tang cholesterol TP va LDL-C Tang ea cholesterol TP, triglycerld va LDL-C
So benh nhan 7 19 12 14 8
T J I e % 11,7 31,7 20,0 23,3 13,3
Nhdnxit: B^nh nhan c6 rdi loan chi 1 thanh phan lipid mau co ti le cao nhat, sau do la nhdm cd tang ca cholesterol TP va LDL-C.
3.3. Sdliin quan giCta cdc thdnh phdn lipid mau vd mot sdyeu tdldm sang vd can lam sang Bang 6. Ndng do lipid mau d nhom THA va khdng THA
Lipid (mmol/) Tang Cholesterol TP Tang Triglyceride GISm HDL-C Tang LDL-C
Khdng THA X ± S D 6,06 ±3,01 2,82 + 2,68 1,04 ±0,49 3,49 ± 2,08
SoBN CO RL 22 17 16 17
CoTHA I X ± S D
5,1 ± 2,37 2,01 ± 0,93 1,10±0,47 3,18±1,75
SoBN CO RL 1 12
8 10
11 1
P
>0,05
>0,05
>ao5
>0,05
Whdn xet; Khdng CO sUkh^cbi§t coy nghTa thdng keve nong dp cac thanh phan lipid mau dnhdm co va khdng cd tang huyet ap (p>0,05).
B^ng 7. Ndng do lipid mau d cac nhom co microalbumin nieu va protein nieu khac nhau
Thanh phan
Cholesterol TP (mmol/l) Triglycerid (mmol/l) HDL-C (mmol/l) LDL-C (mmol/l)
Microalbumin nieu (MAU)
(n = 10)(1) 10,38 ±3,08 1,41 ±0,45 0,69 ± 0,27 1,91 ±0,44
Protein nieu 0,3 - 3,5g/24h (n = 22)(2) 5,65 ± 2,35 2,18 ±1,35 0,98 ± 0,39 2,62 ±1,28
Protein nieu
£ 3,5g/24h (n = 28)(3) 4,98 ±2,38 3,08 ±2,65 1,27 ±0,50 4,77 ±1,89
P(1,2) P(l,3) P«,31
<0,01
>0,05
<0,05
<0,01
Nhan xet. Co sU khac biet ve nong do cholesterol TP, HDL-C va LDL-C 6 eac mile do protein nieu co y
nghTa th6ng l<e (p<0,05). Khong co khae bift ve triglycerid (p>0,05).
DURNAL OF 108 - CLINICAL MEDICINE AND PHARMACY Vol.12-N"1/201;
B i n g 8. Tuong quan giCIa lipid mia va m o t sS yeu t o c^n lam sang i(hac
—--^.^^^ Lipid mau Th6ng so ) C N ~ ~ ^ — L ^ ^
Hb(g/I) 1 (r),(p)
Ure (mmol/l) (r),(p) Creatinin (pmol/i) | (r),(p) MLCT(ml/ph) '(r),(p) Albumin (g/l) (r),(p) Acid urie(mmol/l) [ (r),(p) PTH(pmol/l) (r),(p) HbAIC (%) 1 (r),(p)
Cholesterol TP
(0,12), (0,39) (-0,26), (0,06) (-0,23), (0,08) (0,05), (0,71) (0,16), (0,26) (0,04), (0,90) (-0,02), (0,90) (0,29), (0,04)
Triglycerid
(0,16), (0,23) (0,01), (0,94) (-0,23), (0,08) (0,20), (0,13) (-0,18), (0,19) (0,191,(0,23)
(-0,1),(0,61) (0,05), (0,74)
HDL-C (0,10), (0,47) (0,16), (0,23) (0,01), (0,94) (0,081), (0,56) (0,12), (0,37) (0,11), (0,51) (0,17), (0,38) (-0,52), (0,72)
LDL-C (0,24), (0,068) (-0,29), (0,03) (-0,131,(0,33) (-0,38),(0,005) (-0,30), (0,03) (0,12), (0,48) (0,12), (0,53) (0,10), (0,5)
Nhdn x^t: C6 m d i tUOng quan nghjch giUa LDL-C vdi ure mau, albumin va MLCT (p<0,05). Cd mdi tUdng luan t h u a n giUa cholesterol TP vdi H b A I C (r = 0,29, p<0,05).
I. Ban luan
4.7. Ve dac diem chung cOa nhdm nghiin cihi Tuoi cd lien quan vdi sU phat trien benh DTD.
Hlu h^t cac nghien cUu cho thay d p t u d i cang cao t ^ e mSc b§nh DTD cang tang nhat 1^ d d p t u d i 50 - 59.
"rong nghien cUu cOa chung t d i , benh nhSn it t u d i ihat la 39, cao t u d i nhat \k 86, n h o m t u d i 50 - 59 :hi^m t y le cao nhat (36,6%) (BSng 1). Tudi t r u n g )inh trong nghien cUu la 59,2 ± 9,7 t u d i . Ket q u ^ ighien cUu cCia chOng tdt t u o n g d u o n g vdi ket qu3 :fla cac tac gia khac [5]. Q u ^ t r i n h lao hoa lei nguyen ihan quan t r p n g gay ra t l n h trang khang insulin, :hUc nang t u y cung bi suy giam, cung vdi sU thay fdi cCia Idi sdng do t u d i tac cung d d n g g o p phan juan t r p n g vao benh sinh cOa DTD t y p 2. B^nh nhan :d t h d i gian phat hien DTD < 5 nam chiem t / le 36,6 -fa; t h d i gian phat hien bdnh 5 - 1 0 nam 1^ 31,7% va ' 10 nam la 31,7%. Thdi gian mac benh DTD cang lai thi t y le m i c bien chUng th$n cang tang. Trong ighi^n cua chUng t d i , cac bien chUng hay gap la i e m day than kinh ngoai bien (58,3%), t a n g huyet ip (40%), benh vong mac (16,7%). C^c bien chUng
;hac CO t h e gap la tai bien mach mau nao, due thCiy inh the, benh ly ban chan va benh mach vanh (B^ng :). Cac bien chUng tren d ^ u gay ra n g u y h i ^ m tfnh l a n g va ch^t lUpng song cua ngUdi benh, nen t ^ t c i
c^c benh nhan DTD can p h d n g ngC^a Vei phat hien sdm cac t d n thUdng t r e n .
4^. Vi dac diem roi loan lipid mdu Ket qua B l n g 3 cho thciy n d n g d d cholesterol TP d n h d m t u d i ^ 70 la cao nhSt, triglyceride cao nhgt d n h d m t u d i 50 - 59 va LDL-C cao nhat d nhdm t u d i 39 - 49. Tuy nhien sU khac biet ve n d n ^ dd cac t h a n h p h ^ n lipid m a u giUa cac n h d m t u d i khac biet khdng cd ^ nghTa t h d n g ke (p>0,05). 50% BN tang n d n g d d cholesterol TP, 41,7% BN cd tang triglyceride. 46,6% BN^cd t a n g LDL-C v^ 43,3% BN co giSm HDL-C (Bang 4), t r o n g d o co 31,7% BN chi co rdi loan 1 t h a n h p h i n lipid mau, 20% BN cd tang ca n d n g d d cholesterol TP, triglyceride, 23,3% BN tang n d n g d o cholesterol TP va LDL-C, 13,3% BN cd tang n d n g d p 3 t h a n h phan lipid mau la cholesterol TP, triglyceride va LDL-C (BSng 5). Ket quS nghi§n cUu cCia chung t d i co kha biet so vdi m o t sd tac giS [3], [4], [5], [6] cd t h ^ Id d o cac BN da cd bien chuYig than cho nen cd nhi^u y e u t d 5nh hUdng den t i n h trang rdi loan lipid mau n h u d d t u d i , che dp dinh dUdng, tSp luyen, t i n h t r a n g b e n h t h a n man t i n h . . . N h U vay t y le gap bien chijfng rdi loan lipid mau 6 b§nh nhan DTD rat cao va t h u d n g d dang phdc tap, do d d benh nhan DTD t y p 2 dac biet la DTD t y p 2 da cd bien chUng thSn c i n dUpc lam xet nghiem de phat h i f n
TAP CHf Y o a a c L A M SANG 108 Tap 12-S6 1/2017
va dieu trj kjp t h d i rdi loan lipid mdu g d p p h i n t r o n g p h d n g ngUa t i e n trien benh t i m mach.
4.3. Vemoi lien quan gi&a cdc thdnh phan lipid mdu vdi mot sdyeu tdldm sdng, cdn ldm sdng
Theo nghien cUu t i m mach Framingham tren benh nhan THA thay hdn 80% cd y ^ u t d nguy co t i m mach, ndi bat la rdi loan lipid mau [4]. Tang huyet ap va rdi loan lipid mau deu la nhUng yeu t d nguy c d quan t r p n g ci!ia benh t i m mach. Tuy nhien t r o n g nghien cUu nay chiing t d i khdng thay cd sU khac biet vi n d n g d d cac t h d n h phan lipid mau d cac benh nhan t a n g huyet ap so vol benh nhan khdng cd tang huyet ap (Bdng 6). Nhieu nghien cUu da ket luan Id protein nieu vd t l n h trang rdi loan lipid m a u cd lien quan vdi nhau. Rdi loan m d mau cd t h e la hdu qud cCia benh t h a n cQng cd t h e la nguyen nhan lam nang t h e m t l n h trang cua benh [6]. Ket qua Bang 7 cho t h i y LDL-C t r u n g binh tang t h e o mUc d p protein ni&u, vd hai dai lUpng nay cd tUdng quan kha chat vdi nhau r = 0,58 vd p<0,01. Cholesterol TP, HDL-C t r u n g b i n h d 3 n h d m protein nieu cung khac b'\it cd y nghTa t h d n g ke. Do d d d nhffng benh nhan DTD cd rdi loan m d mau, t h e o guideline cQa NKF/KDOQi t h d i diem t a m soat benh t h a n dai t h d o dudng ddi vdi DTD t y p 2 Id tai t h d i diem BN duac chin doan benh DTD. Bdng 8 cho thay khdng t h a y mdi t u o n g quan giUa cac t h d n h phan m d mau vdi hemoglobin, creatinin, acid uric va PTH nhUng cd mdi tUdng quan thudn giijfa cholesterol TP va H b A l c (r = 0,29, p<0,05) cung tUong tU nghien cUu ciia Singh [7]. LDL-C cd tUdng quan nghjch vdi ure, albumin vd MLCT. Dieu nay t h e hi^n m d i lien quan giijfa lipid mau vd t l n h trang dinh d u d n g vd tien trien cOa t d n thUdng t h a n d cac benh nhan DTD.
5. Ket luan
Qua nghien cUu 60 benh bj dai thao d u d n g t y p 2 cd bien chUng thdn d i ^ u tri ndi t r i i tai Khoa Thdn Tiet nieu Benh vien Bach Mai, chdng tdi rUt ra m d t sd k^t luan sau:
Khdng cd sU khdc bi$t ve ndng dp lipid huyet thanh giffa cdc n h d m t u d i , giQa n h d m c6 t a n g huyet dp vd khdng t a n g huyet dp. Cd su khdc biet ve ndng
dp cholesterol TP, triglycerid vd LDL-C t h e o cac mu'c d p protein n i ^ u (p<0,05).
Cd 31,7% b e n h nhan cd rdi loan chi 1 t h a n h phdn lipid mau, 2 0 % benh nhan cd t a n g cholesterol TP va triglycerid, 23,3% b e n h nhdn t a n g cholesterol TP va LDL-C, 13,3% b e n h nhan cd t a n g cd cholesterol TP, triglycerid va LDL-C Cd m d i tUOng quan nghjch giOa LDL-C vdi ure m a u , a l b u m i n va mUc Ipc cau t h a n (p<0,05). Cd m d i t U d n g q u a n t h u d n giOfa cholesterol TP vdi H b A I C (p<0,05).
Tai lieu t h a m khao
1. Le HuyLieu (1999) Panorama of diabetis mellitus in Vietnam recent years. Journal of endocrine societies 2:34-43.
2. fvlguyen Kim Luong, Thai Hong Quang (2000) Benh mach mdu vd roi loan chuyen hoa lipid d benh nhdn BTD typ 2. KJ yeu cong trinh Noi tiet vd cac rdi loan chuyen hda. Nhd Xuat ban Y hpc, tr. 411 -417.
3. Tran Van Hien, Ta Van Binh va edng sU (2007) Nghien cdu roi loan lipid mdu d benh nhdn ddi thao dudng typ 2 Idn dau duac phdt hien tai Benh vien Noi tiet Trung Ucmg. Hoi nghi khoa hpc todn qudc chuyen nganh ndi tiet va chuyen hod Ian thU 3, tr.
66-669.
4. Cook CB, Erdman DM et al (2002) The impaa of outpatient diabetes management on serum lipids in urban African-Americans with type 2 ^iabetes.
Diabetes Care 2 5 0 ) : 9-15.
5. Kannel WB (1985) Lipids, diabetes, and coronary heart disease: insights from the Framingham Study.
Am Heart J 110 (5): 1100-1107.
6. Niskanen L et al (1990) Microalbuminuria predicts the development of serum lipoprotein abnormalities favouring atherogenesls in newly diagnosed type 2 (non-insulin-dependent) diabetic patients.
Diabetoiogia 33(4): 237-243.
7 Singh, Kumar (2011) Relationship among HbAlc and Lipid Profile In Punajbi Type 2 Diabetic Population. Journal of Exercise Science and Physiotherapy 7(2): 99-102.
