目的 观察初发1型糖尿病(T1DM)儿童血脂水平, 并分析其与患儿糖化血红蛋白(HbA1c)水平的相关关系。方法 回顾性分析保定市儿童医院于2018年1月-2019年6月期间收治的168例T1DM患儿的临床资料, 并以同期内100例健康儿童作为对照组。比较两组儿童血总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等血脂指标的差异。采用Pearson分析及多元回归方法分析T1DM患儿血脂水平与HbA1c水平的相关性。结果 T1DM组儿童TC、TG和LDL-C水平均显著高于对照组(t=4.691、7.705、4.119, P<0.001), HDL-C水平显著低于对照组(t=3.845, P<0.05)。血脂异常组患儿HbA1c水平显著高于血脂正常组患儿[(13.09±2.71)% vs.(11.78±2.56)%, t=3.209, P<0.05]。Pearson相关性分析结果表明, T1DM患儿TC、TG和LDL-C水平与HbA1c水平具有显著正相关关系(r=0.547、0.514、0.438, P<0.05), HDL-C与HbA1c水平无显著相关性(r=0.109, P>0.05)。多元回归分析结果表明, TC和TG与HbA1c显著正相关(β=0.008, 0.045, P＜0.05)。结论 T1DM患儿中血脂异常比例较高, HbA1c水平越高合并血脂异常风险越高, 临床应予以重视。

Objective To observe the blood lipid levels in children with first-onset type 1 diabetes mellitus (T1DM), and to analyze its correlation with the level of glycosylated hemoglobin (HbA1c) in children. Methods Clinical data of 168 children with T1DM admitted to Baoding Children's Hospital from January 2018 to June 2019 were retrospectively analyzed, and 100 healthy children in the same period were selected as control group.Differences on blood lipids such as total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were compared between the two groups.Pearson analysis and multiple linear regression method were used to analyze the correlation between serum lipid level and HbA1c level in children with T1DM. Results The levels of TC, TG and LDL-C in T1DM group were significantly higher than those in control group (t=4.691, 7.705, 4.119, P＜0.001), while HDL-C level in T1DM group was significantly lower(t=3.845, P＜0.05).The level of HbA1c in dyslipidemia group was significantly higher than that in normal blood lipid group[(13.09±2.71)% mmol/L vs.(11.78±2.56)% mmol/L, t=3.209, P<0.05].Pearson correlation analysis showed that HbA1c level was positively related to TC, TG and LDL-C levels(r=0.547, 0.514, 0.438, P＜0.05), while significant correlation between HDL-C and HbA1c level was not found (r=0.109, P>0.05).Multiple linear regression analysis showed that TC and TG levels were closely related to HbA1c level (β=0.008, 0.045, P<0.05). Conclusion The proportion of dyslipidemia is higher in children with T1DM.Higher level of HbA1c indicates higher risk for dyslipidemia, which should be given more consideration in clinic practice.