Watanabe N, Taniguchi T, Taketoh H, Kitagawa Y, Namura H, Yoneda N, Kurimoto Y, Yamada S, Ishikawa Y
Health Care and Promotion Center, Yodogawa Christian Hospital, Osaka, Japan.
Diabetes Care. 1999 Jan;22(1):152-6. doi: 10.2337/diacare.22.1.152.
Impaired glucose tolerance (IGT) in association with insulin resistance is considered to be a risk factor for atherosclerosis. Thus, patients with IGT may have abnormal lipid and lipoprotein profiles. The purpose of this study was to investigate presence of remnant-type hyperlipoproteinemia in patients with IGT.
Serum levels of remnant-like lipoprotein particles (RLP) were measured in 541 subjects (362 men and 179 women, age 53 +/- 7.9 years) who visited our health center for routine medical examinations. We measured RLP cholesterol (RLP-C) and RLP triglycerides (RLP-TG) using immunoaffinity gel containing monoclonal anti-human apoproteins A-I (H-12) and B-100 (JI-H) antibodies. After a 75-g oral glucose tolerance test, subjects were divided into three groups: normal, IGT, and type 2 diabetic.
After matching for sex, age, and body weight, serum RLP-C in normal, IGT, and diabetic groups were 4.2 +/- 1.7, 6.2 +/- 3.4, and 6.2 +/- 4.2 mg/dl, respectively. The corresponding RLP-TG values were 16.7 +/- 9.2, 28.0 +/- 19.1, and 29.0 +/- 27.2 mg/dl. We found that RLP-C and RLP-TG values were significantly higher in the IGT and diabetic groups compared with the normal group (P < 0.001). In the same order, total serum cholesterol levels were 206 +/- 29, 205 +/- 34, and 206 +/- 34 mg/dl and LDL cholesterol levels were 127 +/- 27, 124 +/- 34, and 123 +/- 34 mg/dl, showing no marked difference in these groups. However, serum levels of triglyceride were higher in the IGT and diabetes groups (155 +/- 76 and 151 +/- 81 mg/dl vs. 106 +/- 41 mg/dl; P < 0.0001). Further, the incidence of remnant hyperlipoproteinemia in normocholesterolemic subjects was up to four times higher in IGT and diabetic groups compared with the normal group.
High serum RLP-C and RLP-TG levels in IGT and diabetic patients may represent an increased risk of atherosclerosis in these patients.
糖耐量受损（IGT）伴胰岛素抵抗被认为是动脉粥样硬化的危险因素。因此，IGT患者可能存在血脂和脂蛋白谱异常。本研究旨在调查IGT患者中残留型高脂蛋白血症的情况。
对541名到我们健康中心进行常规体检的受试者（362名男性和179名女性，年龄53±7.9岁）测定血清中残留样脂蛋白颗粒（RLP）水平。我们使用含有抗人载脂蛋白A-I（H-12）和B-100（JI-H）单克隆抗体的免疫亲和凝胶测定RLP胆固醇（RLP-C）和RLP甘油三酯（RLP-TG）。在进行75克口服葡萄糖耐量试验后，受试者被分为三组：正常组、IGT组和2型糖尿病组。
在匹配性别、年龄和体重后，正常组、IGT组和糖尿病组的血清RLP-C分别为4.2±1.7、6.2±3.4和6.2±4.2毫克/分升。相应的RLP-TG值分别为16.7±9.2、28.0±19.1和29.0±27.2毫克/分升。我们发现，IGT组和糖尿病组的RLP-C和RLP-TG值显著高于正常组（P<0.001）。按同样顺序，总血清胆固醇水平分别为206±29、205±34和206±34毫克/分升，低密度脂蛋白胆固醇水平分别为127±27、124±34和123±34毫克/分升，这些组之间无明显差异。然而，IGT组和糖尿病组的血清甘油三酯水平较高（155±76和151±81毫克/分升，而正常组为106±41毫克/分升；P<0.0001）。此外，在正常胆固醇水平的受试者中，IGT组和糖尿病组残留高脂蛋白血症的发生率比正常组高至四倍。
IGT和糖尿病患者血清中高RLP-C和RLP-TG水平可能表明这些患者动脉粥样硬化风险增加。
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