Friedlander Y, Kidron M, Caslake M, Lamb T, McConnell M, Bar-On H
The Department of Social Medicine, The Hebrew University-Hadassah School of Public Health, POB 12272, Jerusalem, Israel.
Atherosclerosis. 2000 Jan;148(1):141-9. doi: 10.1016/s0021-9150(99)00215-4.
The present study aimed to examine the association between low density lipoprotein (LDL) particle size and glucose and insulin variables and with other risk factors that have been related to insulin resistance syndrome. LDL particle size was determined in two groups of subjects who participated in the first examination of the Jerusalem Diabetes Study and who were invited to be re-examined after 8-10 years. The first group were non-diabetic subjects who were found to have at the first examination high insulin levels (above the sex and age specific 90th percentile of the 2 h post-glucose load insulin distribution). The second group was a random sample of individuals who had normal insulin and glucose levels at baseline. Sex-, Age- and body mass index (BMI) mean adjusted LDL-cholesterol (C), triglyceride (TG) and high density lipoprotein cholesterol (HDL-C) levels were significantly different among the LDL subclass groups. Fasting glucose levels and hemoglobin A(1c) did not differ statistically by LDL subclasses. Fasting and 2-h post load insulin levels were significantly higher in persons with LDL subclasses III and IV (small LDL), intermediate in those with LDL subclass II, and lowest in those with LDL subclass I (large LDL). Insulin resistance had an effect on the association between lipids, lipoproteins and LDL particle size. Multivariate analyses indicated that LDL-C, HDL-C and TG were independently associated with LDL particle size variability. The addition of 'insulin resistance' or insulin and glucose levels had no independent effects on LDL particle size. In conclusion, an association of LDL particle size with the cluster of risk factors that characterize the insulin resistance syndrome has been demonstrated. The association of 'insulin resistance' and LDL particle diameter, however, is not mediated directly through the level of insulinemia but via alterations in lipid metabolism.
本研究旨在探讨低密度脂蛋白（LDL）颗粒大小与血糖和胰岛素变量之间的关联，以及与其他已与胰岛素抵抗综合征相关的危险因素之间的关联。在参加耶路撒冷糖尿病研究首次检查并被邀请在8 - 10年后再次检查的两组受试者中测定了LDL颗粒大小。第一组是非糖尿病受试者，他们在首次检查时发现胰岛素水平较高（高于葡萄糖负荷后2小时胰岛素分布的性别和年龄特异性第90百分位数）。第二组是基线胰岛素和血糖水平正常的个体的随机样本。LDL亚类组之间的性别、年龄和体重指数（BMI）平均调整后的低密度脂蛋白胆固醇（C）、甘油三酯（TG）和高密度脂蛋白胆固醇（HDL - C）水平存在显著差异。空腹血糖水平和糖化血红蛋白A1c在LDL亚类之间无统计学差异。LDL亚类III和IV（小LDL）患者的空腹和负荷后2小时胰岛素水平显著更高，LDL亚类II患者的胰岛素水平中等，而LDL亚类I（大LDL）患者的胰岛素水平最低。胰岛素抵抗对脂质、脂蛋白和LDL颗粒大小之间的关联有影响。多变量分析表明，LDL - C、HDL - C和TG与LDL颗粒大小变异性独立相关。添加“胰岛素抵抗”或胰岛素和血糖水平对LDL颗粒大小无独立影响。总之，已证明LDL颗粒大小与表征胰岛素抵抗综合征的危险因素聚集有关。然而，“胰岛素抵抗”与LDL颗粒直径之间的关联并非直接通过胰岛素血症水平介导，而是通过脂质代谢的改变介导。
