Teno S, Uto Y, Nagashima H, Endoh Y, Iwamoto Y, Omori Y, Takizawa T
Department of Internal Medicine, Saitamaken Saiseikai Kurihashi Hospital, Saitama, Japan.
Diabetes Care. 2000 Sep;23(9):1401-6. doi: 10.2337/diacare.23.9.1401.
Serum triglyceride levels are important in the development of atherosclerosis. Although triglyceride levels are generally increased in the postprandial periods, the association between postprandial triglyceride (pTG) levels and atherosclerosis has not been investigated in diabetic patients. To investigate the role of pTG levels in atherosclerosis, we examined the correlation between pTG levels and carotid intimal-medial thickness (IMT).
Carotid IMT was measured by ultrasonography in 61 patients with type 2 diabetes. Plasma glucose (PG), insulin, total cholesterol, triglycerides, and HDL cholesterol levels were measured after overnight fasting and 4 h after a meal.
Carotid IMT of the patients with fasting hypertriglyceridemia was greater than that of the patients with normal fasting triglyceride (fTG) levels (0.85+/-0.12 vs. 0.76+/-0.14 mm; P = 0.02). The carotid IMT was increased in the patients with pTG levels >2.27 mmol/l. The normo-normo (NN) and normo-hyper (NH) groups consisted of patients with normal fTG levels but with pTG levels <2.27 and >2.27 mmol/l, respectively. Patients with both hypertriglyceridemia and pTG levels >2.27 mmol/l formed the hyper-hyper (HH) group. Carotid IMT was significantly increased in the NH (0.86+/-0.13 mm) and HH (0.85+/-0.12 mm) groups compared with the NN group (0.73+/-0.13 mm; P<0.01). Although postprandial PG, pTG, and fasting LDL cholesterol levels were all independently correlated with carotid IMT, pTG levels had the strongest statistical influence (P = 0.002).
Postprandial hypertriglyceridemia despite normal fTG levels may be an independent risk factor for early atherosclerosis in type 2 diabetes.
血清甘油三酯水平在动脉粥样硬化的发展过程中具有重要意义。尽管餐后甘油三酯水平通常会升高，但餐后甘油三酯（pTG）水平与动脉粥样硬化之间的关联在糖尿病患者中尚未得到研究。为了探究pTG水平在动脉粥样硬化中的作用，我们检测了pTG水平与颈动脉内膜中层厚度（IMT）之间的相关性。
对61例2型糖尿病患者进行超声检查以测量颈动脉IMT。在空腹过夜及餐后4小时测量血浆葡萄糖（PG）、胰岛素、总胆固醇、甘油三酯和高密度脂蛋白胆固醇水平。
空腹甘油三酯血症患者的颈动脉IMT大于空腹甘油三酯（fTG）水平正常的患者（0.85±0.12 vs. 0.76±0.14 mm；P = 0.02）。pTG水平>2.27 mmol/l的患者颈动脉IMT增加。正常-正常（NN）组和正常-高（NH）组分别由fTG水平正常但pTG水平<2.27和>2.27 mmol/l的患者组成。同时患有高甘油三酯血症且pTG水平>2.27 mmol/l的患者组成高-高（HH）组。与NN组（0.73±0.13 mm）相比，NH组（0.86±0.13 mm）和HH组（0.85±0.12 mm）的颈动脉IMT显著增加（P<0.01）。尽管餐后PG、pTG和空腹低密度脂蛋白胆固醇水平均与颈动脉IMT独立相关，但pTG水平具有最强的统计学影响（P = 0.002）。
尽管fTG水平正常，但餐后高甘油三酯血症可能是2型糖尿病早期动脉粥样硬化的独立危险因素。
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