Pascot A, Després J P, Lemieux I, Bergeron J, Nadeau A, Prud'homme D, Tremblay A, Lemieux S
Lipid Research Center, CHUL Research Center, Ste-Foy, Québec, Canada.
Diabetologia. 2000 Sep;43(9):1126-35. doi: 10.1007/s001250051503.
AIMS/HYPOTHESIS: Impaired glucose tolerance is associated with metabolic alterations which increase cardiovascular disease risk. The contribution of hyperglycaemia to this increased risk is, however, not clear. Abdominal obesity is often observed in subjects with impaired glucose tolerance; our objective was therefore to find the contribution of visceral adipose tissue to the deterioration of the metabolic risk profile noted in subjects with impaired glucose tolerance.
We studied 284 men with a normal glucose tolerance and 66 men with impaired glucose tolerance which was defined as a glycaemia between 7.8 and 11.1 mmol/l 2 h after a 75-g glucose load.
Men with impaired glucose tolerance had more visceral adipose tissue and higher concentrations of plasma glucose and insulin in the fasting state and following a 75-g oral glucose load than men with a normal glucose tolerance. They also had higher concentrations of plasma cholesterol, triglycerides, apolipoprotein B and lower concentrations of HDL-cholesterol as well as higher cholesterol:HDL-cholesterol ratios than men with a normal glucose tolerance. The two groups of men were then compared after a statistical adjustment for the amount of visceral adipose tissue. Although men with impaired glucose tolerance still had higher fasting plasma glucose and insulin concentrations after the adjustment for visceral adipose tissue, differences in all the variables of the lipid-lipoprotein profile were eliminated.
CONCLUSION/INTERPRETATION: Visceral adipose tissue accumulation is an important factor in the deterioration of the plasma lipid-lipoprotein noted in men with impaired glucose tolerance.
目的/假设：糖耐量受损与代谢改变相关，而代谢改变会增加心血管疾病风险。然而，高血糖对这种风险增加的作用尚不清楚。糖耐量受损的受试者常伴有腹型肥胖；因此，我们的目的是确定内脏脂肪组织在糖耐量受损受试者代谢风险状况恶化中所起的作用。
我们研究了284名糖耐量正常的男性和66名糖耐量受损的男性，后者被定义为在75克葡萄糖负荷后2小时血糖水平在7.8至11.1毫摩尔/升之间。
与糖耐量正常的男性相比，糖耐量受损的男性在内脏脂肪组织更多，空腹状态下以及75克口服葡萄糖负荷后血浆葡萄糖和胰岛素浓度更高。他们的血浆胆固醇、甘油三酯、载脂蛋白B浓度也更高，高密度脂蛋白胆固醇浓度更低，胆固醇与高密度脂蛋白胆固醇的比值也高于糖耐量正常的男性。在对内脏脂肪组织量进行统计调整后，对两组男性进行了比较。尽管在对内脏脂肪组织进行调整后，糖耐量受损的男性空腹血浆葡萄糖和胰岛素浓度仍然较高，但脂质-脂蛋白谱所有变量的差异均被消除。
结论/解读：内脏脂肪组织堆积是糖耐量受损男性血浆脂质-脂蛋白恶化的一个重要因素。
