Baena R M, Campoy C, Bayés R, Blanca E, Fernández J M, Molina-Font J A
Department of Biochemistry and Molecular Biology, University of Granada, Granada, Spain.
Eur J Clin Nutr. 2002 Jan;56(1):44-50. doi: 10.1038/sj.ejcn.1601279.
A case-control study was conducted to evaluate the effects of type 1 diabetes mellitus (IDDM) on plasma levels of vitamin A (retinol) and serum levels of retinol-binding protein (RBP) and their relationship with the atherogenic indicators.
A total of 47 randomised IDDM children were recruited from those treated at the Endocrinology Unit of the University Hospital of Granada (Spain). They were matched for age and sex with 16 healthy children.
The following parameters were measured in all patients: serum concentrations of total cholesterol, triglycerides, high (HDL, spectrophotometry), very low (VLDL) and low (LDL) density lipoprotein cholesterol (Friedewald's formula); serum levels of RBP (kinetic nephelometry); plasma vitamin A and glycosilated haemoglobin (HbA1c; high performance chromatography).
Higher RBP concentrations in IDDM children (P=0.05), lower retinol levels (P=0.05) and lower vitamin A/cholesterol ratio (P=0.02) than in the control group were found; no differences in the atherogenic indicators were observed. There was a correlation between RBP and vitamin A (P=0.0001). Relationships between retinol, RBP and atherogenic indicators were demonstrated in the IDDM group (A-LDLc/HDLc (P=0.01); A-(VLDL+LDL)c/HDLc (P=0.007); RBP-LDLc/HDLc (P=0.05); RBP-(VLDL+LDL)c/HDLc (P=0.02)), and an inverse relationship was found between the vitamin A/TG ratio and HbA1c (P=0.004). The children with HbA1c>8% showed increased atherogenic indicators and lower vitamin A/CHOL and vitamin A/TG ratios than those with good control of the illness.
The IDDM children with poor metabolic control face a higher atherogenic risk and vitamin A 'relative deficiency' risk than those with good metabolic control of their illness. Relationships between retinol and RBP with atherogenic indicators were found. The results suggest that vitamin A therapeutic supplements in IDDM children may reduce or prevent atherogenic risk.
开展一项病例对照研究，以评估1型糖尿病（IDDM）对血浆维生素A（视黄醇）水平、血清视黄醇结合蛋白（RBP）水平的影响及其与致动脉粥样硬化指标的关系。
从西班牙格拉纳达大学医院内分泌科接受治疗的患者中随机招募了47名IDDM儿童。他们在年龄和性别上与16名健康儿童相匹配。
对所有患者测量以下参数：血清总胆固醇、甘油三酯、高密度脂蛋白（HDL，分光光度法）、极低密度脂蛋白（VLDL）和低密度脂蛋白（LDL）胆固醇浓度（Friedewald公式）；血清RBP水平（动态散射比浊法）；血浆维生素A和糖化血红蛋白（HbA1c；高效液相色谱法）。
发现IDDM儿童的RBP浓度较高（P = 0.05），视黄醇水平较低（P = 0.05），维生素A/胆固醇比值较低（P = 0.02）；致动脉粥样硬化指标未见差异。RBP与维生素A之间存在相关性（P = 0.0001）。在IDDM组中，视黄醇、RBP与致动脉粥样硬化指标之间存在关联（A-LDLc/HDLc（P = 0.01）；A-(VLDL + LDL)c/HDLc（P = 0.007）；RBP-LDLc/HDLc（P = 0.05）；RBP-(VLDL + LDL)c/HDLc（P = 0.02）），并且维生素A/TG比值与HbA1c之间存在负相关（P = 0.004）。HbA1c>8%的儿童与病情控制良好的儿童相比，致动脉粥样硬化指标升高，维生素A/CHOL和维生素A/TG比值降低。
与病情代谢控制良好的IDDM儿童相比，病情代谢控制不佳的IDDM儿童面临更高的致动脉粥样硬化风险和维生素A“相对缺乏”风险。发现视黄醇和RBP与致动脉粥样硬化指标之间存在关联。结果表明，IDDM儿童补充维生素A治疗可能降低或预防致动脉粥样硬化风险。
