Krone W, Müller-Wieland D, Wirth H
Klinik II und Poliklinik für Innere Medizin, Universität Köln.
Fortschr Med. 1992 Dec 10;110(34):645-8.
Insulin resistance and consecutive hyperinsulinemia in individuals with the metabolic syndrome are associated with dyslipidemia. This latter is characterised by hypertriglyceridemia and a diminishment of high-density lipoprotein (HDL) cholesterol in the plasma. In severe forms of insulin resistance, low density lipoprotein (LDL) cholesterol may also be elevated. Hypertriglyceridemia is due to an increase in the rate of synthesis of very low density lipoproteins (VLDL) in the liver, and a reduction in their breakdown by the lipoprotein lipase in non-hepatic tissue. Changes in VLDL metabolism are associated with a reduction in HDL concentrations. In addition, direct effects of insulin on the lipid metabolism have been described. Changes in lipid metabolism due to insulin resistance and hyperinsulinemia may be of significance for the atherosclerosis risk in patients with the metabolic syndrome.
代谢综合征患者的胰岛素抵抗及随之而来的高胰岛素血症与血脂异常有关。后者的特征是血浆中甘油三酯水平升高和高密度脂蛋白（HDL）胆固醇水平降低。在严重的胰岛素抵抗形式中，低密度脂蛋白（LDL）胆固醇水平也可能升高。高甘油三酯血症是由于肝脏中极低密度脂蛋白（VLDL）合成速率增加，以及非肝脏组织中脂蛋白脂肪酶对其分解减少所致。VLDL代谢的变化与HDL浓度降低有关。此外，胰岛素对脂质代谢的直接作用也已得到描述。胰岛素抵抗和高胰岛素血症引起的脂质代谢变化可能对代谢综合征患者的动脉粥样硬化风险具有重要意义。
