Yoshida Hiroshi, Hirowatari Yuji, Kurosawa Hideo, Tada Norio
Division of General Medicine, Department of Internal Medicine, Kashiwa Hospital, Jikei University School of Medicine, Chiba 277-856, Japan.
Clin Sci (Lond). 2005 Sep;109(3):297-302. doi: 10.1042/CS20040353.
The present study was performed to investigate the relevance of cholesterol levels of plasma lipoproteins [HDL (high-density lipoprotein), LDL (low-density lipoprotein), IDL (immediate-density lipoprotein), VLDL (very-LDL) and chylomicrons] determined by a novel HPLC method, with adiponectin, which is decreased in Type II diabetes and assumed to be involved in dysregulated metabolism and atherogenesis. Type II diabetic patients who were not treated with insulin, statins and fibrates were enrolled. Study subjects included Type II diabetic patients with normolipidaemia (DM-NL; n=15), type 4 hyperlipidaemia (DM-T4HL; n=13), Type IIa hyperlipidaemia (DM-T2aHL; n=15) and Type IIb hyperlipidaemia (DM-T2bHL; n=13). Fasting blood samples were collected. The serum adiponectin level was lower in DM-T2bHL than in any of the other groups. Cholesterol levels of each lipoprotein fraction, serum triacylglycerol (triglyceride), remnant-like particle-cholesterol, fasting plasma glucose, HbA1c (glycated haemoglobin), age, gender difference and BMI (body mass index) were incorporated into a stepwise regression analysis as independent variables. VLDL-cholesterol correlated inversely with adiponectin independently of age, BMI, gender difference and glycaemic control. Although the mechanisms remain to be explored, serum adiponectin was reduced particularly in Type II diabetics with type IIb hyperlipidaemia and correlated inversely with VLDL-cholesterol. Measuring VLDL-cholesterol may be helpful for understanding the pathological features of diabetic dyslipidaemia.
本研究旨在通过一种新型高效液相色谱法(HPLC)测定血浆脂蛋白[高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、中密度脂蛋白(IDL)、极低密度脂蛋白(VLDL)和乳糜微粒]的胆固醇水平,并研究其与脂联素的相关性。脂联素在II型糖尿病中减少,被认为与代谢失调和动脉粥样硬化的发生有关。纳入未接受胰岛素、他汀类药物和贝特类药物治疗的II型糖尿病患者。研究对象包括血脂正常的II型糖尿病患者(DM-NL;n = 15)、4型高脂血症患者(DM-T4HL;n = 13)、IIa型高脂血症患者(DM-T2aHL;n = 15)和IIb型高脂血症患者(DM-T2bHL;n = 13)。采集空腹血样。DM-T2bHL组的血清脂联素水平低于其他任何组。将各脂蛋白组分的胆固醇水平、血清三酰甘油(甘油三酯)、残粒样颗粒胆固醇、空腹血糖、糖化血红蛋白(HbA1c)、年龄、性别差异和体重指数(BMI)作为自变量纳入逐步回归分析。VLDL胆固醇与脂联素呈负相关,且不受年龄、BMI、性别差异和血糖控制的影响。尽管具体机制尚待探索,但血清脂联素在IIb型高脂血症的II型糖尿病患者中尤其降低,并与VLDL胆固醇呈负相关。检测VLDL胆固醇可能有助于了解糖尿病血脂异常的病理特征。