Manuel-Y-Keenoy B, de Vos C, van Campenhout A, Vinckx M, Abrams P, van Campenhout C
Metabolic Research Unit, University of Antwerp, Antwerp, Belgium.
Eur J Clin Nutr. 2008 Mar;62(3):401-10. doi: 10.1038/sj.ejcn.1602698. Epub 2007 Apr 4.
The two- to fourfold higher risk of cardiovascular disease in diabetes mellitus is more strongly predicted by the postprandial than by the fasting blood glucose and lipids. We aimed to investigate the impact of postprandial changes in serum lipoprotein fractions on lipid peroxidation in type I diabetes mellitus (T1DM).
This was a prospective observational study.
The study was performed at Antwerp University Hospital, Belgium.
Twenty-three well-controlled T1DM patients were included.
Patients received a standard breakfast and lunch (>50% energy as fat). Blood was sampled at fasting (F), after the post-breakfast hyperglycemic peak (BP), just before lunch (B), after the post-lunch hyperglycemic peak (LP), after the post-lunch dale (LD) and 5 h after lunch (L) for the measurement of serum lipids, lipoprotein subfraction composition, alpha-tocopherol and lipid peroxidation in vivo and in vitro.
Serum triacylglycerols (Tgs) increased (from 1.03+/-0.40 at F to 1.60+/-0.87 mmol/l at LP, P=0.001), but cholesterol decreased by 12% in parallel with alpha-tocopherol (from 4.43+/-0.76 at F to 4.12+/-0.82 micromol/mmol total lipid at B, P=0.006). Although plasma malondialdehyde increased from 1.02+/-0.36 at F to 1.14+/-0.40 micromol/L at LP, P=0.03, copper-induced in vitro peroxidation decreased in the low-density lipoprotein and high-density lipoprotein fractions.
In well-controlled T1DM patients moderate postprandial increases in serum Tgs are accompanied by a relative deficiency in alpha-tocopherol. Lipid peroxidation in vivo increases but cannot be ascribed to changes in the susceptibility of lipoproteins to copper-induced in vitro peroxidation.
糖尿病患者心血管疾病风险高出两至四倍，餐后血糖和血脂对此风险的预测作用比空腹血糖和血脂更强。我们旨在研究I型糖尿病（T1DM）患者血清脂蛋白组分的餐后变化对脂质过氧化的影响。
这是一项前瞻性观察研究。
该研究在比利时安特卫普大学医院进行。
纳入23例病情控制良好的T1DM患者。
患者接受标准早餐和午餐（脂肪提供超过50%的能量）。在空腹（F）、早餐后高血糖峰值出现后（BP）、午餐前（B）、午餐后高血糖峰值出现后（LP）、午餐后血糖下降后（LD）以及午餐后5小时（L）采集血样，用于测定血清脂质、脂蛋白亚组分组成、α-生育酚以及体内和体外的脂质过氧化情况。
血清三酰甘油（Tgs）升高（从空腹时的1.03±0.40 mmol/L升至午餐后高血糖峰值时的1.60±0.87 mmol/L，P = 0.001），但胆固醇与α-生育酚平行下降了12%（从空腹时的4.43±0.76降至午餐前的4.12±0.82 μmol/mmol总脂质，P = 0.006）。尽管血浆丙二醛从空腹时的1.02±0.36 μmol/L升至午餐后高血糖峰值时的1.14±0.40 μmol/L，P = 0.03，但在低密度脂蛋白和高密度脂蛋白组分中，铜诱导的体外过氧化作用下降。
在病情控制良好的T1DM患者中，餐后血清Tgs适度升高伴随着α-生育酚相对缺乏。体内脂质过氧化增加，但不能归因于脂蛋白对铜诱导的体外过氧化敏感性的变化。
