Carstensen Marius, Thomsen Claus, Gotzsche Ole, Holst Jens Juul, Schrezenmeir Jürgen, Hermansen Kjeld
Department of Endocrinology and Metabolism C, Aarhus University Hospital, Aarhus Sygehus THG, Tage-Hansens Gade 2, DK-8000 Aarhus, Denmark.
Rev Diabet Stud. 2004 Winter;1(4):175-84. doi: 10.1900/RDS.2004.1.175. Epub 2005 Feb 10.
Postprandial lipemia plays an important role in the development of coronary heart disease through an elevation of triglyceride-rich lipoproteins. In type 2 diabetic male subjects, our aim was to compare postprandial lipemia in a high-risk population with former myocardial infarction (MI) with that of a lower risk population free of clinically detectable heart disease. 32 male type 2 diabetic subjects were included in the study. We matched 17 cases with a verified history of MI with 15 controls according to age, BMI, HbA1c, diabetes duration, smoking, and treatment of diabetes. Ongoing metformin, insulin, or lipid lowering pharmacological treatment were exclusion criteria. After a maximal exercise tolerance test and echocardiography, the subjects underwent a hyperinsulinemic, euglycemic clamp and a vitamin A fat loading test. Plasma triglyceride levels in the case group were significantly higher after 360 minutes (4.6 +/- 3.1 vs. 2.8 +/- 1.8 mmol/l, p = 0.04) and 480 minutes (3.6 +/- 2.2 vs. 2.4 +/- 2.4 mmol/l, p = 0.03), as was the incremental Area Under the Curve (iAUC) for the whole period (560 +/- 452 vs. 297 +/- 214 mmol x 480 min./l; p = 0.048). In addition, the retinyl palmitate responses in the chylomicron-fraction from the case group were significantly higher (iAUC 311,502 +/- 194,933 vs. 187,004 +/- 102,928 ng x 480 min./ml; p = 0.035). Type 2 diabetic males with prior MI had higher postprandial triglyceride-rich lipoprotein responses than those without MI, indicating that high responses may be a marker for a high-risk population.
餐后血脂异常通过富含甘油三酯的脂蛋白升高在冠心病的发展中起重要作用。在2型糖尿病男性受试者中，我们的目的是比较有既往心肌梗死（MI）的高危人群与无临床可检测心脏病的低危人群的餐后血脂异常情况。32名2型糖尿病男性受试者被纳入研究。我们根据年龄、体重指数、糖化血红蛋白、糖尿病病程、吸烟情况和糖尿病治疗情况，将17例有确诊MI病史的患者与15名对照进行匹配。正在进行二甲双胍、胰岛素或降脂药物治疗为排除标准。在进行最大运动耐量试验和超声心动图检查后，受试者接受了高胰岛素正常血糖钳夹试验和维生素A脂肪负荷试验。病例组在360分钟（4.6±3.1 vs. 2.8±1.8 mmol/l，p = 0.04）和480分钟（3.6±2.2 vs. 2.4±2.4 mmol/l，p = 0.03）时血浆甘油三酯水平显著更高，整个时间段的曲线下增量面积（iAUC）也是如此（560±452 vs. 297±214 mmol×480 min./l；p = 0.048）。此外，病例组乳糜微粒部分中棕榈酸视黄酯的反应显著更高（iAUC 311,502±194,933 vs. 187,004±102,928 ng×480 min./ml；p = 0.035）。既往有MI的2型糖尿病男性的餐后富含甘油三酯的脂蛋白反应高于无MI者，表明高反应可能是高危人群的一个标志物。
