Nakajo Y, Tanaka A, Uchimura I
Third Department of Internal Medicine, Faculty of Medicine, Tokyo Medical and Dental University.
Bull Tokyo Med Dent Univ. 1991 Dec;38(4):63-71.
To clarify the mechanism of the high incidence of ischemic heart disease in the diabetics, we studied the particle size of the lipoprotein with particular attention to the structural abnormality. Using high performance liquid chromatography, the particle size of the lipoprotein was determined with elution volume, which was precisely correlated with the particle size. The particle size of low density lipoprotein (LDL) from the diabetics with normolipidemia is larger than that from the nondiabetics (p less than 0.001) in the elution pattern of triglyceride. The examination of the elution pattern of the triglyceride and cholesterol revealed that this large LDL was composed of a large amount of triglyceride. These characteristics of the large LDL resembled that of the atherogenic intermediate density lipoprotein. The particle size of high density lipoprotein (HDL) from the diabetics with normolipidemia was larger than that from the nondiabetic controls (p less than 0.001), detected by the elution pattern of triglyceride. The comparison of the triglyceride and cholesterol elution pattern indicated that also the large HDL in the diabetics with normolipidemia was rich with triglyceride, which was reported to inhibit the activity of the lipid transfer protein. These facts revealed that the disorder of the lipid metabolism not accompanied with hyperlipidemia produced the large LDL and HDL, which might lead to the excess mortality rate of the ischemic heart disease in the diabetics even with normolipidemia.
为阐明糖尿病患者缺血性心脏病高发的机制，我们研究了脂蛋白的颗粒大小，尤其关注其结构异常。使用高效液相色谱法，通过洗脱体积来测定脂蛋白的颗粒大小，洗脱体积与颗粒大小精确相关。在甘油三酯洗脱模式中，血脂正常的糖尿病患者的低密度脂蛋白（LDL）颗粒大小比非糖尿病患者的大（p小于0.001）。对甘油三酯和胆固醇洗脱模式的检测显示，这种大的LDL含有大量甘油三酯。这种大LDL的这些特征类似于致动脉粥样硬化的中间密度脂蛋白。通过甘油三酯洗脱模式检测发现，血脂正常的糖尿病患者的高密度脂蛋白（HDL）颗粒大小比非糖尿病对照组的大（p小于0.001）。甘油三酯和胆固醇洗脱模式的比较表明，血脂正常的糖尿病患者中的大HDL也富含甘油三酯，据报道甘油三酯会抑制脂质转运蛋白的活性。这些事实表明，不伴有高脂血症的脂质代谢紊乱产生了大的LDL和HDL，这可能导致即使血脂正常的糖尿病患者缺血性心脏病的死亡率过高。
