Department of Medicine, Oregon Health & Sciences University, Portland, OR, United States.
Diabetes Res Clin Pract. 2009 Sep;85(3):265-71. doi: 10.1016/j.diabres.2009.06.012. Epub 2009 Jul 19.
Young women with T1D develop CHD without any apparent lipid related risk factor. To determine whether abnormalities in the five immunochemically defined apoB-containing lipoprotein subclasses might influence this risk, we have measured these subclasses in T1D subjects.
ApoA- and B-containing lipoprotein subclasses were isolated immunochemically and quantitated in 37 young (mean age 31.8+/-12.7 years) otherwise healthy subjects (16 males; 21 females) with T1D (HbA1c=8.2+/-1.7%) treated conventionally with subcutaneous insulin.
T1D women had significantly more cholesterol-rich Lp-B particles (T1D: 55.9+/-4.5 vs. control 46.8+/-11.1mg apoB/dL; p<.01) which were over-represented in the apolipoprotein B particle pool (apoB/Lp-B: T1D: 1.49+/-.19 vs. control: 1.67+/-.22; p<.01). HbA1c correlated with Lp-B (r=0.60; p<.001) and the mass of apoB subclasses containing apoC-III (r=0.69; p<.001).
Women with T1D have a disturbance in the transport of Lp-B particles manifested by both an absolute and relative increase in their number that may result from portal hypoinsulinemia and reduced LDL B,E receptor activity. This pathway may enhance CHD risk in T1D women when of LDL and apoB levels are normal.
患有 T1D 的年轻女性发生 CHD,而没有明显的脂质相关风险因素。为了确定五种免疫化学定义的载 apoB 的脂蛋白亚类中的异常是否会影响这种风险,我们已经在 T1D 患者中测量了这些亚类。
用免疫化学方法分离载 apoA 和 B 的脂蛋白亚类,并定量分析 37 名年轻(平均年龄 31.8+/-12.7 岁)且健康的 T1D 患者(16 名男性;21 名女性)的载 apoA 和 B 的脂蛋白亚类,这些患者的 T1D 得到常规的皮下胰岛素治疗,糖化血红蛋白(HbA1c)为 8.2+/-1.7%。
T1D 女性的富含胆固醇的 Lp-B 颗粒显著增加(T1D:55.9+/-4.5 vs. 对照组 46.8+/-11.1mg apoB/dL;p<.01),并且在载 apoB 脂蛋白颗粒池中的占比更高(apoB/Lp-B:T1D:1.49+/-.19 vs. 对照组:1.67+/-.22;p<.01)。HbA1c 与 Lp-B(r=0.60;p<.001)和含有 apoC-III 的 apoB 亚类的质量相关(r=0.69;p<.001)。
患有 T1D 的女性存在 Lp-B 颗粒转运异常,表现为其数量的绝对值和相对值均增加,这可能是由于门静脉低血糖和 LDL B、E 受体活性降低所致。当 LDL 和 apoB 水平正常时,这种途径可能会增加 T1D 女性的 CHD 风险。