Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusett, USA.
Diabetes. 2010 May;59(5):1153-60. doi: 10.2337/db09-1114. Epub 2010 Feb 25.
Diabetic dyslipoproteinemia is characterized by low HDL cholesterol and high triglycerides. We examined the association of lipoprotein particle size and concentration measured by nuclear magnetic resonance (NMR) spectroscopy with clinical type 2 diabetes.
This was a prospective study of 26,836 initially healthy women followed for 13 years for incident type 2 diabetes (n = 1,687). Baseline lipids were measured directly and lipoprotein size and concentration by NMR. Cox regression models included nonlipid risk factors (age, race, smoking, exercise, education, menopause, blood pressure, BMI, family history, A1C, and C-reactive protein). NMR lipoproteins were also examined after further adjusting for standard lipids.
Incident diabetes was significantly associated with baseline HDL cholesterol, triglycerides, and NMR-measured size and concentration of LDL, IDL, HDL, and VLDL particles. The associations of these particles differed substantially by size. Small LDL(NMR) and small HDL(NMR) were positively associated with diabetes (quintile 5 vs. 1 [adjusted hazard ratios and 95% CIs], 4.04 [3.21-5.09] and 1.84 [1.54-2.19], respectively). By contrast, large LDL(NMR) and large HDL(NMR) were inversely associated (quintile 1 vs. 5, 2.50 [2.12-2.95] and 4.51 [3.68-5.52], respectively). For VLDL(NMR), large particles imparted higher risk than small particles (quintile 5 vs. 1, 3.11 [2.35-4.11] and 1.31 [1.10-1.55], respectively). Lipoprotein particle size remained significant after adjusting for standard lipids and nonlipid factors.
In this prospective study of women, NMR lipoprotein size and concentrations were associated with incident type 2 diabetes and remained significant after adjustment for established risk factors, including HDL cholesterol and triglycerides.
糖尿病血脂异常的特征是高密度脂蛋白胆固醇降低和甘油三酯升高。我们研究了通过磁共振（NMR）光谱测量的脂蛋白颗粒大小和浓度与临床 2 型糖尿病的相关性。
这是一项对 26836 名最初健康的女性进行的前瞻性研究，她们在 13 年内发生了 2 型糖尿病（n=1687）。基线脂质直接测量，脂蛋白大小和浓度通过 NMR 测量。Cox 回归模型包括非脂质危险因素（年龄、种族、吸烟、运动、教育、绝经、血压、BMI、家族史、A1C 和 C 反应蛋白）。NMR 脂蛋白还在进一步调整标准脂质后进行了检查。
新诊断的糖尿病与基线时的 HDL 胆固醇、甘油三酯以及 LDL、IDL、HDL 和 VLDL 颗粒的 NMR 测量的大小和浓度显著相关。这些颗粒的相关性在大小上有很大的不同。小 LDL（NMR）和小 HDL（NMR）与糖尿病呈正相关（五分位 5 与 1 [调整后的危险比和 95%CI]，4.04 [3.21-5.09] 和 1.84 [1.54-2.19]）。相比之下，大 LDL（NMR）和大 HDL（NMR）呈负相关（五分位 1 与 5，2.50 [2.12-2.95] 和 4.51 [3.68-5.52]）。对于 VLDL（NMR），大颗粒比小颗粒带来更高的风险（五分位 5 与 1，3.11 [2.35-4.11] 和 1.31 [1.10-1.55]）。在调整标准脂质和非脂质因素后，脂蛋白颗粒大小仍然具有显著性。
在这项对女性的前瞻性研究中，NMR 脂蛋白大小和浓度与 2 型糖尿病的发生有关，在调整包括 HDL 胆固醇和甘油三酯在内的既定危险因素后仍然具有显著性。
