Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University School of Medicine, Tokyo, Japan.
J Atheroscler Thromb. 2010 Apr 30;17(4):410-5. doi: 10.5551/jat.1891. Epub 2010 Mar 3.
To clarify the clinical significance of small,dense LDL (sLDL) in the metabolic syndrome associated with type 2 diabetes.
One hundred and ten healthy non-diabetic and non-metabolic syndrome subjects (58 male/52 female), 77 non-metabolic diabetic subjects (62/15), 58 non-diabetic metabolic subjects (25/33), and 46 metabolic diabetic subjects (29/17) were enrolled in this study.
The subjects with metabolic syndrome (both with and without type 2 diabetes) had significantly higher fasting blood glucose, total-cholesterol (C), LDL-C, triglyceride, sLDL-C and hs-CRP levels than non-metabolic and non-diabetic subjects. HDL-C levels were significantly decreased in the former compared to the latter. Among the metabolic syndrome subjects, those with type 2 diabetes had significantly higher fasting blood glucose, systolic blood pressure and hs-CRP values than those without diabetes. sLDL-C, LDL-C and hs-CRP were the highest and HDL-C was lowest in the metabolic syndrome with diabetes group. A multiple regression analysis revealed the most significant determinant of sLDL-C to be LDL-C, followed by HDL-C, total-C, metabolic syndrome, type 2 diabetes mellitus, and triglyceride.
Metabolic syndrome is a significant determinant of the plasma sLDL-C level. Hs-CRP was the highest in the metabolic syndrome patients with type 2 diabetes. Therefore, type 2 diabetes may further increase the risk of coronary artery disease in the metabolic syndrome subjects through cardiovascular inflammation.
阐明代谢综合征合并 2 型糖尿病患者中小而密的 LDL（sLDL）的临床意义。
本研究纳入 110 例健康非糖尿病非代谢综合征受试者（58 名男性/52 名女性）、77 例非代谢性糖尿病受试者（62 名男性/15 名女性）、58 例非糖尿病代谢性受试者（25 名男性/33 名女性）和 46 例代谢性糖尿病受试者（29 名男性/17 名女性）。
代谢综合征患者（合并或不合并 2 型糖尿病）的空腹血糖、总胆固醇（C）、LDL-C、甘油三酯、sLDL-C 和 hs-CRP 水平明显高于非代谢和非糖尿病患者。与后者相比，前者的 HDL-C 水平明显降低。在代谢综合征患者中，合并 2 型糖尿病的患者空腹血糖、收缩压和 hs-CRP 值明显高于无糖尿病患者。sLDL-C、LDL-C 和 hs-CRP 在合并糖尿病的代谢综合征患者中最高，HDL-C 最低。多元回归分析显示，sLDL-C 的最显著决定因素是 LDL-C，其次是 HDL-C、总胆固醇、代谢综合征、2 型糖尿病和甘油三酯。
代谢综合征是血浆 sLDL-C 水平的重要决定因素。hs-CRP 在合并 2 型糖尿病的代谢综合征患者中最高。因此，2 型糖尿病可能通过心血管炎症进一步增加代谢综合征患者发生冠心病的风险。
