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不同糖耐量人群高密度脂蛋白胆固醇水平与胰岛β细胞功能的相关性。

Correlation between HDL cholesterol levels and beta-cell function in subjects with various degree of glucose tolerance.

机构信息

Section of Endocrinology, Department of Clinical Pathophysiology, University of Florence, Viale Pieraccini 6, 50134, Florence, Italy.

出版信息

Acta Diabetol. 2013 Apr;50(2):277-81. doi: 10.1007/s00592-011-0339-0. Epub 2011 Oct 14.

Abstract

Some reports showed direct effects of high density lipoprotein cholesterol (HDL-C) on beta-cells survival and insulin secretion, suggesting an its role on glucose metabolism. We queried, whether subjects screened for type 2 diabetes (DM2) could display some impairment of beta-cell performance related to their HDL-C levels. A total of 1,087 clinical outpatients at risk of DM2 with no history of diabetes were studied. All participants were assessed for anthropometry, fasting lipid profile, and 2hOGTT with blood samples for plasma glucose and insulin determinations. Matsuda index of insulin sensitivity, early (insulinogenic index × Matsuda) and total (insulin secretion-sensitivity index-2 [ISSI-2]) indices of beta-cell function OGTT derived were applied. Linear regression analyzed the association between HDL-C levels and indices of beta-cell activity in subjects with normal glucose tolerance (NGT), impaired fasting glycemia (IFG), and impaired glucose tolerance (IGT). After adjustment for triglyceride levels, waist circumference, blood pressure and age, in total NGT subjects the HDL-C levels were not significantly associated with IGI × Matsuda (β = 0.039, P = 0.10) and ISSI-2 index (β = 0.069, P = 0.18), while in NGT with low HDL-C and IFG subjects the IGI × Matsuda (β = 0.052, P = 0.019) and ISSI-2 indices (β = 0.061, P = 0.023) were significantly associated with HDL-C levels. This significant linear correlation has been also observed in IGT patients for both indices (β = 0.264, P = 0.0001 and β = 0.191, P = 0.002, respectively). In conclusion, in subjects with impaired glucose regulation, HDL-C levels are associated with indices of beta-cell dysfunction; thus, more attention, it should be deserve to HDL-C concentrations in IFG/IGT patients due their potential conversion to DM2.

摘要

一些报告显示高密度脂蛋白胆固醇(HDL-C)对β细胞的存活和胰岛素分泌有直接影响,提示其在葡萄糖代谢中的作用。我们探讨了在筛查 2 型糖尿病(DM2)的人群中,其 HDL-C 水平是否与β细胞功能障碍有关。共研究了 1087 例无糖尿病史的 2 型糖尿病高危临床门诊患者。所有参与者均接受了人体测量学、空腹血脂谱和 2hOGTT 评估,采集血样测定血浆葡萄糖和胰岛素。应用胰岛素敏感性的 Matsuda 指数、早期(胰岛素生成指数×Matsuda)和总(胰岛素分泌敏感性指数-2 [ISSI-2])β细胞功能的 OGTT 衍生指数。线性回归分析了在糖耐量正常(NGT)、空腹血糖受损(IFG)和糖耐量受损(IGT)患者中,HDL-C 水平与β细胞活性指标之间的关系。在校正甘油三酯水平、腰围、血压和年龄后,在 NGT 患者中,HDL-C 水平与 IGI×Matsuda(β=0.039,P=0.10)和 ISSI-2 指数(β=0.069,P=0.18)无显著相关性,但在 NGT 患者中,低 HDL-C 和 IFG 患者的 IGI×Matsuda(β=0.052,P=0.019)和 ISSI-2 指数(β=0.061,P=0.023)与 HDL-C 水平显著相关。在 IGT 患者中,这两个指数也观察到了显著的线性相关性(β=0.264,P=0.0001 和 β=0.191,P=0.002)。结论:在葡萄糖调节受损的患者中,HDL-C 水平与β细胞功能障碍的指标相关;因此,由于 IFG/IGT 患者可能转化为 DM2,应更加关注其 HDL-C 浓度。

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