Barakat H A, Carpenter J W, McLendon V D, Khazanie P, Leggett N, Heath J, Marks R
Department of Biochemistry, School of Medicine, East Carolina University, Greenville, North Carolina 27858.
Diabetes. 1990 Dec;39(12):1527-33. doi: 10.2337/diab.39.12.1527.
The possible causes of the enhanced risk for coronary heart disease (CHD) were examined in morbidly obese women with normoglycemia, impaired glucose tolerance (IGT), and non-insulin-dependent diabetes mellitus (NIDDM) before and after gastric bypass surgery. Compared with age-matched lean women, plasma lipid and apolipoprotein concentrations of the obese women before surgery favored atherogenesis. The risk for CHD may further be exacerbated in the IGT and NIDDM groups by the prevalence of smaller and denser low-density-lipoprotein (LDL) particles. LDL size correlated negatively with plasma insulin levels independent of triglyceride levels, age, or body mass index (BMI). After surgery, BMI, plasma insulin, and triglyceride levels decreased, but LDL size increased, and LDL density decreased. Neither cholesterol nor LDL cholesterol levels were affected after surgery, but high-density-lipoprotein cholesterol was increased in all patients after surgery. Although the mechanisms underlying the changes in the properties of LDL could not be determined from this study, these changes appear to be of benefit in reducing CHD risk in these patients.
在胃旁路手术前后，对血糖正常、糖耐量受损（IGT）和非胰岛素依赖型糖尿病（NIDDM）的病态肥胖女性冠心病（CHD）风险增加的可能原因进行了研究。与年龄匹配的瘦女性相比，肥胖女性术前的血浆脂质和载脂蛋白浓度有利于动脉粥样硬化的发生。IGT和NIDDM组中较小且密度较高的低密度脂蛋白（LDL）颗粒的流行可能会进一步加剧CHD风险。LDL大小与血浆胰岛素水平呈负相关，与甘油三酯水平、年龄或体重指数（BMI）无关。术后，BMI、血浆胰岛素和甘油三酯水平下降，但LDL大小增加，LDL密度下降。术后胆固醇和LDL胆固醇水平均未受影响，但所有患者术后高密度脂蛋白胆固醇均升高。尽管本研究无法确定LDL性质变化的潜在机制，但这些变化似乎有利于降低这些患者的CHD风险。
