Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
Acta Diabetol. 2014 Feb;51(1):15-22. doi: 10.1007/s00592-012-0420-3. Epub 2012 Aug 2.
We hypothesized that the influence of metabolic parameters depends on metabolic syndrome (MetS) status. The clinical and metabolic implications of postprandial triglyceride (ppTG) in Korean type 2 diabetes were investigated in the presence or absence of MetS, MetS+, or MetS-. To investigate the relationship between ppTG and metabolic parameters, we analyzed plasma TG levels in 126 newly diagnosed, drug-naïve diabetic patients after ingestion of a standardized low calorie and fat (500 kcal, 17.5 g fat) liquid meal formula. We report that MetS+ patients have significantly higher BMI, waist/hip ratio, HOMA-IR, and HOMA-β, but insignificantly higher fasting TG, ppTG, and ΔTG than MetS- patients. In the MetS+ patients, ppTG correlated with fasting TG and non-HDL, but was not related to HOMA-IR. In MetS- patients, ppTG correlated with fasting TG, non-HDL, blood pressure, waist/hip ratio, fasting C-peptide and insulin levels, and HOMA-IR. Multivariate analysis showed HOMA-IR to be a predictive factor for ppTG in MetS- patients but not in MetS+ patients. ppTG correlated with IR in MetS- type 2 diabetic patients but not in MetS+. This unexpected result implies that MetS+ diabetic patients already have high fasting TG and that IR influences fasting TG more dominantly than ppTG.
我们假设代谢参数的影响取决于代谢综合征（MetS）的状态。本研究旨在探讨韩国 2 型糖尿病患者中存在或不存在代谢综合征（MetS）、MetS+或 MetS-时，餐后甘油三酯（ppTG）的临床和代谢意义。为了研究 ppTG 与代谢参数之间的关系，我们分析了 126 例新诊断、未服用药物的糖尿病患者在摄入标准化低热量和低脂肪（500 千卡，17.5 克脂肪）液体餐配方后的血浆 TG 水平。结果显示，MetS+患者的 BMI、腰围/臀围比、HOMA-IR 和 HOMA-β显著升高，而空腹 TG、ppTG 和ΔTG 显著升高，MetS-患者的 BMI、腰围/臀围比、HOMA-IR 和 HOMA-β显著升高。在 MetS+患者中，ppTG 与空腹 TG 和非高密度脂蛋白胆固醇（non-HDL）相关，但与 HOMA-IR 无关。在 MetS-患者中，ppTG 与空腹 TG、非高密度脂蛋白胆固醇、血压、腰围/臀围比、空腹 C 肽和胰岛素水平以及 HOMA-IR 相关。多变量分析显示，HOMA-IR 是 MetS-患者 ppTG 的预测因素，但不是 MetS+患者的预测因素。ppTG 与 MetS-2 型糖尿病患者的 IR 相关，但与 MetS+患者无关。这一意外结果表明，MetS+糖尿病患者的空腹 TG 已经很高，IR 对空腹 TG 的影响比 ppTG 更显著。
