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糖尿病患者血脂谱的研究。I型糖尿病患者胆固醇水平与血清淀粉酶浓度呈负相关。

Study of the lipidemic profile of diabetic patients. Negative correlation of cholesterol levels of diabetes type I patients with serum amylase concentration.

作者信息

Eleftheriou Phaedra, Tseka Eros, Varaga Evagelia, Nasiou Margarita, Sampanis Christos, Zografou Ioanna, Oulorgia Jensila, Damontsidou Katerina, Zaimi Terpsithea, Markou Helen-Irene, Varsamidis Kostantinos, Petrou Christos, Limberaki Eugenia, Ganou Christina-Joulia

机构信息

Department of Medical Laboratory Studies, School of Health and Medical Care, Alexander TEI of Thessaloniki, 57400, TEI Campus, Sindos, Greece.

出版信息

Hell J Nucl Med. 2014 Jan-Apr;17 Suppl 1:35-9.

PMID:24392467
Abstract

Diabetes Mellitus type I (DM1) and II (DM2) share the common characteristic of high blood glucose concentration and the health complications resulting from uncontrolled hyperglycemia such as hyperlipidemia, cardiovascular problems, stroke, ketoacidosis, kidney failure and blindness but have different etiology. DM1 is practically an autoimmune disease. Genetic susceptibility together with environmental factors leads to disease development. The main characteristics of Diabetes type II (DM2) is insulin resistance in muscle and liver cells accompanied by loss of β-cell function. However, adipose tissue, gastro-intestinal tract, pancreatic a-cell activity, may be involved in disease development. In parallel to the impairment of endocrine pancreatic function, a reduction in exocrine function has also been observed in all types of Diabetes Mellitus. A decrease in amylase and lipase activity has been mentioned by many authors, although cases with elevated amylase have been referred. Most recently a trend for positive correlation between HDL cholesterol and amylase in Diabetes type II patients was shown. In the present study we evaluated the lipidemic profile and related factors such as cortisol, total serum antioxidant capacity (TAC) and amylase in patients suffering from diabetes type I and II. The relationship between different parameters was examined. Blood serum from 20 DM1 patients and 45 DM2 patients was used. Serum from 50 healthy individuals was used as control. Total cholesterol and triglycerides were measured using an enzymatic colorimetric method. Serum cortisol, auto-antibodies and anti-Neu5Gc antibodies were measured using immunoenzyme assays and TAC measurement was made using the ABTS method. Mean total cholesterol was 245.5mg/dL in Diabetes I patients and was significantly elevated compared to healthy individuals as well as Diabetes II patients (168.71±76.0mg/dL). The observed difference was statistically significant (P=0.0004). On the contrary, triglyceride values were within normal range in both cases (123.7±63.2mg/dL in DM1 and 168.1±76.0mg/dL in DM2 patients). Cortisol levels were elevated in both cases with higher values observed in Diabetes type I (280.5±162.9ng/mL in DM1 and 248.5±100.1ng/mL in DM2), while total antioxidant capacity was significantly reduced compared to healthy individuals, 1.470mM, with lower values observed in Diabetes type I (0.680±0.116mM in DM1 and 0.849±0.126mM in DM2). Amylase determination revealed a mean amylase value, 81.7U/ml, within normal range and a negative correlation between cholesterol levels and amylase (r=-0.770) in DM1 patients. No correlation was observed between the determined values or the presence of autoantibodies and antibodies against Neu5Gc in the samples. In conlusion, the lipidemic profile and overall atherogenic and cardiovascular risk factors were worse in Diabetes I compared to Diabetes II patients. Most interestingly, cholesterol levels exhibited a negative correlation with serum amylase values. Since, amylase is not known to be involved in lipid metabolism, cholesterol levels and serum amylase activity may have a common modulator related to Diabetes development.

摘要

I型糖尿病(DM1)和II型糖尿病(DM2)具有血糖浓度高以及高血糖失控导致的健康并发症等共同特征,如高脂血症、心血管问题、中风、酮症酸中毒、肾衰竭和失明,但病因不同。DM1实际上是一种自身免疫性疾病。遗传易感性与环境因素共同导致疾病发展。II型糖尿病(DM2)的主要特征是肌肉和肝细胞中的胰岛素抵抗,并伴有β细胞功能丧失。然而,脂肪组织、胃肠道、胰腺α细胞活性可能参与疾病发展。与内分泌胰腺功能受损同时,在所有类型的糖尿病中也观察到外分泌功能降低。许多作者提到淀粉酶和脂肪酶活性降低,尽管也有淀粉酶升高的病例。最近显示,II型糖尿病患者中高密度脂蛋白胆固醇与淀粉酶呈正相关趋势。在本研究中,我们评估了I型和II型糖尿病患者的血脂谱以及相关因素,如皮质醇、总血清抗氧化能力(TAC)和淀粉酶。检查了不同参数之间的关系。使用了20例DM1患者和45例DM2患者的血清。50名健康个体的血清用作对照。总胆固醇和甘油三酯采用酶比色法测量。血清皮质醇、自身抗体和抗Neu5Gc抗体采用免疫酶测定法测量,TAC测量采用ABTS法。I型糖尿病患者的平均总胆固醇为245.5mg/dL,与健康个体以及II型糖尿病患者(168.71±76.0mg/dL)相比显著升高。观察到的差异具有统计学意义(P = 0.0004)。相反,两种情况下甘油三酯值均在正常范围内(DM1患者为123.7±63.2mg/dL,DM2患者为168.1±76.0mg/dL)。两种情况下皮质醇水平均升高,I型糖尿病中观察到的值更高(DM1中为280.5±162.9ng/mL,DM2中为248.5±100.1ng/mL),而与健康个体相比,总抗氧化能力显著降低,为1.470mM,I型糖尿病中观察到的值更低(DM1中为0.680±0.116mM,DM2中为0.849±0.126mM)。淀粉酶测定显示平均淀粉酶值为81.7U/ml,在正常范围内,且DM1患者中胆固醇水平与淀粉酶呈负相关(r = -0.770)。在样本中,未观察到测定值之间或自身抗体和抗Neu5Gc抗体的存在之间的相关性。总之,与II型糖尿病患者相比,I型糖尿病患者的血脂谱以及总体动脉粥样硬化和心血管危险因素更差。最有趣的是,胆固醇水平与血清淀粉酶值呈负相关。由于淀粉酶不参与脂质代谢,胆固醇水平和血清淀粉酶活性可能有一个与糖尿病发展相关的共同调节因子。

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