Billingham M S, Milles J J, Green A, Bailey C J, Hall R A
Department of Clinical Chemistry, Good Hope General Hospital, Birmingham, UK.
Scand J Clin Lab Invest. 1989 May;49(3):239-47.
The effect of sample pre-treatment as a source of variability of apolipoprotein (apo) AI, AII and B assays was demonstrated with lipid dissociating agents. The average mean percentage change ranged from -58 to +133% compared with untreated samples. The apolipoprotein method selected was validated by comparing their concentrations with their corresponding lipoprotein lipid or protein in normal controls and Type 2 (non-insulin-dependent) diabetic patients. The coefficient of variation was maintained below 3.5% for apo AI, AII, B and HDL2-apo AI. The apolipoprotein concentrations of fasting plasma lipoproteins were determined in a cross-sectional study of non-obese (body-mass index less than or equal to 30) patients with Type 2 diabetes mellitus. Compared with normal subjects matched for sex, age, body-mass index, exercise, alcohol consumption and smoking. Type 2 patients at diagnosis showed reduced apo AI and HDL2-apo AI concentrations, lowered apo AI:B ratio and increased concentrations of apo B. Type 2 patients treated by diet alone (for 6-72 months) and diet plus glibenclamide (2.5-15 mg/day for 6-48 months) exhibited similar abnormalities of plasma apolipoprotein concentration to Type 2 patients at diagnosis. However, in Type 2 patients treated with insulin (25-65 U/day for 8-144 months) concentrations of apo AI and HDL2-apo AI, and the apo AI:B ratio were normal. Apo B concentrations were generally lower compared with all groups of non-insulin treated patients. These abnormalities of apolipoprotein metabolism, which are associated with premature coronary disease, are still evident in patients treated by diet and diet plus glibenclamide, but are not seen in Type 2 patients treated with insulin.
用脂质解离剂证明了样品预处理作为载脂蛋白（apo）AI、AII和B检测变异性来源的影响。与未处理的样品相比，平均百分比变化范围为-58%至+133%。通过将其浓度与正常对照和2型（非胰岛素依赖型）糖尿病患者中相应的脂蛋白脂质或蛋白质进行比较，对所选的载脂蛋白方法进行了验证。apo AI、AII、B和HDL2-apo AI的变异系数保持在3.5%以下。在一项对非肥胖（体重指数小于或等于30）2型糖尿病患者的横断面研究中，测定了空腹血浆脂蛋白的载脂蛋白浓度。与在性别、年龄、体重指数、运动、饮酒和吸烟方面相匹配的正常受试者相比。2型患者在诊断时显示apo AI和HDL2-apo AI浓度降低，apo AI:B比值降低，apo B浓度升高。仅通过饮食治疗（6 - 72个月）和饮食加格列本脲治疗（2.5 - 15毫克/天，6 - 48个月）的2型患者，其血浆载脂蛋白浓度异常与诊断时的2型患者相似。然而，在接受胰岛素治疗（25 - 65单位/天，8 - 144个月）的2型患者中，apo AI和HDL2-apo AI浓度以及apo AI:B比值正常。与所有非胰岛素治疗患者组相比，apo B浓度通常较低。这些与早发冠心病相关的载脂蛋白代谢异常，在通过饮食和饮食加格列本脲治疗的患者中仍然明显，但在接受胰岛素治疗的2型患者中未观察到。
