Burns Stephen F, Lee SoJung, Bacha Fida, Tfayli Hala, Hannon Tamara S, Arslanian Silva A
Division of Weight Management and Wellness, Metabolism and Diabetes Mellitus, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA 15201; Physical Education and Sports Science Academic Group, Nanyang Technological University, Singapore 637616.
Division of Weight Management and Wellness, Metabolism and Diabetes Mellitus, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA 15201.
Metabolism. 2014 Dec;63(12):1528-35. doi: 10.1016/j.metabol.2014.08.008. Epub 2014 Aug 27.
To compare atherogenic lipoprotein particles and vascular smooth muscle biomarkers in overweight youth with pre-diabetes (PD) vs. normal glucose tolerance (NGT).
144 adolescents (60 black, 84 white; 102 female; PD=45, NGT=99) aged 10-19 years underwent a fasting blood draw and 2-h OGTT. Lipoprotein particle size and subclass concentration and vascular smooth muscle biomarkers (ICAM-1, VCAM-1 and E-selectin) were compared between youth with PD and NGT.
Compared with NGT, PD adolescents had smaller LDL (mean±SE: 20.5±0.1 vs. 21.0±0.1 nm; P=0.002) and HDL (8.62±0.05 vs. 8.85±0.04 nm; P=0.013) size and elevated medium small (159.2±10.3 vs. 123.8±6.4 nmol/L; P=0.037) and very small (626.3±45.4 vs. 458.5±26.4 nmol/L; P=0.032) LDL particle concentrations, after adjustment for race and BMI. Further adjusting for fasting insulin or visceral adiposity obviated these differences between the groups except for LDL size. ICAM-1 and E-selectin did not differ in youth with PD but correlated with LDL and HDL size, and small LDL particle concentrations.
Overweight adolescents with PD have an atherogenic lipoprotein profile of small LDL and HDL size and increased concentrations of small LDL, moderated by insulin resistance and visceral adiposity, but independently driven by dysglycemia for LDL size. Associations between smooth muscle biomarkers and lipoproteins could be an early signal heralding the atherogenic process. It remains to be determined if correction of dysglycemia and associated lipoprotein abnormalities in obese youth could prove effective in halting this process.
比较超重的糖尿病前期（PD）青年与糖耐量正常（NGT）青年的致动脉粥样硬化脂蛋白颗粒和血管平滑肌生物标志物。
144名年龄在10至19岁的青少年（60名黑人，84名白人；102名女性；PD组45人，NGT组99人）进行了空腹抽血和2小时口服葡萄糖耐量试验（OGTT）。比较了PD青年和NGT青年的脂蛋白颗粒大小、亚类浓度以及血管平滑肌生物标志物（细胞间黏附分子-1、血管细胞黏附分子-1和E-选择素）。
与NGT相比，校正种族和体重指数（BMI）后，PD青少年的低密度脂蛋白（LDL）（均值±标准误：20.5±0.1 vs. 21.0±0.1 nm；P = 0.002）和高密度脂蛋白（HDL）（8.62±0.05 vs. 8.85±0.04 nm；P = 0.013）颗粒较小，中、小LDL颗粒浓度升高（159.2±10.3 vs. 123.8±6.4 nmol/L；P = 0.037），极小微LDL颗粒浓度升高（626.3±45.4 vs. 458.5±26.4 nmol/L；P = 0.032）。进一步校正空腹胰岛素或内脏脂肪后，除LDL大小外，两组间的这些差异消失。PD青年的细胞间黏附分子-1和E-选择素无差异，但与LDL和HDL大小以及小LDL颗粒浓度相关。
超重的PD青少年具有致动脉粥样硬化的脂蛋白谱，即LDL和HDL颗粒较小，小LDL浓度增加，这受胰岛素抵抗和内脏脂肪影响，但LDL大小独立受血糖异常驱动。平滑肌生物标志物与脂蛋白之间的关联可能是动脉粥样硬化过程的早期信号。肥胖青年中血糖异常及相关脂蛋白异常的纠正是否能有效阻止这一过程仍有待确定。
