Brugnara Laura, Mallol Roger, Ribalta Josep, Vinaixa Maria, Murillo Serafín, Casserras Teresa, Guardiola Montse, Vallvé Joan Carles, Kalko Susana G, Correig Xavier, Novials Anna
Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain; Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Barcelona, Spain.
Metabolomics Platform, Universitat Rovira i Virgili (URV), Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.
PLoS One. 2015 Aug 28;10(8):e0136348. doi: 10.1371/journal.pone.0136348. eCollection 2015.
Patients with type 1 diabetes (T1D) present increased risk of cardiovascular disease (CVD). The aim of this study is to improve the assessment of lipoprotein profile in patients with T1D by using a robust developed method 1H nuclear magnetic resonance spectroscopy (1H NMR), for further correlation with clinical factors associated to CVD. Thirty patients with T1D and 30 non-diabetes control (CT) subjects, matched for gender, age, body composition (DXA, BMI, waist/hip ratio), regular physical activity levels and cardiorespiratory capacity (VO2peak), were analyzed. Dietary records and routine lipids were assessed. Serum lipoprotein particle subfractions, particle sizes, and cholesterol and triglycerides subfractions were analyzed by 1H NMR. It was evidenced that subjects with T1D presented lower concentrations of small LDL cholesterol, medium VLDL particles, large VLDL triglycerides, and total triglycerides as compared to CT subjects. Women with T1D presented a positive association with HDL size (p<0.005; R = 0.601) and large HDL triglycerides (p<0.005; R = 0.534) and negative (p<0.005; R = -0.586) to small HDL triglycerides. Body fat composition represented an important factor independently of normal BMI, with large LDL particles presenting a positive correlation to total body fat (p<0.005; R = 0.505), and total LDL cholesterol and small LDL cholesterol a positive correlation (p<0.005; R = 0.502 and R = 0.552, respectively) to abdominal fat in T1D subjects; meanwhile, in CT subjects, body fat composition was mainly associated to HDL subclasses. VO2peak was negatively associated (p<0.005; R = -0.520) to large LDL-particles only in the group of patients with T1D. In conclusion, patients with T1D with adequate glycemic control and BMI and without chronic complications presented a more favourable lipoprotein profile as compared to control counterparts. In addition, slight alterations in BMI and/or body fat composition showed to be relevant to provoking alterations in lipoproteins profiles. Finally, body fat composition appears to be a determinant for cardioprotector lipoprotein profile.
1型糖尿病（T1D）患者患心血管疾病（CVD）的风险增加。本研究的目的是通过使用一种成熟的方法——1H核磁共振波谱法（1H NMR），改进对T1D患者脂蛋白谱的评估，以便进一步与CVD相关临床因素进行关联分析。对30例T1D患者和30例非糖尿病对照（CT）受试者进行了分析，这些受试者在性别、年龄、身体成分（双能X线吸收法、BMI、腰臀比）、日常身体活动水平和心肺功能（VO2峰值）方面相匹配。评估了饮食记录和常规血脂情况。通过1H NMR分析血清脂蛋白颗粒亚组分、颗粒大小以及胆固醇和甘油三酯亚组分。结果表明，与CT受试者相比，T1D受试者的小LDL胆固醇、中VLDL颗粒、大VLDL甘油三酯和总甘油三酯浓度较低。T1D女性患者与HDL大小呈正相关（p<0.005；R = 0.601）以及与大HDL甘油三酯呈正相关（p<0.005；R = 0.534），而与小HDL甘油三酯呈负相关（p<0.005；R = -0.586）。身体脂肪组成是一个重要因素，独立于正常BMI，在T1D受试者中，大LDL颗粒与全身脂肪呈正相关（p<0.005；R = 0.505），总LDL胆固醇和小LDL胆固醇与腹部脂肪呈正相关（分别为p<0.005；R = 0.502和R = 0.552）；与此同时，在CT受试者中，身体脂肪组成主要与HDL亚类相关。仅在T1D患者组中，VO2峰值与大LDL颗粒呈负相关（p<0.005；R = -0.520）。总之，血糖控制良好、BMI正常且无慢性并发症的T1D患者与对照受试者相比，具有更有利的脂蛋白谱。此外，BMI和/或身体脂肪组成的轻微变化似乎与脂蛋白谱的改变有关。最后，身体脂肪组成似乎是心脏保护脂蛋白谱的一个决定因素。
