糖尿病血脂异常：评估与机制
Diabetic dyslipidemia: evaluation and mechanism.
作者信息
Yanai Hidekatsu, Hirowatari Yuji, Yoshida Hiroshi
机构信息
Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan.
Laboratory Sciences, Department of Health Sciences, School of Health and Social Service, Saitama Prefectural University, Saitama, Japan.
出版信息
Glob Health Med. 2019 Oct 31;1(1):30-35. doi: 10.35772/ghm.2019.01007.
Abstract
Diabetes is one of the well-established independent risk factors for cardiovascular diseases. Diabetes induces dyslipidemia which is characterized by elevated fasting triglyceride (TG) and reduced high-density lipoprotein-cholesterol (HDL-C), and such diabetic dyslipidemia is a crucial determinant for atherogenesis and atherosclerotic progression in patients with diabetes. Previous measurement methods of lipoproteins have problems including time-consuming (ultracentrifugation) and inaccurate and impossible measurements of TG-rich lipoproteins such as chylomicron, intermediate-density lipoprotein (IDL) and very low-density lipoprotein (VLDL). Our developed anion-exchange high-performance liquid chromatography (AEX-HPLC) can measure all fractions of lipoproteins accurately. Our studies using AEX-HPLC showed that IDL and VLDL in type 2 diabetes were higher than non-diabetic subjects, and IDL and VLDL were higher in the order of type 2 diabetic patients with obesity, type 2 diabetic patients without obesity, and non-diabetic subjects. Here, we also describe the underlying mechanisms for development of diabetic dyslipidemia.
摘要
糖尿病是公认的心血管疾病独立危险因素之一。糖尿病会引发血脂异常，其特征为空腹甘油三酯（TG）升高和高密度脂蛋白胆固醇（HDL-C）降低，而这种糖尿病性血脂异常是糖尿病患者动脉粥样硬化形成和进展的关键决定因素。以往的脂蛋白测量方法存在诸多问题，包括耗时（超速离心法）以及对富含TG的脂蛋白（如乳糜微粒、中间密度脂蛋白（IDL）和极低密度脂蛋白（VLDL））测量不准确甚至无法测量。我们研发的阴离子交换高效液相色谱法（AEX-HPLC）能够准确测量脂蛋白的所有组分。我们使用AEX-HPLC进行的研究表明，2型糖尿病患者的IDL和VLDL高于非糖尿病受试者，且按肥胖的2型糖尿病患者、非肥胖的2型糖尿病患者和非糖尿病受试者的顺序，IDL和VLDL依次升高。在此，我们还阐述了糖尿病性血脂异常发生的潜在机制。
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