Diabetes Center, Ebina General Hospital.
Yurakubashi Clinic.
J Atheroscler Thromb. 2022 May 1;29(5):762-774. doi: 10.5551/jat.62789. Epub 2021 Apr 29.
Abnormal compositional changes in low-density lipoprotein (LDL) particles, such as triglyceride (TG) enrichment and size reduction, are common in patients with diabetes. Several cohort studies have demonstrated that LDL-TG and sdLDL-cholesterol (C) are sensitive biomarkers for predicting atherosclerotic cardiovascular diseases beyond LDL-C. Although sdLDL has been extensively studied, little is known about the properties of LDL-TG. We investigated similarities or differences between LDL-TG and sdLDL-C.
Fasting plasma was obtained from 1,085 patients with type 2 diabetes who were enrolled in the diabetes regional cohort study (ViNA Cohort). LDL-TG and sdLDL-C concentrations were measured using a homogeneous assay established by us. In a subset of subjects, LDL-TG and sdLDL-C levels were measured postprandially or after treatment with lipid-lowering drugs.
In a quartile analysis, higher LDL-TG quartiles were associated with higher frequency of female and fibrate users, whereas sdLDL-C quartiles were associated with frequency of men, drinking, and metabolic syndrome-related measurements. Higher quartiles of LDL-TG/LDL-C were associated with smoking, drinking, fibrate users, and statin users. LDL-TG was significantly correlated with TG, LDL-C, sdLDL-C, and apolipoprotein (apo) B, with apoB being the primary determinant. LDL-TG correlated to high sensitive C-reactive protein (CRP) independently of other lipids. Mean LDL-TG did not change with fasting/non-fasting. Statin treatment reduced LDL-TG, whereas fibrates increased it, but these drugs reduced sdLDL-C equally.
LDL-TG levels were more tightly regulated by the number of LDL particles than plasma TG levels were. SdLDL-C was closely associated with metabolic syndrome-related factors, whereas LDL-TG was associated with low-grade systemic inflammation.
低密度脂蛋白（LDL）颗粒中异常的组成变化，如甘油三酯（TG）的富集和粒径减小，在糖尿病患者中很常见。几项队列研究表明，LDL-TG 和 sdLDL-胆固醇（C）是预测动脉粥样硬化性心血管疾病的敏感生物标志物，超出了 LDL-C 的预测范围。尽管 sdLDL 已经得到了广泛的研究，但对于 LDL-TG 的特性知之甚少。我们研究了 LDL-TG 和 sdLDL-C 之间的相似性或差异性。
从参加糖尿病区域性队列研究（ViNA 队列）的 1085 例 2 型糖尿病患者中采集空腹血浆。使用我们建立的均相测定法测量 LDL-TG 和 sdLDL-C 浓度。在亚组受试者中，测定了餐后或降脂药物治疗后的 LDL-TG 和 sdLDL-C 水平。
在四分位分析中，LDL-TG 四分位越高，女性和贝特类药物使用者的频率越高，而 sdLDL-C 四分位越高，男性、饮酒和代谢综合征相关测量的频率越高。LDL-TG/LDL-C 的四分位越高，与吸烟、饮酒、贝特类药物使用者和他汀类药物使用者相关。LDL-TG 与 TG、LDL-C、sdLDL-C 和载脂蛋白（apo）B 显著相关，apoB 是主要决定因素。LDL-TG 与其他脂质无关，与高敏 C 反应蛋白（CRP）独立相关。空腹/非空腹时 LDL-TG 均值无变化。他汀类药物治疗降低 LDL-TG，贝特类药物增加 LDL-TG，但这些药物对 sdLDL-C 的降低作用相当。
LDL-TG 水平受 LDL 颗粒数的调节比血浆 TG 水平更严格。sdLDL-C 与代谢综合征相关因素密切相关，而 LDL-TG 与低度全身炎症相关。
