基于核磁共振（NMR）技术的脂蛋白颗粒浓度变化与空腹血糖受损、葡萄糖耐量受损或显性 2 型糖尿病有关。
NMR derived changes of lipoprotein particle concentrations related to impaired fasting glucose, impaired glucose tolerance, or manifest type 2 diabetes mellitus.
机构信息
Institute of Biophysics and Physical Biochemistry and Centre of Magnetic Resonance in Chemistry and Biomedicine, University of Regensburg, Universitätsstr. 31, 93040, Regensburg, Germany.
Blutspendedienst des Bayerischen Roten Kreuzes Gemeinnützige GmbH, Herzog-Heinrich-Straße 2, 80336, Munich, Germany.
出版信息
Lipids Health Dis. 2023 Mar 24;22(1):42. doi: 10.1186/s12944-023-01801-7.
BACKGROUND
Type 2 diabetes mellitus (T2D) and corresponding borderline states, impaired fasting glucose (IFG) and/or glucose tolerance (IGT), are associated with dyslipoproteinemia. It is important to distinguish between factors that cause T2D and that are the direct result of T2D.
METHODS
The lipoprotein subclass patterns of blood donors with IFG, IGT, with IFG combined with IGT, and T2D are analyzed by nuclear magnetic resonance (NMR) spectroscopy. The development of lipoprotein patterns with time is investigated by using samples retained for an average period of 6 years. In total 595 blood donors are classified by oral glucose tolerance test (oGTT) and their glycosylated hemoglobin (HbA1c) concentrations. Concentrations of lipoprotein particles of 15 different subclasses are analyzed in the 10,921 NMR spectra recorded under fasting and non-fasting conditions. The subjects are assumed healthy according to the strict regulations for blood donors before performing the oGTT.
RESULTS
Under fasting conditions manifest T2D exhibits a significant concentration increase of the smallest HDL particles (HDL A) combined with a decrease in all other HDL subclasses. In contrast to other studies reviewed in this paper, a general concentration decrease of all LDL particles is observed that is most prominent for the smallest LDL particles (LDL A). Under normal nutritional conditions a large, significant increase of the concentrations of VLDL and chylomicrons is observed for all groups with IFG and/or IGT and most prominently for manifest T2D. As we show it is possible to obtain an estimate of the concentrations of the apolipoproteins Apo-A1, Apo-B100, and Apo-B48 from the NMR data. In the actual study cohort, under fasting conditions the concentrations of the lipoproteins are not increased significantly in T2D, under non-fasting conditions only Apo-B48 increases significantly.
CONCLUSION
In contrast to other studies, in our cohort of "healthy" blood donors the T2D associated dyslipoproteinemia does not change the total concentrations of the lipoprotein particles produced in the liver under fasting and non-fasting conditions significantly but only their subclass distributions. Compared to the control group, under non-fasting conditions participants with IGT and IFG or T2D show a substantial increase of plasma concentrations of those lipoproteins that are produced in the intestinal tract. The intestinal insulin resistance becomes strongly observable.
背景
2 型糖尿病（T2D）和相应的边缘状态，空腹血糖受损（IFG）和/或葡萄糖耐量受损（IGT），与血脂异常有关。区分导致 T2D 的因素和 T2D 的直接结果很重要。
方法
采用核磁共振（NMR）光谱法分析 IFG、IGT、IFG 合并 IGT 以及 T2D 献血者的脂蛋白亚类模式。通过使用保留平均 6 年的样本研究脂蛋白模式随时间的发展。总共 595 名献血者根据口服葡萄糖耐量试验（oGTT）和糖化血红蛋白（HbA1c）浓度进行分类。在空腹和非空腹条件下记录的 10921 个 NMR 谱中分析了 15 种不同亚类的脂蛋白颗粒浓度。根据 oGTT 前执行的严格献血者规定，受试者被假定为健康。
结果
在空腹状态下，表现出 T2D 的患者，最小的高密度脂蛋白颗粒（HDL A）浓度显著增加，而所有其他 HDL 亚类的浓度都降低。与本文综述的其他研究相反，观察到所有 LDL 颗粒的浓度普遍降低，最小的 LDL 颗粒（LDL A）最为明显。在正常营养条件下，所有 IFG 和/或 IGT 组以及表现出 T2D 的患者，VLDL 和乳糜微粒的浓度显著增加。正如我们所展示的，从 NMR 数据中可以获得载脂蛋白 Apo-A1、Apo-B100 和 Apo-B48 的浓度估计值。在实际研究队列中，空腹状态下 T2D 患者的脂蛋白浓度没有显著增加，非空腹状态下只有 Apo-B48 显著增加。
结论
与其他研究相比，在我们的“健康”献血者队列中，与 T2D 相关的血脂异常不会显著改变空腹和非空腹条件下肝脏产生的脂蛋白颗粒的总浓度，但只会改变其亚类分布。与对照组相比，IGT 和 IFG 或 T2D 患者在非空腹条件下，肠道产生的脂蛋白的血浆浓度显著增加。肠道胰岛素抵抗变得非常明显。
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