非胰岛素依赖型糖尿病患者的载脂蛋白A-IV水平及表型分布

Apolipoprotein A-IV levels and phenotype distribution in NIDDM.

作者信息

Vergès B L, Vaillant G, Goux A, Lagrost L, Brun J M, Gambert P

机构信息

Service d'Endocrinologie, Hôpital du Bocage, Dijon, France.

出版信息

Diabetes Care. 1994 Aug;17(8):810-7. doi: 10.2337/diacare.17.8.810.

DOI:10.2337/diacare.17.8.810

PMID:7956623

Abstract

OBJECTIVE

To determine plasma apolipoprotein A-IV (apoA-IV) levels and phenotype distribution in non-insulin-dependent diabetes mellitus (NIDDM) patients and to analyze the influence of apoA-IV phenotype on lipid profiles in NIDDM.

RESEARCH DESIGN AND METHODS

Total cholesterol, triglyceride, high-density lipoprotein (HDL) cholesterol, HDL2 cholesterol, HDL3 cholesterol, free fatty acid, and apoA-IV levels were measured in 83 NIDDM patients and 100 normal control subjects. The apoA-IV phenotype was determined in each individual.

RESULTS

In both sexes, NIDDM patients had significantly higher levels of triglyceride and free fatty acid and significantly lower levels of HDL cholesterol and HDL2 cholesterol than control subjects. In men and women, apoA-IV levels were significantly higher in diabetic patients than in control subjects (men: 17.1 +/- 7.9 vs. 12.3 +/- 3.6 mg/dl, P < 0.001; women: 18.9 +/- 9.9 vs. 11.9 +/- 3.5 mg/dl, P < 0.001). The multiple regression analysis showed that the apoA-IV level in NIDDM patients was significantly and independently related to log triglyceride (P = 0.0001) and HDL cholesterol (P = 0.01) levels. The apoA-IV phenotype distribution was not significantly different between NIDDM patients and control subjects. In the control subjects, the apoA-IV-1-2 phenotype was associated with significantly higher levels of HDL cholesterol (69 +/- 12 vs. 56 +/- 11 mg/dl, P < 0.01) and of HDL2 cholesterol (36 +/- 15 vs. 25 +/- 12 mg/dl, P < 0.05) compared with the apoA-IV-1-1 phenotype; on the other hand, HDL cholesterol and HDL2 cholesterol levels were not different between the two apoA-IV phenotypes in NIDDM patients.

CONCLUSIONS

Plasma apoA-IV levels are increased in NIDDM patients. This increase in apoA-IV is related mainly to hypertriglyceridemia and, to a lesser extent, to HDL cholesterol level. The apoA-IV phenotype distribution is not different between NIDDM patients and nondiabetic control subjects. The potential protective lipid profile (characterized by increased HDL and HDL2 cholesterol levels) linked with apoA-IV-1-2 phenotype in control subjects is no longer found in NIDDM patients. We suggest that the metabolic state of NIDDM has erased the potential protective lipid profile associated with the apoA-IV-1-2 phenotype.

摘要

目的

测定非胰岛素依赖型糖尿病（NIDDM）患者的血浆载脂蛋白A-IV（apoA-IV）水平及表型分布，并分析apoA-IV表型对NIDDM患者血脂谱的影响。

研究设计与方法

测定了83例NIDDM患者和100例正常对照者的总胆固醇、甘油三酯、高密度脂蛋白（HDL）胆固醇、HDL2胆固醇、HDL3胆固醇、游离脂肪酸和apoA-IV水平。确定了每个个体的apoA-IV表型。

结果

在男性和女性中，NIDDM患者的甘油三酯和游离脂肪酸水平显著高于对照组，而HDL胆固醇和HDL2胆固醇水平显著低于对照组。在男性和女性中，糖尿病患者的apoA-IV水平显著高于对照组（男性：17.1±7.9 vs. 12.3±3.6 mg/dl，P<0.001；女性：18.9±9.9 vs. 11.9±3.5 mg/dl，P<0.001）。多元回归分析显示，NIDDM患者的apoA-IV水平与甘油三酯对数（P = 0.0001）和HDL胆固醇（P = 0.01）水平显著且独立相关。NIDDM患者和对照者之间的apoA-IV表型分布无显著差异。在对照者中，与apoA-IV-1-1表型相比，apoA-IV-1-2表型的HDL胆固醇（69±12 vs. 56±11 mg/dl，P<0.01）和HDL2胆固醇（36±15 vs. 25±12 mg/dl，P<0.05）水平显著更高；另一方面，NIDDM患者的两种apoA-IV表型之间的HDL胆固醇和HDL2胆固醇水平无差异。

结论

NIDDM患者血浆apoA-IV水平升高。apoA-IV的这种升高主要与高甘油三酯血症有关，在较小程度上与HDL胆固醇水平有关。NIDDM患者和非糖尿病对照者之间的apoA-IV表型分布无差异。在对照者中与apoA-IV-1-2表型相关的潜在保护性血脂谱（以HDL和HDL2胆固醇水平升高为特征）在NIDDM患者中不再存在。我们认为，NIDDM的代谢状态消除了与apoA-IV-1-2表型相关的潜在保护性血脂谱。