Lahdenperä S, Groop P H, Tilly-Kiesi M, Kuusi T, Elliott T G, Viberti G C, Taskinen M R
Third Department of Medicine, University of Helsinki, Finland.
Diabetologia. 1994 Jul;37(7):681-8. doi: 10.1007/BF00417692.
To answer the question whether the elevation of LDL-cholesterol in IDDM patients with incipient and established diabetic nephropathy is accompanied by changes in LDL size or composition, we studied distribution of LDL particles in 57 normoalbuminuric [AER 7 (1-9) micrograms/min, median and range], in 46 microalbuminuric [AER 50 (20-192) micrograms/min] and in 33 proteinuric [AER 422 (233-1756) micrograms/min] IDDM patients as well as in 49 non-diabetic control subjects with normoalbuminuria. The three diabetic groups were matched for duration of diabetes and glycaemic control. The mean particle diameter of the major LDL peak was determined by nondenaturing gradient gel electrophoresis. Composition and density distribution of LDL were determined in the subgroups of each patient group by density gradient ultracentrifugation. Normoalbuminuric IDDM patients had larger LDL particles than non-diabetic control subjects (260 A vs 254 A, p < 0.05). LDL particle diameter was inversely correlated with serum triglycerides in all groups (p < 0.05 for normoalbuminuric and p < 0.001 for other groups). Triglyceride content of LDL was higher in three IDDM groups compared to control group (p < 0.05). The elevation of LDL mass in microalbuminuric and proteinuric IDDM groups compared to normoalbuminuric IDDM group (p < 0.05 for both) was mainly due to the increment of light LDL (density 1.0212-1.0343 g/ml). There were no significant changes in the density distribution or composition of LDL between the three diabetic groups. In conclusion the increase of LDL mass without major compositional changes suggests that the elevation of LDL in incipient and established diabetic nephropathy is primarily due to the increased number of LDL particles.(ABSTRACT TRUNCATED AT 250 WORDS)
为了回答初发和已确诊糖尿病肾病的胰岛素依赖型糖尿病（IDDM）患者低密度脂蛋白胆固醇（LDL-胆固醇）升高是否伴有LDL大小或组成变化这一问题，我们研究了57例正常白蛋白尿患者[AER 7（1-9）微克/分钟，中位数及范围]、46例微量白蛋白尿患者[AER 50（20-192）微克/分钟]、33例蛋白尿患者[AER 422（233-1756）微克/分钟]以及49例正常白蛋白尿非糖尿病对照者的LDL颗粒分布情况。这三组糖尿病患者在糖尿病病程和血糖控制方面相匹配。主要LDL峰的平均颗粒直径通过非变性梯度凝胶电泳测定。通过密度梯度超速离心法在每组患者的亚组中测定LDL的组成和密度分布。正常白蛋白尿的IDDM患者的LDL颗粒比非糖尿病对照者大（260 Å对254 Å，p<0.05）。所有组中LDL颗粒直径与血清甘油三酯呈负相关（正常白蛋白尿组p<0.05，其他组p<0.001）。与对照组相比，三组IDDM患者LDL的甘油三酯含量更高（p<0.05）。微量白蛋白尿和蛋白尿的IDDM组与正常白蛋白尿的IDDM组相比，LDL质量升高（两者均p<0.05），主要是由于轻LDL（密度1.0212-1.0343 g/ml）增加。三组糖尿病患者之间LDL的密度分布或组成无显著变化。总之，LDL质量增加但无主要组成变化表明，初发和已确诊糖尿病肾病患者LDL升高主要是由于LDL颗粒数量增加。（摘要截短于250字）
