Uddin F, Miah A K
Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine & Metabolic Disorders, Dhaka.
Bangladesh Med Res Counc Bull. 1995 Aug;21(2):64-72.
Atherosclerotic cardiovascular disease is the major cause of morbidity and mortality in NIDDM patients. But the exact pathophysiology of accelerated atherosclerosis seen in NIDDM is not completely understood. Hyperinsulinemia and hyperlipidemia frequently coexist in these subjects. Present study was undertaken to demonstrate relationship of serum insulin with atherogenic lipids in 92 (male = 62, female = 30) newly diagnosed, middle-aged, nonsmoking, uncomplicated and untreated NIDDM patients with normal body mass index (BMI). Fourty (male = 20, female = 20) non-diabetic healthy subjects with a negative family history of diabetes served as control. After an overnight fasting, venous blood was collected for plasma glucose, serum insulin and lipid profile. ECG and oral glucose tolerance test (OGTT) were done in all subjects. Diabetes mellitus was diagnosed by WHO criteria. Total cholesterol, LDL-c, LDL/HDL ratio, TG (p always < 0.001) and fasting serum insulin (p = 0.033) were significantly higher and HDL-c was significantly lower (p = 0.001) in NIDDM than control subjects. Fasting serum insulin was inversely related to the degree of hyperglycemia in NIDDM subjects (r = -0.1867; p = 0.037). NIDDM with hyperinsulinemia (n = 18) had a strong negative correlation (r = -0.449, p = 0.031) with HDL-c. Neither total cholesterol nor LDL-c had any significant correlation with insulin. The results indicate that diabetic state itself is associated with atherogenic lipid disorder.
动脉粥样硬化性心血管疾病是2型糖尿病患者发病和死亡的主要原因。但2型糖尿病中加速动脉粥样硬化的确切病理生理学尚未完全明确。高胰岛素血症和高脂血症在这些患者中常同时存在。本研究旨在探讨92例（男性62例，女性30例）新诊断的、中年的、不吸烟的、无并发症且未接受治疗的体重指数（BMI）正常的2型糖尿病患者血清胰岛素与致动脉粥样硬化脂质之间的关系。40例（男性20例，女性20例）无糖尿病家族史的非糖尿病健康受试者作为对照。空腹过夜后，采集静脉血检测血浆葡萄糖、血清胰岛素和血脂谱。所有受试者均进行心电图和口服葡萄糖耐量试验（OGTT）。糖尿病根据世界卫生组织标准诊断。2型糖尿病患者的总胆固醇、低密度脂蛋白胆固醇、低密度脂蛋白/高密度脂蛋白比值、甘油三酯（p均<0.001）和空腹血清胰岛素（p = 0.033）显著高于对照组，高密度脂蛋白胆固醇显著低于对照组（p = 0.001）。2型糖尿病患者空腹血清胰岛素与高血糖程度呈负相关（r = -0.1867；p = 0.037）。高胰岛素血症的2型糖尿病患者（n = 18）与高密度脂蛋白胆固醇呈强负相关（r = -0.449，p = 0.031）。总胆固醇和低密度脂蛋白胆固醇与胰岛素均无显著相关性。结果表明，糖尿病状态本身与致动脉粥样硬化的脂质紊乱有关。
