Fernández V, Campos G, Rincón E, Valbuena H, Ryder E, Gomez M E, Raleigh X
Instituto de Investigaciones Clínicas, Universidad del Zulia, Maracaibo, Venezuela.
Invest Clin. 1996 Mar;37(1):17-34.
The aim of this study was to evaluate the alterations of the lipoprotein composition and their relation with the insulin-resistance and/or hyperinsulinemia in non diabetic obese patients. Twenty-two no obese(13 women and 9 men) and 30 obese patients (BMI > 30) were studied, who were divided into two groups according to the total lipid levels. The first group was formed by 18 obese patients (10 women and 8 men) with normal serum cholesterol (Chol) concentration < 200 mg/dL and triglycerides (TG) < 150mg/dL (NO), while the second group were formed by 12 obese patients (3 women and 9 men) with elevated Chol level > 200mg/dL and/or TG > 150 mg/dL (HO). A clinical and anthropometric examination was performed to each patient, as well as a glucose tolerance test, including serum glucose and insulin determinations. Likewise, the plasma lipoproteins (VLDL, LDL, HDL2 and HDL3) were isolated by ultracentrifugation and their cholesterol and triglycerides content were determined by enzymatic methods. In this report, we demonstrate the existence of compensatory basal hyperinsulinemia in men and women on both obese patients populations as well as alterations in the lipoprotein composition, mostly a TG overload even on NO. On the other hand, the presence of lipids and lipoproteins modification were obvious in those patients with abdominal obesity, on whom the hyperinsulinemia was more evident, which could be related with the high risk of cardiovascular disease in this kind of patients.
本研究的目的是评估非糖尿病肥胖患者脂蛋白组成的变化及其与胰岛素抵抗和/或高胰岛素血症的关系。研究了22名非肥胖者(13名女性和9名男性)和30名肥胖患者(BMI>30),根据总血脂水平将他们分为两组。第一组由18名肥胖患者(10名女性和8名男性)组成,其血清胆固醇(Chol)浓度<200mg/dL且甘油三酯(TG)<150mg/dL(正常血脂组,NO),而第二组由12名肥胖患者(3名女性和9名男性)组成,其Chol水平>200mg/dL和/或TG>150mg/dL(高血脂组,HO)。对每位患者进行了临床和人体测量检查,以及葡萄糖耐量试验,包括测定血清葡萄糖和胰岛素。同样,通过超速离心分离血浆脂蛋白(极低密度脂蛋白、低密度脂蛋白、高密度脂蛋白2和高密度脂蛋白3),并用酶法测定其胆固醇和甘油三酯含量。在本报告中,我们证明了在这两组肥胖患者人群中,男性和女性均存在代偿性基础高胰岛素血症,以及脂蛋白组成的改变,即使在正常血脂组中也主要是甘油三酯过载。另一方面,腹部肥胖患者中脂质和脂蛋白修饰的存在很明显,这些患者的高胰岛素血症更明显,这可能与这类患者心血管疾病的高风险有关。