非胰岛素依赖型糖尿病中的胆固醇吸收、合成及低密度脂蛋白代谢

Cholesterol absorption, synthesis, and LDL metabolism in NIDDM.

作者信息

Gylling H, Miettinen T A

机构信息

Department of Medicine, University of Helsinki, Finland.

出版信息

Diabetes Care. 1997 Jan;20(1):90-5. doi: 10.2337/diacare.20.1.90.

DOI:10.2337/diacare.20.1.90

PMID:9028702

Abstract

OBJECTIVE

Cholesterol and lipoprotein metabolism was studied in mildly hypercholesterolemic nonobese men with NIDDM to find out which metabolic parameters regulate serum cholesterol level in these NIDDM subjects.

RESEARCH DESIGN AND METHODS

Nonobese NIDDM subjects (n = 13) and control subjects (n = 18) with serum cholesterol > or = 6.0 and triglycerides < or = 2.5 mmol/l were studied on a similar monoene-enriched diet. Cholesterol absorption was studied with peroral double isotopes and by measuring serum plant sterols with gas-liquid chromatography; cholesterol synthesis was studied by measuring sterol balance and by measuring serum cholesterol precursor sterols; and LDL kinetics was measured with 131I-labeled autologous apoprotein (apo) B.

RESULTS

Cholesterol absorption was significantly lower in NIDDM subjects than in the control subjects, as detected by low serum plant sterol levels and absorption percentage (23 vs. 29%, P < 0.05). Cholesterol synthesis was significantly higher in NIDDM subjects than in the control subjects, as detected by precursor sterols or balance data (18 vs. 12 mg.kg-1.day-1, P < 0.01), cholesterol turnover (19 vs. 13 mg.kg-1.day-1, P < 0.01), and LDL apo B removal (0.343 vs. 0.267 pools/day, P < 0.01). Serum total and LDL cholesterol levels were inversely correlated with cholesterol synthesis, which was positively related to the catabolism of LDL apo B and negatively related to cholesterol absorption efficiency.

CONCLUSIONS

In this small selected group of mildly hypercholesterolemic nonobese NIDDM subjects, the regulation of serum cholesterol levels was achieved by the homeostasis between cholesterol absorption, synthesis, and LDL fractional catabolism. Cholesterol turnover and removal of LDL apo B were high in NIDDM subjects, compared with the control subjects, whereas cholesterol absorption efficiency was abnormally low Because of the relatively small number of selected subjects, the present results are not directly applicable to the overall NIDDM population.

摘要

目的

对患有非胰岛素依赖型糖尿病（NIDDM）的轻度高胆固醇血症非肥胖男性的胆固醇和脂蛋白代谢进行研究，以找出哪些代谢参数调节这些NIDDM患者的血清胆固醇水平。

研究设计与方法

对血清胆固醇≥6.0且甘油三酯≤2.5 mmol/L的非肥胖NIDDM患者（n = 13）和对照受试者（n = 18）采用类似的富含单烯的饮食进行研究。通过口服双同位素并采用气液色谱法测量血清植物甾醇来研究胆固醇吸收；通过测量甾醇平衡和血清胆固醇前体甾醇来研究胆固醇合成；并用131I标记的自体载脂蛋白（apo）B测量低密度脂蛋白（LDL）动力学。

结果

通过低血清植物甾醇水平和吸收百分比检测发现，NIDDM患者的胆固醇吸收显著低于对照受试者（23%对29%，P < 0.05）。通过前体甾醇或平衡数据检测发现，NIDDM患者的胆固醇合成显著高于对照受试者（18对12 mg·kg-1·天-1，P < 0.01），胆固醇周转率（19对13 mg·kg-1·天-1，P < 0.01），以及LDL apo B清除率（0.343对0.267池/天，P < 0.01）。血清总胆固醇和LDL胆固醇水平与胆固醇合成呈负相关，胆固醇合成与LDL apo B的分解代谢呈正相关，与胆固醇吸收效率呈负相关。

结论

在这一小群经挑选的轻度高胆固醇血症非肥胖NIDDM患者中，血清胆固醇水平的调节是通过胆固醇吸收、合成和LDL分解代谢分数之间的稳态实现的。与对照受试者相比，NIDDM患者的胆固醇周转率和LDL apo B清除率较高，而胆固醇吸收效率异常低。由于所选受试者数量相对较少，目前的结果不能直接应用于整个NIDDM人群。