Kasim-Karakas S E, Lane E, Almario R, Mueller W, Walzem R
Division of Endocrinology and Metabolism, School of Medicine, University of California at Davis, USA.
Metabolism. 1997 Apr;46(4):431-6. doi: 10.1016/s0026-0495(97)90061-5.
Hypertriglyceridemia is an independent risk factor for coronary artery disease (CAD) and is also commonly associated with other coronary risk factors, ie, small, dense low-density lipoprotein (LDL) particles and low plasma levels of high-density lipoprotein cholesterol (HDL-C). Dietary fat restriction is recommended for the prevention of nutrition-related cancers. Low-fat, high-carbohydrate intake can increase plasma triglyceride (TG) and decrease HDL-C. In general, plasma TG levels are inversely related to the particle size of LDL. We investigated the effects of dietary fat restriction on the concentration and particle size of plasma lipoproteins in 14 healthy postmenopausal women (aged 61 +/- 11 years). During a 4-month period of eucaloric controlled feeding, dietary fat was reduced stepwise from a habitual intake of 33% +/- 8% to 23% and then to 14% of daily energy. Changes in the plasma lipid level and particle size of very-low-density lipoprotein (VLDL), LDL, and HDL were determined at the end of each dietary phase. Increasing carbohydrate intake without weight loss was associated with an increase in plasma TG (1.86 +/- 0.30 v 2.47 +/- 0.37 mmol/L) and decreases in total cholesterol (5.82 +/- 0.25 v 5.40 +/- 0.21 mmol/L), LDL-C (3.07 +/- 0.18 v 2.61 +/- 0.21 mmol/L), HDL-C (1.42 +/- 0.1 v 1.24 +/- 0.1 mmol/L), and apolipoprotein (apo) A1 (5.14 +/- 0.25 v 4.61 +/- 0.36 mmol/L), whereas plasma apo B did not change. The particle size of VLDL increased (42.7 +/- 1.4 v 47.0 +/- 0.9 nm). However, there was no change in either LDL (25.1 +/- 0.2 v 25.3 +/- 0.2 nm) or HDL particle size. Although at each level of dietary fat intake LDL particle size correlated inversely with plasma TG and apo B, there was no relationship between the increase in plasma TG and LDL particle size. These results show that hypertriglyceridemia caused by a eucaloric high-carbohydrate intake is not associated with a decrease in LDL particle size. Therefore, carbohydrate-induced hypertriglyceridemia may not have the same atherogenic potential as genetic hypertriglyceridemias.
高甘油三酯血症是冠状动脉疾病（CAD）的独立危险因素，并且通常还与其他冠心病危险因素相关，即小而密的低密度脂蛋白（LDL）颗粒以及血浆高密度脂蛋白胆固醇（HDL-C）水平低。建议通过限制饮食脂肪来预防营养相关癌症。低脂、高碳水化合物摄入会增加血浆甘油三酯（TG）并降低HDL-C。一般来说，血浆TG水平与LDL的颗粒大小呈负相关。我们研究了饮食脂肪限制对14名健康绝经后女性（年龄61±11岁）血浆脂蛋白浓度和颗粒大小的影响。在为期4个月的等热量控制饮食期间，饮食脂肪从习惯摄入量的33%±8%逐步降至23%，然后降至每日能量的14%。在每个饮食阶段结束时测定极低密度脂蛋白（VLDL）、LDL和HDL的血浆脂质水平和颗粒大小的变化。在体重未减轻的情况下增加碳水化合物摄入与血浆TG升高（1.86±0.30对2.47±0.37 mmol/L）以及总胆固醇降低（5.82±0.25对5.40±0.21 mmol/L）、LDL-C降低（3.07±0.18对2.61±0.21 mmol/L）、HDL-C降低（1.42±0.1对1.24±0.1 mmol/L）和载脂蛋白（apo）A1降低（5.14±0.25对4.61±0.36 mmol/L）相关，而血浆apo B未改变。VLDL的颗粒大小增加（42.7±1.4对47.0±0.9 nm）。然而，LDL（25.1±0.2对25.3±0.2 nm）或HDL颗粒大小均无变化。尽管在每个饮食脂肪摄入水平下，LDL颗粒大小与血浆TG和apo B呈负相关，但血浆TG升高与LDL颗粒大小之间没有关系。这些结果表明，等热量高碳水化合物摄入引起的高甘油三酯血症与LDL颗粒大小减小无关。因此，碳水化合物诱导的高甘油三酯血症可能没有与遗传性高甘油三酯血症相同的致动脉粥样硬化潜力。
