Hansen P M, Jensen T, Egeberg J, Lithell H, Kofoed-Enevoldsen A, Deckert T
Steno Diabetes Center, Gentofte, Denmark.
J Diabetes Complications. 1997 Jul-Aug;11(4):230-5. doi: 10.1016/s1056-8727(96)00048-7.
In patients with insulin-dependent diabetes mellitus (IDDM), albuminuria reflects widespread vascular dysfunction. Albuminuria has been associated to defects of heparan sulfate proteoglycan (HSPG) within the extracellular matrix. Our hypothesis is that loss of HSPG in vascular walls reduces the HSPG-bound lipoprotein-lipase activity (LPLA), thereby causing elevated levels of plasma triglyceride (TG) seen in IDDM patients with albuminuria. The aim of the present study was to evaluate whether LPLA in muscle capillaries could be related to TG in IDDM patients with and without albuminuria. This is a cross-sectional study including ten healthy control subjects (group C), nine patients with IDDM and urinary albumin excretion rate (AER) of 30 mg/24 h or less (group D0) and 20 patients with IDDM and AER greater than 30 mg/24 h (group DA). Muscle LPLA, plasma TG, total cholesterol, high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), and very-low-density lipoprotein cholesterol (VLDL) were measured. Between groups no difference in total cholesterol, TG, VLDL, and LDL was found. In patients with albuminuria, LPLA was reduced compared to controls, however, the difference between the groups was not statistically significant [median (range)] 35.9 mU/g (20.4-103) versus 44.6 mU/g (28.2-57.2) and 40.9 mU/g (21.7-53.5) in group DA, C, and D0, respectively, p = 0.76. AER was not correlated to LPLA. An overall negative correlation between TG and LPLA was found; r = -0.33, p = 0.04, supported by an overall significant positive correlation between LPLA and HDL; r = 0.32, p = 0.045. We conclude that, in insulin-dependent diabetes mellitus, skeletal muscle lipoprotein-lipase activity is associated with plasma triglyceride, while an association between lipoprotein-lipase activity and urinary albumin excretion is questionable.
在胰岛素依赖型糖尿病（IDDM）患者中，蛋白尿反映了广泛的血管功能障碍。蛋白尿与细胞外基质中硫酸乙酰肝素蛋白聚糖（HSPG）的缺陷有关。我们的假设是，血管壁中HSPG的缺失会降低与HSPG结合的脂蛋白脂肪酶活性（LPLA），从而导致蛋白尿的IDDM患者血浆甘油三酯（TG）水平升高。本研究的目的是评估有蛋白尿和无蛋白尿的IDDM患者肌肉毛细血管中的LPLA是否与TG有关。这是一项横断面研究，包括10名健康对照者（C组）、9名IDDM患者且尿白蛋白排泄率（AER）为30mg/24h或更低（D0组）以及20名IDDM患者且AER大于30mg/24h（DA组）。测量了肌肉LPLA、血浆TG、总胆固醇、高密度脂蛋白胆固醇（HDL）、低密度脂蛋白胆固醇（LDL）和极低密度脂蛋白胆固醇（VLDL）。组间总胆固醇、TG、VLDL和LDL无差异。有蛋白尿的患者与对照组相比，LPLA降低，然而，组间差异无统计学意义[中位数（范围）]，DA组、C组和D0组分别为35.9mU/g（20.4 - 103）、44.6mU/g（28.2 - 57.2）和40.9mU/g（21.7 - 53.5），p = 0.76。AER与LPLA无相关性。发现TG与LPLA总体呈负相关；r = -0.33，p = 0.04，LPLA与HDL总体呈显著正相关支持了这一结果；r = 0.32，p = 0.045。我们得出结论，在胰岛素依赖型糖尿病中，骨骼肌脂蛋白脂肪酶活性与血浆甘油三酯相关，而脂蛋白脂肪酶活性与尿白蛋白排泄之间的关联值得怀疑。
