Gray R S, Robbins D C, Wang W, Yeh J L, Fabsitz R R, Cowan L D, Welty T K, Lee E T, Krauss R M, Howard B V
Medlantic Research Institute, Washington, DC 20010-2933, USA.
Arterioscler Thromb Vasc Biol. 1997 Nov;17(11):2713-20. doi: 10.1161/01.atv.17.11.2713.
Small, dense LDL has been shown to be associated with the insulin resistance syndrome and coronary heart disease (CHD). We examined the distribution of LDL size and phenotype within a population-based sample of American Indians to determine the relationships with prevalent CHD and to examine associations with hyperinsulinemia and other components of the insulin resistance syndrome. Data were available for 4505 men and women between 45 and 74 years of age who are members of 13 American Indian communities in three geographic areas. Diabetes, CHD, and CHD risk factors were assessed by standardized techniques, and LDL size was measured by gradient gel electrophoresis. LDL size was smaller in men than in women and in individuals with diabetes than in those without diabetes. In multivariate analysis, LDL size was significantly related to several components of the insulin resistance syndrome, including triglycerides (inversely) and HDL cholesterol (positively). Although univariate relations were positive, LDL size was not significantly related to fasting insulin concentrations or body mass index in the multivariate model. LDL size also showed no relationship to apolipoprotein E phenotype. When LDL size was compared in individuals with and without CHD, no significant differences were observed, either in nondiabetic or diabetic individuals. We conclude that LDL size is most strongly related to lipoprotein components of the insulin resistance syndrome, especially plasma triglycerides. However, in this population with low LDL, it is not related to cardiovascular disease.
小而密的低密度脂蛋白（LDL）已被证明与胰岛素抵抗综合征及冠心病（CHD）相关。我们在美国印第安人群体样本中研究了LDL大小和表型的分布情况，以确定其与CHD患病率的关系，并研究其与高胰岛素血症及胰岛素抵抗综合征其他组分的关联。研究数据来自4505名年龄在45至74岁之间的男性和女性，他们是三个地理区域13个美国印第安社区的成员。通过标准化技术评估糖尿病、CHD及CHD危险因素，并采用梯度凝胶电泳法测量LDL大小。男性的LDL大小小于女性，糖尿病患者的LDL大小小于非糖尿病患者。在多变量分析中，LDL大小与胰岛素抵抗综合征的多个组分显著相关，包括甘油三酯（呈负相关）和高密度脂蛋白胆固醇（呈正相关）。尽管单变量分析显示为正相关，但在多变量模型中，LDL大小与空腹胰岛素浓度或体重指数无显著相关性。LDL大小与载脂蛋白E表型也无关联。比较有CHD和无CHD个体的LDL大小，无论是非糖尿病个体还是糖尿病个体，均未观察到显著差异。我们得出结论，LDL大小与胰岛素抵抗综合征的脂蛋白组分关系最为密切，尤其是血浆甘油三酯。然而，在这个LDL水平较低的人群中，它与心血管疾病无关。
