Intensive insulin therapy reduces small dense low-density lipoprotein particles in patients with type 2 diabetes mellitus: relationship to triglyceride-rich lipoprotein subspecies
Intensive insulin therapy reduces small dense low-density lipoprotein particles in patients with type 2 diabetes mellitus: relationship to triglyceride-rich lipoprotein subspecies
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DOI：
10.1016/j.metabol.2006.02.014
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发表时间：
2006-07-01
影响因子：
9.8
通讯作者：
Adachi, Mitsuru
中科院分区：
文献类型：
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作者：
Hayashi, Toshiyuki;Hirano, Tsutornu;Adachi, Mitsuru
目前尚不清楚胰岛素是否能改善2型糖尿病患者的血脂异常。小而致密的低密度脂蛋白(SD-LDL)颗粒被认为是冠心病的一个强大的危险因素，在2型糖尿病患者中经常升高。我们检测了强化胰岛素治疗对SD-LDL颗粒和富含甘油三酯(TG)的脂蛋白亚型的影响。对46例接受大剂量磺脲类药物治疗的控制不良的2型糖尿病患者进行强化胰岛素治疗(每餐前给予门冬氨酸胰岛素[日本东京新捷普]，睡前给予异丙酚胰岛素混悬液)。分别在胰岛素治疗开始前和治疗后14天采集空腹血清样本。用梯度凝胶电泳法测定低密度脂蛋白的大小，用新沉淀法测定小密度脂蛋白胆固醇(SD-LDL-C)浓度。用超速离心法分离乳糜粒(Svedberg浮选单位>；400)、极低密度脂蛋白1(VLDL1)(SF，60-400)和VLDL2(SF，20-60)。用酶免疫法测定血清载脂蛋白B-48和脂蛋白脂酶水平。胰岛素治疗显著降低了血糖和糖白蛋白水平。低密度脂蛋白体积增大(25.8~26.0次，P
It remains unclear whether insulin improves dyslipidemia in patients with type 2 diabetes mellitus. Small dense low-density lipoprotein (sd-LDL) particles are recognized as a powerful risk factor for coronary heart disease and are often elevated in type 2 diabetes mellitus. We examined the effect of intensive insulin therapy on sd-LDL particles and triglyceride (TG)-rich lipoprotein subspecies. Intensive insulin therapy (insulin aspart [NovoRapid, Tokyo, Japan] before each meal and isophane insulin suspension at bedtime) was given to poorly controlled type 2 diabetic patients (n = 46) who were on high doses of sulfonylureas. Fasting serum samples were collected before and 14 days after the commencement of insulin therapy. Low-density lipoprotein size was measured by gradient gel electrophoresis, and the small dense LDL cholesterol (sd-LDL-C) concentration was measured by a new precipitation method. Chylomicrons (Svedberg flotation unit > 400), very low-density lipoprotein 1 (VLDL1) (Sf, 60-400), and VLDL2 (Sf, 20-60) were separated by ultracentrifiagation. Serum apolipoprotein B-48 and lipoprotein lipase levels were measured by the enzyme immunoassay method. Serum glucose and glycoalbumin levels were substantially decreased by insulin treatment. The LDL size increased (25.8-26.0 run, P