Lipoprotein particle size and concentration by nuclear magnetic resonance and incident type 2 diabetes in women.
Lipoprotein particle size and concentration by nuclear magnetic resonance and incident type 2 diabetes in women.
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作者：
Mora S;Otvos JD;Rosenson RS;Pradhan A;Buring JE;Ridker PM
糖尿病血脂异常的特征是低HDL胆固醇和高甘油三酯。我们研究了通过核磁共振（NMR）光谱测量的脂蛋白颗粒大小和浓度与临床2型糖尿病的关系。这是一项前瞻性研究，对26，836名最初健康的女性进行了13年的2型糖尿病事件随访（n = 1，687）。直接测量基线脂质，并通过NMR测量脂蛋白大小和浓度。考克斯回归模型包括非血脂风险因素（年龄、种族、吸烟、运动、教育、绝经、血压、BMI、家族史、A1 C和C反应蛋白）。在进一步调整标准脂质后，还检查了NMR脂蛋白。糖尿病发病率与基线HDL胆固醇、甘油三酯和NMR测量的LDL、IDL、HDL和VLDL颗粒的大小和浓度显著相关。这些颗粒的缔合物的大小有很大的不同。小LDLNMR和小HDLNMR与糖尿病呈正相关（五分位数5 vs. 1 [校正风险比和95% CI]，分别为4.04 [3.21-5.09]和1.84 [1.54-2.19]）。相比之下，大LDLNMR和大HDLNMR呈负相关（五分位数1与5，分别为2.50 [2.12-2.95]和4.51 [3.68-5.52]）。对于VLDLNMR，大颗粒比小颗粒具有更高的风险（五分位数分别为5 vs. 1、3.11 [2.35-4.11]和1.31 [1.10-1.55]）。调整标准血脂和非血脂因素后，脂蛋白颗粒大小仍显着。在这项女性前瞻性研究中，NMR脂蛋白的大小和浓度与2型糖尿病的发病率相关，并且在调整了包括HDL胆固醇和甘油三酯在内的既定风险因素后仍然显着。
Diabetic dyslipoproteinemia is characterized by low HDL cholesterol and high triglycerides. We examined the association of lipoprotein particle size and concentration measured by nuclear magnetic resonance (NMR) spectroscopy with clinical type 2 diabetes. This was a prospective study of 26,836 initially healthy women followed for 13 years for incident type 2 diabetes (n = 1,687). Baseline lipids were measured directly and lipoprotein size and concentration by NMR. Cox regression models included nonlipid risk factors (age, race, smoking, exercise, education, menopause, blood pressure, BMI, family history, A1C, and C-reactive protein). NMR lipoproteins were also examined after further adjusting for standard lipids. Incident diabetes was significantly associated with baseline HDL cholesterol, triglycerides, and NMR-measured size and concentration of LDL, IDL, HDL, and VLDL particles. The associations of these particles differed substantially by size. Small LDLNMR and small HDLNMR were positively associated with diabetes (quintile 5 vs. 1 [adjusted hazard ratios and 95% CIs], 4.04 [3.21–5.09] and 1.84 [1.54–2.19], respectively). By contrast, large LDLNMR and large HDLNMR were inversely associated (quintile 1 vs. 5, 2.50 [2.12–2.95] and 4.51 [3.68–5.52], respectively). For VLDLNMR, large particles imparted higher risk than small particles (quintile 5 vs. 1, 3.11 [2.35–4.11] and 1.31 [1.10–1.55], respectively). Lipoprotein particle size remained significant after adjusting for standard lipids and nonlipid factors. In this prospective study of women, NMR lipoprotein size and concentrations were associated with incident type 2 diabetes and remained significant after adjustment for established risk factors, including HDL cholesterol and triglycerides.