Insulin resistance is independently associated with postprandial alterations of triglyceride-rich lipoproteins in type 2 diabetes mellitus
Insulin resistance is independently associated with postprandial alterations of triglyceride-rich lipoproteins in type 2 diabetes mellitus
复制标题
DOI：
10.1161/01.atv.0000146267.71816.30
复制
发表时间：
2004-12-01
影响因子：
8.7
通讯作者：
Rivellese, AA
中科院分区：
文献类型：
--
作者：
Annuzzi, G;De Natale, C;Rivellese, AA
目的：通过将2型糖尿病患者与血糖和胰岛素水平相似的非糖尿病患者进行比较，评估胰岛素抵抗在2型糖尿病患者餐后血脂异常发展中的作用。方法与结果-血糖控制最佳的2型糖尿病患者8例，对照组7例（年龄50.0 +/- 2.6和48.1 +/- 1.3岁，体重指数28.3 +/- 1.2和25.6 +/- 1.1 kg/m）；空腹血浆甘油三酯分别为1.12 +/- 0.13和0.87 +/- 0.08 mmol/L；平均值+/- SEM；NS)在8小时的高胰岛素血糖钳夹期间食用混合膳食。两组患者钳夹期间平均血糖约为7.8 mmol/L，餐前稳定状态血浆胰岛素约为480 pmol/L，胰岛素敏感性存在差异（糖尿病患者的M/I值较低[1.65 +/- 0.30和3.42 +/- 0.60;P < 0.05]）。受试者糖尿病患者餐后血脂和载脂蛋白B水平较高(飞机观测)大非常低密度脂蛋白(增量区域甘油三酯1814 + / - 421和549 + / - 153μmol / L x 6小时;P < 0.05;胆固醇694 + / - 167和226 + / - 41 mumol / L x 6小时;P < 0.05; apoB-48 6.3 + / - 1.0和2.6 + / - 0.7 mg / L x 6小时;P < 0.05;飞机观测- 100 - 56.5 + / - 14.9和26.2 + / - 11.0 mg / L x 6小时;NS)。糖尿病患者餐前和餐后的基础脂蛋白脂肪酶（LPL）活性较高，而餐后6小时的肝素后LPL活性相似。结论：胰岛素抵抗也与急性高血糖和高胰岛素血症纠正后2型糖尿病餐后脂蛋白异常有关。
Objective - To evaluate the role of insulin resistance in development of postprandial dyslipidemia in type 2 diabetic patients in an experimental setting in which these patients were compared with nondiabetic subjects at similar glucose and insulin blood levels.Methods and Results - Eight type 2 diabetic patients in optimal blood glucose control and 7 control subjects ( aged 50.0 +/- 2.6 and 48.1 +/- 1.3 years; body mass index 28.3 +/- 1.2 and 25.6 +/- 1.1 kg/m(2); fasting plasma triglycerides 1.12 +/- 0.13 and 0.87 +/- 0.08 mmol/L, respectively; mean +/- SEM; NS) consumed a mixed meal during an 8-hour hyperinsulinemic glycemic clamp. Mean blood glucose during clamp was approximate to 7.8 mmol/L, and plasma insulin during the preprandial steady state was approximate to 480 pmol/L in both groups, that differed for insulin sensitivity (M/I value lower in diabetic subjects [1.65 +/- 0.30 and 3.42 +/- 0.60; P < 0.05]). Subjects with diabetes had higher postprandial levels of lipids and apolipoprotein B (apoB) in large very low-density lipoprotein (incremental area for triglycerides 1814 +/- 421 versus 549 +/- 153 μmol/ L x 6 hours; P < 0.05; cholesterol 694 +/- 167 versus 226 +/- 41 mumol/L x 6 hours; P < 0.05; apoB-48 6.3 +/- 1.0 versus 2.6 +/- 0.7 mg/L x 6 hours; P < 0.05; apoB-100 56.5 +/- 14.9 versus 26.2 +/- 11.0 mg/ L x 6 hours; NS). Basal lipoprotein lipase (LPL) activity before and after meal was higher in diabetic subjects, whereas postheparin LPL activity 6 hours after the meal was similar.Conclusions - Insulin resistance is also associated with postprandial lipoprotein abnormalities in type 2 diabetes after acute correction for hyperglycemia and hyperinsulinemia.