Effect of pancreas transplantation on lipoprotein lipase, postprandial lipemia, and HDL cholesterol.
Effect of pancreas transplantation on lipoprotein lipase, postprandial lipemia, and HDL cholesterol.
复制标题
胰腺移植对脂蛋白脂肪酶、餐后血脂和高密度脂蛋白胆固醇的影响。
DOI：
10.1097/00007890-199410270-00007
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发表时间：
1994
期刊：
影响因子：
6.2
通讯作者：
Patsch,JR
中科院分区：
文献类型：
--
作者：
Föger,B;Königsrainer,A;Palos,G;Brandstätter,E;Ritsch,A;König,P;Miesenböck,G;Lechleitner,M;Margreiter,R;Patsch,JR
全身静脉引流的胰腺移植引起血浆胰岛素水平升高，胰岛素是血浆脂蛋白代谢的有效调节剂。我们研究了11例I型糖尿病后胰肾移植受者，9例因皮下胰岛素治疗而出现外周高胰岛素血症的I型糖尿病肾移植受者，11例非糖尿病肾移植受者作为免疫抑制药物影响的对照，以及11例健康对照，所有受试者在年龄、性别和体重指数上都相匹配。我们测定了空腹血脂、脂蛋白和脂溶酶，以及标准化口服脂肪负荷后的餐后脂质代谢。胰肾移植患者高密度脂蛋白（HDL）胆固醇平均为1.98 (0.40)mmol/L，明显高于肾移植受者（1.52 (0.36)mmol/L， P< 0.05）或对照组（1.50 (0.38)mmol/L， P< 0.05）。胰肾移植患者餐后血脂最低，脂蛋白脂肪酶活性最高（分别为对照组平均值的32%和154%），与非糖尿病肾移植患者（P< 0.005， P< 0.05）和健康对照组（P< 0.001， P< 0.01）比较，差异有统计学意义。在I型糖尿病肾移植受者中，高密度脂蛋白胆固醇水平（1.88 (0.63)mmol/L）、餐后脂血症和脂蛋白脂肪酶活性介于胰肾移植患者和健康对照之间。胰肾移植患者的高密度脂蛋白胆固醇明显升高，可以很容易地解释为由脂蛋白脂肪酶高活性引起的餐后甘油三酯水平低。糖尿病后胰肾移植受者非常有利的脂质特征有望抵消长期糖尿病的严重动脉粥样硬化风险。
Pancreas transplantation with systemic venous drainage of the graft causes elevated plasma levels of insulin, known to be a potent regulator of plasma lipoprotein metabolism. We studied 11 post-type I diabetic pancreas-kidney transplant recipients, 9 type I diabetic kidney transplant recipients displaying peripheral hyperinsulinemia due to subcutaneous insulin treatment, 11 nondiabetic kidney transplant recipients as controls for the effects of immunosuppressive medication, and 11 healthy control subjects, all matched for age, sex, and body mass index. We determined fasting lipids, lipoproteins and lipolytic enzymes, as well as postprandial lipid metabolism after a standardized oral fat load. High-density lipoprotein (HDL) cholesterol averaged 1.98 (0.40) mmol/L in pancreas-kidney transplant patients, clearly higher than that of kidney transplant recipients (1.52 (0.36) mmol/L, P< 0.05) or of controls (1.50 (0.38) mmol/L, P< 0.05). In pancreas-kidney transplant patients postprandial lipemia was lowest and lipoprotein lipase activity was highest (average 32% and 154%, respectively, of the mean of the controls) compared with nondiabetic kidney transplant recipients (P< 0.005, P< 0.05) and healthy controls (P< 0.001, P< 0.01). In type I diabetic kidney transplant recipients the levels of HDL cholesterol (1.88 (0.63) mmol/L), postprandial lipemia, and lipoprotein lipase activity were intermediate between pancreas-kidney transplant patients and healthy controls. The distinctly elevated HDL cholesterol in pancreas-kidney transplant patients can be readily explained by the low postprandial triglyceride levels resulting from a high activity of lipoprotein lipase. The very favorable lipid profile in post-diabetic pancreas-kidney transplant recipients could be expected to counteract the severe atherosclerotic risk of long-standing diabetes.