Lipoprotein subfraction cholesterol distribution is more atherogenic in insulin resistant adolescents with type 1 diabetes
Lipoprotein subfraction cholesterol distribution is more atherogenic in insulin resistant adolescents with type 1 diabetes
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DOI：
10.1111/pedi.12277
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发表时间：
2016-06-01
影响因子：
3.4
通讯作者：
Nadeau, Kristen J.
中科院分区：
文献类型：
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作者：
Cree-Green, Melanie;Maahs, David M.;Nadeau, Kristen J.
目的/假设：1型糖尿病（T1 D）青少年的空腹血脂水平通常低于对照组，尽管成年后心血管疾病（CVD）的发病率增加。我们以前报道了致动脉粥样硬化脂蛋白亚组分胆固醇分布与胰岛素抵抗（IR）在T1 D成人。我们试图通过一项横断面研究来确定T1 D青年是否比对照组有更多的动脉粥样硬化形成特征。方法：在控制饮食和限制运动3天后，从28名T1 D青年中抽取空腹血浆样本[50%女性，年龄15.3 ± 2岁，体重指数（BMI）48% ile;糖尿病病程73 +/- 52个月，血红蛋白A1 c（HbA 1c）8.3 +/- 1.4%]和17名非糖尿病对照组（47%女性，年龄：15.0 +/- 2岁，BMI 49%ile）。通过快速蛋白液相色谱法（FPLC）分离脂蛋白，并测定脂蛋白胆固醇分布。通过葡萄糖输注速率（GIR）和FPLC脂蛋白亚组分胆固醇分布评估IR。T1 D青年IR更多（GIR 9.1 +/- 3.6 vs. 14.7 +/- 3.9 mg/kg/min，p < 0.0001），且有更多的胆固醇分布为小而密的低密度脂蛋白胆固醇（LDL-C），而较少分布为大而浮的高密度脂蛋白胆固醇（HDL-C）高于对照组（p < 0.05），尽管空腹血脂组无差异。T1 D女孩缺乏典型的女性致动脉粥样硬化性较低的特征，而对照组女孩与对照组男孩相比倾向于向密度较低的LDL-C和HDL-C转变。在T1 D，IR，但没有HbA 1c与一个更动脉粥样硬化脂蛋白profile.Conclusions/解释：正常体重T1 D青年，特别是女性，有更多的动脉粥样硬化的LDL-C和HDL-C的分布与较低的胰岛素敏感性。IR可能导致T1 D中CVD负担增加。
Aims/Hypothesis: Adolescents with type 1 diabetes (T1D) often have a less atherogenic-appearing fasting lipid profile than controls, despite increased rates of cardiovascular disease (CVD) as adults. We previously reported an atherogenic lipoprotein subfraction cholesterol distribution associated with insulin resistance (IR) in T1D adults. We sought to determine if T1D youth have more atherogenic profile than controls via a cross-sectional study.Methods: Following 3 days of controlled diet and restricted exercise, fasting plasma samples were drawn from 28 T1D youth [50% female, age 15.3 +/- 2 yr, body mass index (BMI) 48%ile; diabetes duration 73 +/- 52 months, hemoglobin A1c (HbA1c) 8.3 +/- 1.4%] and 17 non-diabetic controls (47% female, age: 15.0 +/- 2 yr, BMI 49%ile) prior to a hyperinsulinemic euglycemic clamp. Lipoproteins were fractionated by fast protein liquid chromatography (FPLC) and lipoprotein cholesterol distribution determined. Outcome measures were IR assessed by glucose infusion rate (GIR) and FPLC lipoprotein subfraction cholesterol distribution.Results: T1D youth were more IR (GIR 9.1 +/- 3.6 vs. 14.7 +/- 3.9 mg/kg/min, p < 0.0001) and had more cholesterol distributed as small dense low density lipoprotein-cholesterol (LDL-C) and less as large buoyant high density lipoprotein-cholesterol (HDL-C) than controls (p < 0.05), despite no differences in the fasting lipid panel. T1D girls lacked the typical female less-atherogenic profile, whereas control girls tended to have a shift toward less dense LDL-C and HDL-C vs. control boys. Among T1D, IR but not HbA1c was associated with a more atherogenic lipoprotein profile.Conclusions/Interpretations: Normal weight T1D youth, especially females, had more atherogenic LDL-C and HDL-C distributions which correlated with lower insulin sensitivity. IR may contribute to the increased CVD burden in T1D.