INFLUENCE OF OBESITY, IMPAIRED GLUCOSE-TOLERANCE, AND NIDDM ON LDL STRUCTURE AND COMPOSITION - POSSIBLE LINK BETWEEN HYPERINSULINEMIA AND ATHEROSCLEROSIS
INFLUENCE OF OBESITY, IMPAIRED GLUCOSE-TOLERANCE, AND NIDDM ON LDL STRUCTURE AND COMPOSITION - POSSIBLE LINK BETWEEN HYPERINSULINEMIA AND ATHEROSCLEROSIS
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DOI：
10.2337/diabetes.39.12.1527
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发表时间：
1990-12-01
期刊：
影响因子：
7.7
通讯作者：
MARKS, R
中科院分区：
文献类型：
--
作者：
BARAKAT, HA;CARPENTER, JW;MARKS, R
在胃旁路手术前和手术后，对伴有血糖正常、糖耐量受损（IGT）和非胰岛素依赖型糖尿病（NIDDM）的病态肥胖女性进行了研究，以探讨冠心病（CHD）风险增加的可能原因。与年龄匹配的瘦型女性相比，肥胖女性术前的血脂和载脂蛋白浓度有利于动脉粥样硬化的形成。在IGT和NIDDM组中，由于低密度脂蛋白（LDL）颗粒更小和更密集，CHD的风险可能进一步加剧。LDL大小与血浆胰岛素水平呈负相关，与甘油三酯水平、年龄或体重指数（BMI）无关。手术后，BMI、血浆胰岛素和甘油三酯水平降低，但LDL大小增加，LDL密度降低。胆固醇和低密度脂蛋白胆固醇水平在手术后均未受到影响，但所有患者的高密度脂蛋白胆固醇在手术后均升高。尽管这项研究无法确定LDL性质变化的机制，但这些变化似乎有利于降低这些患者的CHD风险。
The possible causes of the enhanced risk for coronary heart disease (CHD) were examined in morbidly obese women with normoglycemia, impaired glucose tolerance (IGT), and non-insulin-dependent diabetes mellitus (NIDDM) before and after gastric bypass surgery. Compared with age-matched lean women, plasma lipid and apolipprotein concentrations of the obese women before surgery favored atherogenesis. The risk for CHD may further be exacerbated in the IGT and NIDDM groups by the prevalence of smaller and denser low-density-lipoprotein (LDL) particles. LDL size correlated negatively with plasma insulin levels independent of triglyceride levels, age, or body mass index (BMI). After surgery, BMI, plasma insulin, and triglyceride levels decreased, but LDL size increased, and LDL density decreased. Neither cholesterol nor LDL cholesterol levels were affected after surgery, but high-density-lipoprotein cholesterol was increased in all patients after surgery. Although the mechanisms underlying the changes in the properties of LDL could not be determined from this study, these changes appear to be of benefit in reducing CHD risk in these patients.