LIPOPROTEIN METABOLISM IN DIABETES AND THE EFFECTS OF THERAPY

VLDL升高和HDL降低通常与非- 胰岛素依赖型糖尿病由于其可能 在心血管疾病发病率大大增加的病因中的作用 疾病在这种混乱中。 这项研究比较了VLDL和LDL 在非胰岛素依赖型糖尿病患者和年龄中的代谢， 体重匹配的非糖尿病患者 在糖尿病患者中进行了研究 在磺脲类药物治疗前后， 在高脂肪和低脂肪饮食中进行比较。 数据表明 糖尿病患者VLDL异常，糖尿病影响VLDL-TG 与apoB的产生无关。 LDL浓度 糖尿病患者受到两种相反变化的影响- 直接清除VLDL，但降低VLDL的FCR。 改进 口服降糖药控制血糖， VLDL-TG和LDL胆固醇显著福尔斯下降， VLDL组成异常，VLDL甘油三酯产生， 脂肪酶活性和HDL亚组分。 糖尿病患者的转移 高碳水化合物、低饱和脂肪的饮食 LDL降低，HDL无变化，VLDL无变化， 糖尿病人 对两种饮食的代谢研究表明，VLDL 去除膳食饱和脂肪后的减少是由于 提高清除率。 富含甘油三酯的VLDL在 低脂肪高碳水化合物饮食的糖尿病患者 转化为LDL，但VLDL apoB和VLDL 甘油三酯较低。 结果表明，高 碳水化合物低脂饮食可减少动脉粥样硬化 在大多数非胰岛素依赖型糖尿病患者中，

The increased VLDL and decreased HDL commonly associated with non- insulin dependent diabetes are of concern because of their possible role in the etiology of the greatly increased cardiovascular disease in this disorder. This study compares VLDL and LDL metabolism in non-insulin dependent diabetics and in age and weight-matched nondiabetics. Studies were conducted in diabetics before and after therapy with sulfonylureas; also diabetics were compared on high and low fat diets. The data suggest that diabetics have abnormal VLDL and that diabetes influences VLDL-TG production independent of that of apoB. LDL concentrations in diabetics are influenced by two opposing changes - increase in direct removal of VLDL, but decrease in FCR for VLDL. Improvement of glycemic control with oral hypoglycemic therapy is followed by significant falls in VLDL-TG and LDL cholesterol and reversal of abnormalities of VLDL composition, VLDL triglyceride productions, lipase activities, and HDL subfractions. Transfer of the diabetics to a high carbohydrate, low saturated fat diet is associated with decreases in LDL, no change in HDL, and no change in VLDL in most diabetics. Metabolic studies on the two diets indicate that VLDL decreases upon removal of dietary saturated fat are due to increased clearance. The larger triglyceride rich VLDL in diabetics on a low fat, high carbohydrate diet are less efficiently converted to LDL, but clearance of both VLDL apoB and VLDL triglyceride are lower. The results indicate that high carbohydrate low fat diets can result in less atherogenic lipoproteins in most subjects with non-insulin dependent diabetes.