LIPID METABOLISM IN DIABETES AND THE EFFECTS OF THERAPY

极低密度脂蛋白升高和高密度脂蛋白降低通常与非胰岛素相关 依赖型糖尿病令人担忧，因为它们可能在 本病的病因中心血管疾病大大增加。 此外，目前还没有确定糖尿病的治疗方法，无论是 饮食或口服降糖剂会影响脂蛋白代谢。这 研究比较了极低密度脂蛋白和低密度脂蛋白代谢、脂肪酸代谢和 II型糖尿病患者脂蛋白脂肪酶活性与年龄和 体重匹配的非糖尿病患者。研究也在糖尿病患者中进行。 治疗前后的磺脲类药物和糖尿病患者 比较高脂肪饮食和低脂肪饮食。数据表明，糖尿病患者有 极低密度脂蛋白异常和糖尿病对极低密度脂蛋白-甘油三酯产生的非依赖性影响 可能是通过提高游离脂肪酸或 葡萄糖。糖尿病患者的低密度脂蛋白浓度受两个相反因素的影响 变化-直接清除极低密度脂蛋白增加，但FCR减少 极低密度脂蛋白。血糖控制的改善之后是显著的下降 极低密度脂蛋白-甘油三酯和低密度脂蛋白与高密度脂蛋白异常逆转 亚组分和极低密度脂蛋白组成。转移到高碳水化合物，低碳水化合物 饱和脂肪饮食使低密度脂蛋白降低，高密度脂蛋白无变化。这 大多数糖尿病患者的极低密度脂蛋白没有变化；两兄弟， 然而，显示极低密度脂蛋白和血糖显著增加，表明 糖尿病患者转换为高碳水化合物时必须仔细监测 养生法。

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. Moreover, it has not been established how therapy of diabetes, with either diet or oral hypoglycemic agents, influences lipoprotein metabolism. This study compares VLDL and LDL metabolism, fatty acid metabolism, and lipoprotein lipase activities in type II diabetics and in age and weight-matched non-diabetics. Studies were also conducted in diabetics before and after therapy with sulfonylureas and also diabetics are being 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, possibly through elevations of free-fatty acids or glucose. 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 is followed by significant falls in VLDL-TG and LDL cholesterol and reversal of abnormalities of HDL subfractions and VLDL composition. Transfer to a high carbohydrate, low saturated fat diet leads to decreases in LDL and no change in HDL. This was accompanied by no change in VLDL in most diabetics; two brothers, however, showed significant increases in VLDL and glucose, indicating that diabetics must be carefully monitored when transferred to high carbohydrate regimens.