Mechanism of hypertriglyceridaemia in diabetic patients with fasting hyperglycaemia
Mechanism of hypertriglyceridaemia in diabetic patients with fasting hyperglycaemia
复制标题
糖尿病空腹高血糖患者发生高甘油三酯血症的机制
DOI：
10.1007/bf00261698
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发表时间：
1980
期刊：
影响因子：
8.2
通讯作者：
G. Reaven
中科院分区：
文献类型：
--
作者：
M. Greenfield;O. Kolterman;J. Olefsky;G. Reaven
摘要为了明确胰岛素非依赖型糖尿病合并空腹高血糖患者高甘油三酯血症的机制，从多个方面对脂代谢进行了研究。非胰岛素依赖型糖尿病患者的肥胖(P<；0.001)和空腹血浆甘油三酯浓度(387±66 mg/dl)显著高于胰岛素依赖型糖尿病患者(P<；0.001)和正常人(73±1 mg/dl)(P&t；0.001)。胰岛素非依赖性糖尿病患者的极低密度脂蛋白分泌率(14.65±1.37 mg/kg/h)也显著高于正常对照组(7.64±0.60 mg·kg/h)和胰岛素依赖型糖尿病患者(9.86±0.75 mg/kg/h)(p<0.01-0.001)。然而，糖尿病患者和正常人的血浆甘油三酯浓度和极低密度脂蛋白-甘油三酯分泌的关系是相似的。糖尿病组的空腹和餐后高血糖程度相当，空腹血浆非酯化游离脂肪酸水平也有相应升高(胰岛素非依赖性=0.72±0.07 mm ol/L，胰岛素依赖性=0.63±0.08 mm ol/L)。然而，非胰岛素依赖型糖尿病患者的餐后血浆胰岛素浓度达到正常水平，并且高于胰岛素依赖型糖尿病患者(p<；0.001)。因此，伴有空腹高血糖的胰岛素非依赖型糖尿病患者的高甘油三酯血症与肝脏极低密度脂蛋白-甘油三酯分泌增加和血浆胰岛素水平正常有关。胰岛素依赖型糖尿病患者的甘油三酯水平较低被认为是由于他们的相对低血糖所致。
SummarySeveral aspects of lipid metabolism were studied to define the mechanism of hypertriglyceridaemia in insulin-independent diabetic patients with fasting hyperglycaemia. Patients with insulin-independent diabetes were more obese (p<0.001) and had a significantly (p<0.001) higher mean (± SEM) fasting plasma triglyceride concentration (387 ±66 mg/dl) than did either insulin-dependent diabetics (133±11 mg/dl) or normal (73±1 mg/dl) subjects. Very low density lipoprotein secretion rate was also significantly (p<0.01 — <0.001) higher in patients with insulin-independent diabetes (14.65±1.37 mg/kg/h) as compared to 7.64±0.60 mg · kg/h and 9.86±0.75 mg/kg/h in normal subjects and patients with insulin-dependent diabetes, respectively. However, the relationship between plasma triglyceride concentration and very low density lipoprotein-triglyceride secretion was similar in diabetics and in normals. The diabetic groups had equivalent degrees of fasting and postprandial hyperglycaemia, and comparable elevations of fasting plasma nonesterified free fatty acid levels (insulin-independent = 0.72±0.07 mmol/L, insulin-dependent = 0.63±0.08 mmol/L). Postprandial plasma insulin concentrations, however, reached normal levels in insulin-independent diabetics and were higher (p<0.001) than in insulin-dependent diabetics. Thus, hypertriglyceridaemia in insulin-independent diabetics with fasting hyperglycaemia was associated with increased hepatic very low density lipoprotein-triglyceride secretion, and normal plasma insulin levels. The lower triglyceride levels in the insulin-dependent diabetics is assumed to be due to their relative hypoinsulinaemia.