LIPOPROTEIN 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 胰岛素依赖型糖尿病是令人担忧的，因为它们可能 在心血管疾病显著增加的病因中的作用 这种疾病中的疾病。这项研究比较了极低密度脂蛋白和低密度脂蛋白 非胰岛素依赖型糖尿病患者的代谢以及年龄和 体重匹配的非糖尿病患者。研究是在糖尿病患者中进行的 使用磺脲类药物治疗前后；糖尿病患者也 比较高脂肪饮食和低脂肪饮食。数据表明， 糖尿病患者存在极低密度脂蛋白异常，糖尿病影响极低密度脂蛋白-甘油三酯 不依赖于apoB的生产。低密度脂蛋白的浓度 糖尿病患者受到两种截然相反的变化的影响- 直接清除极低密度脂蛋白，但极低密度脂蛋白的FCR减少。改进 口服降糖治疗的血糖控制之后是 极低密度脂蛋白-甘油三酯和低密度脂蛋白显著下降，并逆转 极低密度脂蛋白成分异常，极低密度脂蛋白甘油三酯生成异常， 脂肪酶活性和高密度脂蛋白亚组分。糖尿病患者的转院 高碳水化合物、低饱和脂肪饮食与 低密度脂蛋白降低，高密度脂蛋白无变化，极低密度脂蛋白无变化 糖尿病患者。对这两种饮食的代谢研究表明，极低密度脂蛋白 减少饮食中饱和脂肪的摄入是由于 增加了净空。较大的富含极低密度脂蛋白的甘油三酯 低脂肪、高碳水化合物饮食的糖尿病患者效率较低 转换为低密度脂蛋白，但清除极低密度脂蛋白载脂蛋白B和极低密度脂蛋白 甘油三酯较低。结果表明，该模型具有较高的通用性。 碳水化合物低脂饮食可导致较少的动脉粥样硬化 大多数非胰岛素依赖型糖尿病患者的脂蛋白。

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.