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共同相关 患有非胰岛素依赖型糖尿病的人令人担忧，因为 它们在发病机制中的可能作用大大增加 心血管疾病在这种疾病中的作用。这项研究比较了 非胰岛素依赖型糖尿病患者的极低密度脂蛋白和低密度脂蛋白代谢 在年龄和体重匹配的非糖尿病患者中。进行了研究 在使用磺脲类药物治疗前后的糖尿病患者中； 对糖尿病患者的高脂肪饮食和低脂肪饮食进行了比较。数据 提示糖尿病患者有异常的极低密度脂蛋白，糖尿病 独立于载脂蛋白B影响极低密度脂蛋白-甘油三酯的产生。 糖尿病患者的低密度脂蛋白浓度受两种截然相反的影响 变化--直接清除极低密度脂蛋白增加，但减少 极低密度脂蛋白的FCR。口服改善血糖控制的研究 降糖治疗后极低密度脂蛋白-甘油三酯显著下降 和低密度脂蛋白与极低密度脂蛋白异常逆转 成分、极低密度脂蛋白甘油三酯产量、脂肪酶活性和 高密度脂蛋白亚组分。糖尿病患者向高血糖的转移 碳水化合物，低饱和脂肪饮食与减少 在低密度脂蛋白中，大多数人的高密度脂蛋白和极低密度脂蛋白没有变化 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 diabetes 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.