Effect of metabolic control of the serum lipid and lipoprotein levels on insulin-dependent diabetes mellitus.

L Romics, I Karádi, M Rozenberczki, L Kammerer
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Abstract

In diabetic patients with poor metabolic control (Group I) and with repeated hypoglycaemic crises (Group II) the serum concentration of cholesterol, triglyceride, of LDL, VLDL and HDL-cholesterol, as well of VLDL and LDL + HDL-triglyceride were measured before and after metabolic control and before and after control of the hypoglycaemic crises. Parallel with the control of diabetic metabolism in Group I, achieved in 15 +/- 6 days, a significant increase in HDL-cholesterol concentration was demonstrable, together with a decrease in the mean value of blood glucose and of daily urinary glucose excretion. In the diabetic patients of Group I, the LDL-cholesterol, serum triglyceride and VLDL-triglyceride levels were significantly higher, the HDL cholesterol levels significantly lower before as well as after metabolic correction, than in the control group. In Group II the serum lipid and lipoprotein lipid concentrations remained unaffected by the control of the hypoglycaemic crises. The results indicate that lipid metabolism in diabetes may considerably be affected by insulin deficiency, but it will respond to an intensified insulin effect. An increase in the concentration of the antiatherogenic HDL-cholesterol is an essential factor of the improvement.

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代谢控制血脂和脂蛋白水平对胰岛素依赖型糖尿病的影响。
对代谢控制不佳的糖尿病患者(I组)和多次低血糖危像患者(II组),测定代谢控制前后和低血糖危像控制前后血清胆固醇、甘油三酯、LDL、VLDL、hdl -胆固醇、VLDL、LDL + hdl -甘油三酯浓度。与第1组在15 +/- 6天内控制糖尿病代谢的同时,高密度脂蛋白胆固醇浓度显著增加,血糖平均值和每日尿糖排泄量下降。1组糖尿病患者代谢校正前后ldl -胆固醇、血清甘油三酯、vldl -甘油三酯水平均显著高于对照组,HDL -胆固醇水平显著低于对照组。在II组中,血脂和脂蛋白脂浓度不受低血糖危机控制的影响。结果表明,胰岛素缺乏可能对糖尿病的脂质代谢有很大影响,但它会对胰岛素效应的增强作出反应。抗动脉粥样硬化高密度脂蛋白胆固醇浓度的增加是改善的重要因素。
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