| The purpose of this study was to determine if postprandial lipemia disturbances are found in type 2 diabetic patients strictly normotriglyceridemia in the fasting state, and their relative factors. Multiple epidemiological and clinical studies have established that dyslipidemia such as increased total cholesterol (T - Cho) , particular low - density lipoprotein cholesterol ( LDL - C) , and decreased high - density lipoprotein - cholesterol ( HDL - C ) , is the most crucial factor in the pathogeriesis of atherosclerosis (AS) , including coronary heart disease (CHD) and subsequent sudden death. More and more studies suggested that pathogenesis of AS in diabetes mellitus is closely associated with dyslipidemia. On ADA meeting in 2001, McGary who awarded Banting Medal reported that disorder lipid metabolism is a primary event in the pathophysiology of diabetes and its complications, and diabetes mellitus should be called as diabelip-idtes. UKPDS reports showed that dyslipidemia is much more common in T2DM and the major abnormality is elevated triglyceride (TG) and low HDL cholesterol concentrations, and LDL cholesterol and total cholesterol is not seen significant differences between type 2 diabetic patients and normal subjects.The postprandial state last more than half during one day, and the lipids metabolism of postprandial state often change before the fasting state. So the study of postprandial metabolism should be taken more attention. In the past, most studies on the relationship between atherosclerosis and lipids were based on the fasting lipids level. However the postprandial state is the most time in human life. So the fasting lipidemia parameter as research specimen is difficult to fully respond the entire progress of lipids metabolism and the pathogenesis of atherosclerosis. In 1979, Zilversmit hypothesized that chylomicrons, which are syn-thesized and secreted after fat ingestion, and their remnants may be taken up by the arterial cells and that accumulation of cholesterol - loaded remnants in arterial wall may be critical in the development of the atherogenic process. Recently, however, some prospective studies have clearly showed the potential importance of postprandial hypertriglyceridemia in the etiology of CHD even after adjusting for HDL - C using multivariate analyses. Braschi S et al have demonstrated that the atherogenicity of TG was mainly in the postprandial state, and the predictive intensity of postprandial TG level to AS is independent and higher than fasting TG level. Postprandial dyslipidemia often appears in T2DM. Until now the studies on postprandial lipid in China is very few. Our study was to explore further the issue of postprandial lipemia in normortriglyceridemic type 2 diabetic patients and expected to provide a new target for prediction and treatment to atherosclerosis.Materials and Methods1. SubjectsA total of 25 normotriglyceridernic type 2 diabetic patients and 19 health subjects participated in this study. The two groups were matched for age, sex, body mass index (BMI) , blood pressure (BP) , and fasting TG level.1.1. Enrollment standards for patients:Patients who have been made the definite diagnosis based on the criteria of WHO in 1999.Duration of diabetes mellitus is less than 10 years.All of the patients have no coronary heart disease, no cerebrovascular disease, no heptic and nephrotic disease and no other endocritic disease.All of the patients take no medication affecting carbohydrate or lipid metabolism.Antidiabetic and antilipid agents are withdrawn 48 hours before the trial.They all have no smoke or drink liquor history.2. Protocol of study2.1. Oral fat -loading test;The test meal was made according to some published studies and we also made some amendment. The meal contains 40g fat /m2 ( body surface area). The total energy is 1000 kcal in male and 800 kcal in female. The ratio of Saturated fat to unsaturated fat in the meal is 1.2.2. Specimen collections:After fasting for at least 12 hours, a tes... |
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