The waist-to-hip ratio corrected for body mass index is related to serum triglycerides and high-density lipoprotein cholesterol but not to parameters of glucose metabolism in healthy premenopausal women

Summary Android obesity is associated with metabolic disorders, but the causality of this relationship remains unclear. We investigated the association of body mass index (BMI) and waist-to-hip ratio (WHR) with hormones, glucose tolerance, insulin sensitivity, serum lipoproteins, and the serum activity of hepatic enzymes in 40 healthy premenopausal women (BMI 19.2–46.1, mean 32.6±1.3 kg/M²; WHR 0.68-1.01, mean 0.82±0.02). BMI correlated with WHR (r=0.52, P<0.01). After correction for WHR, BMI was negatively correlated with high-density lipoprotein cholesterol and positively with total and very low density lipoprotein triglycerides, insulin sensitivity, blood glucose, serum insulin and glucagon. After adjustment for BMI, WHR was significantly associated with high-density lipoprotein cholesterol, total and very low density lipoprotein triglycerides, and the serum activities of hepatic enzymes but not with insulin sensitivity, blood glucose, serum insulin, or glucagon. According to these results, body fat distribution assessed by WHR is related to hypertriglyceridemia and alterations in hepatic function such as a fatty liver. WHR is not primarily related to glucose metabolism in healthy premenopausal women without preexisting metabolic disorders such as glucose intolerance. Therefore the observable association between android obesity and manifest impairment in glucose metabolism may develop secondarily during persisting hyperinsulinemia, which itself is primarily related to obesity. Thus an android body fat distribution may rather be an accompanying feature than a predictor of impaired glucose tolerance and insulin resistance.Abbreviations BMI body mass index - WHR waist-to-hip ratio - HDL high-density lipoprotein - LDL low-density lipoprotein - VLDL very low density lipoprotein - OGTT oral glucose-tolerance test - aP alkaline phosphatase - ALT alanine aminotransferase - AST aspartate aminotransferase - DHEAS dehydroepiandrostendione-sulfate Dedicated to Prof. Dr. G. Paumgartner on the occasion of his 60th birthday     

Effects of exercise cessation on lipids and lipoproteins in distance runners and power athletes

Summary The purpose of this study was to determine the effects of short-term exercise cessation on lipid and lipoprotein profile and insulin sensitivity in highly trained runners (n=12; mean age 19.9 years) and power athletes (n=12; mean age 24.4 years). Following 14 days of exercise cessation, running time to exhaustion and maximal oxygen uptake decreased by 9.2% and 4.8% (P < 0.05) in the runners, while in the power athletes one repetition maximum squat and bench press did not change (P>0.05). No changes occurred in body composition. Data from a 2-h oral glucose tolerance test revealed an impairment of the glycemic state in all athletes (P<0.05). In contrast, exercise cessation did not significantly (P>0.05) alter plasma levels of cholesterol, triglycerides, and low density (LDL) and high density lipoprotein (HDL). No changes were observed in HDL₂, HDL_2b, and HDL₃ subfractions, LDL diameter, and qualitative LDL pattern (P>0.05). These data thus suggest that despite a decrease in insulin sensitivity, short-term exercise cessation, independent of exercise mode, was insufficient to alter plasma lipid and lipoprotein profiles in well-trained athletes.     

Lipoprotein Metabolism in Dogs and Cats

High-density lipoproteins (HDL) are the predominant lipoproteins in plasma of dogs and cats and are the major cholesterol-carrying particles. Two HDL subfractions are identifiable in dog: small, dense particles (equivalent to human HDL₃) and large, buoyant particles called HDL₁, which overlap in hydrated density with low-density lipoproteins (LDL). The HDL₁ are enriched in cholesterol and apolipoprotein (apo) E, and are prevalent in dogs fed high amounts of cholesterol and, or, saturated fat, when they are also referred to as HDL_c. Lipoproteins similar to human HDL₂ and HDL₃ are identifiable in feline plasma, along with trace HDL₁. Lipoprotein lipase (LPL), hepatic lipase (HL) and lecithin: cholesterol acyl transferase (LCAT) activities are present in dogs and cats. Both species lack significant cholesteryl ester transfer protein activity, and reverse cholesterol transport is probably accomplished by receptor-mediated hepatic uptake of HDL₁. Methods for the measurement of canine and feline plasma lipoprotein-cholesterol concentrations, apolipoprotein concentrations, and the activities of LPL, HL and LCAT have been developed. Together with oral and intravenous fat tolerance tests, these methods provide the basis for studying lipoprotein metabolism in cats and dogs.Originally presented at ECCP 95.     

Lipid profile of body builders with and without self-administration of anabolic steroids

Summary Twenty-four top-level body builders [13 anabolic steroid users (A); 11 non-users (N)] and 11 performance-matched controls (C) were examined to determine the effect on lipids, lipoproteins and apolipoproteins of many years of body building with and without simultaneous intake of anabolic steroids and testosterone. After an overnight fast, triglycerides (TG), total cholesterol (TOTC), high density lipoprotein cholesterol (HDLC), low density lipoprotein cholesterol (LDLC), the HDLC subfractions HDL₂C and HDL₃C, as well as apolipoprotein A-I (Apo A-I), apolipoprotein A-II (Apo A-II) and apolipoprotein B (Apo B) were determined. Both A and N, compared to C, showed significantly lower HDLC and higher LDLC concentrations, with the differences between A and C clearly pronounced. In a subgroup of 6 body builders taking anabolic steroids at the time of the study, HDLC, HDL₂C, HDL₃C, Apo A-I and Apo A-II were all significantly lower and LDLC was significantly higher than in a second subgroup of 7 body builders who had discontinued their intake of anabolic steroids at least 4 weeks prior to the study. In some single cases HDLC was barely detectable (2–7 mg·dl⁻¹). The TG and TOTC remained unchanged. The present findings suggest that many years of body building among top-level athletes have no beneficial effect on lipoproteins and apolipoproteins. Simultaneous use of anabolic steroids results in part in extreme alterations in lipoproteins and apolipoproteins, representing an atherogenic profile. After discontinuing the use of anabolic steroids, the changes in lipid metabolism appear to be reversible.     

Impact of hormone replacement therapy on postprandial lipoproteins and lipoprotein(a) in normolipidemic postmenopausal women

In 43 normolipidemic postmenopausal women we studied fasting and postprandial (oral fat load with 50 g fat per square meter; blood sampling for 5 h) lipoprotein components and lipoprotein(a) levels before and with the administration of conjugated equine estrogens opposed by medrogestone (on days 11–21). Data was compared intraindividually; the second testing was performed during the last 5 days of the combined estrogen/progestogen phase of the third cycle. Fasting low-density lipoprotein (LDL) and total cholesterol concentrations decreased significantly; high-density lipoprotein (HDL) cholesterol, including subfractions HDL₂ and HDL₃, was not changed. Fasting triglyceride concentrations increased. All lipoprotein fractions measured showed a postprandial elevation with the exception of chylomicron cholesterol concentrations. There was a significant effect of hormone replacement therapy on the postprandial course of total cholesterol (decrease; P < 0.001), VLDL cholesterol (increase; P = 0.025), and the triglyceride proportion in the LDL plus HDL fraction (increase; P < 0.001). With hormone replacement therapy the postprandial curve of total triglycerides was increased only 1 h after the fat load while chylomicron triglyceride concentrations were lowered after 5 h. VLDL triglycerides were not influenced. In all patients with lipoprotein(a) levels above 10 mg/dl, this parameter decreased (about 25%). Although increasing fasting triglyceride concentrations, hormone replacement therapy does not bring about an exaggerated postprandial increase in triglycerides. Postprandial chylomicron clearance is evidently promoted. Hormone replacement therapy leads to a small increase in triglycerides in the LDL plus HDL fraction by inhibiting hepatic lipase activity. Moreover, the decrease in lipoprotein(a) levels may contribute to the antiatherosclerotic effect.Abbreviations: CEE conjugated equine estrogens - HDL high-density lipoproteins - HRT hormone replacement therapy - LDL low-density lipoproteins - TG triglycerides - VLDL very low density lipoproteins Correspondence to: U. Julius     

Diet, plasma lipoproteins and experimental atherosclerosis in baboons (Papio sp.)

Diet-induced hyperlipidaemia in baboons is similar to that inhumans. As in humans, the ratio between low density lipoprotein(LDL) and high density lipoprotein (HDL) cholesterol is a majordeterminant of atherosclerosis. Baboons, like humans and othernon-human primates, vary in their lipaemic responses to dietarylipids. By selective breeding based on variability in plasmaand lipoprotein cholesterol response to diet, lines of baboonswith high and low responses of various lipoproteins have beendeveloped. Genetic analyses suggest that lipoprotein patternsin responses to dietary cholesterol and fat are heritable. Metabolicand molecular studies of high and low LDL and HDL cholesterolresponses to dietary lipids have suggested that different mechanismsregulate plasma LDL cholesterol on the chow and on the highcholesterol-high fat (HCHF) diet. On the chow diet, plasma LDLcholesterol levels are positively associated with cholesterolabsorption and negatively associated with hepatic LDL receptorlevels and, thus, cholesterol absorption and LDL receptors seemto regulate plasma LDL cholesterol levels. However, when theanimals consume a human-like fat- and cholesterol-enriched diet,plasma LDL cholesterol levels are not associated with eithercholesterol absorption or hepatic LDL receptor mRNA levels,but are negatively associated with plasma 27-hydroxycholesterolconcentrations, hepatic sterol 27-hydroxylase activity, andmRNA levels. Hepatic sterol 27-hydroxylase activity and mRNAlevels are induced by dietary cholesterol and fat in low respondingbaboons more than in high responding baboons. Thus, the abilityto induce sterol 27-hydroxylase determines the LDL cholesterolresponse in baboons. High HDL response baboons often have highlevels of HDL₁ in their plasma. Our studies suggest that theN-terminal fragment of apo C-I with 38 amino acids and a molecularweight of 4 kDa acts as a cholesteryl ester transfer inhibitorpeptide in high HDL₁ baboons. The inhibitor peptide associateswith apo A-1 in HDL to produce a modified apo A-1 protein witha molecular weight of 31 kDa. The inhibitor peptide is a geneproduct and the presence of this peptide produces an antiatherogenichigh HDL₁ phenotype.     

Effect of postmenopausal oestradiol and dydrogesterone therapy on lipoproteins and insulin sensitivity,secretion and elimination in hysterectomised women

OBJECTIVES: To investigate in depth the metabolic effects of oestradiol-17 beta both alone and in combination with the progestagen dydrogesterone. METHODS: Fifteen hysterectomised postmenopausal women were studied before treatment and after 24 weeks taking oestradiol-17 beta alone (2 mg per day), then following a further 6 (oestrogen-alone phase) and 12 (oestrogen plus progestagen phase) weeks with inclusion of dydrogesterone (10 mg per day for days 17-28 of each 28 day cycle). Measurements at each visit included fasting serum lipid and lipoprotein concentrations, insulin sensitivity, secretion and elimination by modelling analysis of intravenous glucose tolerance test glucose, insulin and C-peptide concentrations, body fat distribution by dual-energy X-ray absorptiometry (DXA) and arterial function by carotid artery ultrasound. RESULTS: Significant reductions were seen throughout in total and LDL cholesterol. The net reductions in total and LDL cholesterol by the end of the study were 5.8% (P<0.05) and 18.4% (P<0.001), respectively. HDL and HDL subfraction cholesterol concentrations rose during treatment with oestradiol alone, the rise being primarily in the HDL(2) subfraction (+21.6%, P<0.001). Fasting serum triglycerides rose 30% on oestradiol treatment. These increases were unaffected by the addition of dydrogesterone. Insulin sensitivity, secretion and elimination, body fat distribution and arterial function were not significantly affected at any stage of the therapy. CONCLUSIONS: The small study sample and high variability in measures of glucose and insulin metabolism may have contributed to the absence of the expected significant improvement in these parameters. Orally administered oestradiol had beneficial effects on total, LDL and HDL cholesterol which were unaffected by the addition of dydrogesterone.     

Die Wirkungen gleicher Mengen Linolsäure in oral zugeführten,mehrfach ungesättigten Phospholipiden oder in Safloröl auf die Lipoproteine des Plasmas

Summary The effects of polyenylphosphatidylcholine in a dosage of 10 g per day were compared with an equimolar amount of linoleic acid in 7 g safloroil per day in 8 healthy subjects for 3 weeks. The concentrations of cholesterol, triglycerides, phospholipids, apolipoproteins A-I, A-II and B were measured in serum, as well in VLDL, LDL, HDL, HDL₂, HDL₃ on the day before, after 2 and 3 weeks of application and 6 months after the experiment. The diet was controlled 10 days before and during the experiment using the dietary recall method. According to the dietary records there was an increase of fat supply during application of polyenylphosphatidylcholine inhibiting decrease of LDL cholesterol, which was observed with safloroil. Phospholipid concentrations increased significantly with polyenylphosphatidylcholine in VLDL. Apolipoprotein B in LDL was significantly decreased by both substances. Apolipoprotein A-I and A-II in HDL increased significantly with polyenylphosphatidylcholine. With safloroil this effect was limited to apolipoprotein A-I, but less impressive. The effects of both substances are comparable in the decrease of apolipoprotein B and probably cholesterol. A special effect of polyenylphosphatidylcholine was observed on phospholipids in VLDL and on apolipoprotein A-I and A-II in HDL.

---

Abkürzungen PPC Polyenylphosphatidylcholin - VLDL Very low density lipoproteins - LDL Low density lipoproteins - HDL High density lipoproteins - LCAT Lecithin-Cholesterin-Acyl-Transferase     

Effects of fish oil concentrate on lipoproteins and apolipoproteins in familial combined hyperlipidemia

Summary The effects of two moderate doses of long-chain n-3 fatty acids (3.0 and 4.5 g EPA + DHA per day for 4 weeks each) on serum lipids and lipoproteins of patients with familial combined hyperlipidemia (FCH) were studied in a double-blind, placebo-controlled clinical trial. In nine patients with FCH n-3 fatty acids led to a statistically significant, dose-dependent fall in very low density lipoprotein (VLDL) triglycerides (3 g/day: –42%, 4.5 g/day: –55%) VLDL cholesterol (3 g/day: –41%, 4.5 g/day: –47%), and VLDL apolipoprotein (apo) B-100 (3 g/day: –40%, 4.5 g/day: –56%). No overall change in low-density lipoprotein (LDL) cholesterol was found, as confirmed statistically. However, when analyzing the data of single patients LDL cholesterol and LDL apo B did not change in five patients but increased dose dependently (from pretreatment 4.80±0.93 mmol/l to 5.70+0.93 mmol/l LDL cholesterol after 4.5 g/day) in four. LDL and VLDL composition as indicated by cholesterol/apo B-100 and triglyceride/apo B-100 ratios did not change significantly. High-density lipoprotein (HDL) cholesterol was unchanged; the HDL cholesterol/apo A-I+apo A-II ratio increased by 19% (P<0.05) during fish oil treatment. We conclude that in FCH moderate doses of long-chain n-3 fatty acids are highly effective in lowering pathological VLDL triglycerides, VLDL cholesterol, and VLDL apo B. LDL cholesterol must, however, be monitored during treatment as it may rise substantially in some although not in all patients with this disease.Abbreviations EPA eicosapentaenoic acid - DHA docosahexaenoic acid - FCH familial combined hyperlipidemia - VLDL very low density lipoprotein - LDL low-density lipoprotein - HDL high-density lipoprotein - apo apolipoprotein Dedicated to Prof. Dr. N. Zöllner on the occasion of his 70th birthday     

The acute effect of marathon running on plasma lipoproteins in female subjects

Summary The acute effect of running a 42.2 km marathon race on plasma lipoproteins was investigated in 12 female subjects (aged 21 to 41 years). During the race there was a significant increase (P<0.01) in the concentration of total plasma cholesterol. The mean post-race concentration of high density lipoprotein cholesterol (HDL-C) was 64.0±16.2 (SD) mg 100 ml^–1, compared with 52.1±14.0 mg 100 ml^–1 before the race, representing a significant increase (P<0.002). There was no significant difference in the concentration of very low density lipoprotein (VLDL) or low density lipoprotein (LDL) before and after the exercise. The mean concentration of the cholesteryl ester moiety of the HDL increased from 43.7±12.3 to 54.3±15.7 mg 100 ml^–1 (P<0.002), while there was no significant change in the concentration of the unesterified cholesterol, phospholipid, triacylglycerol or protein moieties of the HDL. The relative proportions of apolipoproteins A-I, A-II, C and E remained unchanged during the exercise. The changes in the concentration of each of the lipoprotein fractions observed during the marathon varied considerably between subjects. The individual increases in the concentration of HDL-C ranged from 4.1 to 28.4 mg 100 ml^–1, while both increases and decreases in individual concentrations of VLDL and LDL as well as of total plasma cholesterol were observed. These observations suggest that women undergo greater changes in HDL-C concentration than men during acute exercise, while considerable variation between individuals occurs.     

The ratio of waist-to-hip circumference, plasma insulin level, and glucose intolerance as independent predictors of the HDL2 cholesterol level in older adults

High plasma levels of HDL2, a subfraction of high-density lipoprotein (HDL) cholesterol, are associated with a reduced risk of coronary heart disease. To investigate the characteristics related to HDL2 cholesterol levels, we measured lipoprotein levels and several metabolic and anthropometric variables in 146 healthy subjects (77 men and 69 women) in the seventh decade of life. The level of HDL2 cholesterol was inversely correlated with the ratio of the waist-to-hip circumference (r = -0.335 for men; r = -0.370 for women; P less than 0.01) and the plasma insulin level (r = -0.400 for men; r = -0.398 for women; P less than 0.001). In a multiple regression model including both sexes, 41 percent of the variance in the HDL2 level was explained by the combined effect of the waist-to-hip ratio (P less than 0.0001), the plasma insulin level (P = 0.0003), and the degree of glucose tolerance indicated by the integrated area under the plasma glucose curve after an oral glucose-tolerance test (P = 0.05). The body-mass index, total percentage of body fat, maximal oxygen uptake, diet, and sex were not significant predictors of the HDL2 level when added to this model, whereas the original variables remained significant predictors. The HDL2 cholesterol level in subjects at the 25th percentile for waist-to-hip ratio was 153 percent of that in subjects at the 75th percentile. We conclude that HDL2 levels are inversely correlated with truncal fat, plasma insulin levels, and the presence of glucose intolerance and are not independently associated with sex or total body fat.     

Effect of treatment on the concentration of lipoproteins and the postheparin-lipolytic activity in the plasma of noninsulin-dependent diabetics

Summary To study the effect of treatment on plasma lipid and lipoprotein concentration and on postheparin-lipolytic activity (PHLA) in plasma, 26 noninsulin-dependent diabetics were investigated who were treated with maximally effective doses of glibenclamide. The patients were randomly divided into two groups: In group I, glibenclamide was replaced by a long-acting insulin preparation given once daily at variable doses until satisfactory metabolic control was achieved. In group II, glibenclamide was replaced by placebo. At weeks 0, 1, 3, 7, and 12 after change of treatment, the following parameters were determined: Blood glucose, plasma concentrations of cholesterol, triglycerides, phospholipids, HDL cholesterol, very-low-density lipoproteins, intermediate-density lipoporteins, low density lipoproteins, high-density lipoproteins₂ (HDL₂), HDL₃, and PHLA. At week 0, no statistically significant differences existed between group I and group II with respect to all parameters mentioned above. The replacement of glibenclamide by insulin resulted in a continous decrease of blood glucose (p<0.01) with a concomitant increase in HDL₂ (p<0.01) and in PHLA (p<0.01) during the period of investigation. In contrast, replacement of glibenclamide by placebo exerted no significant influence on all determined parameters during 12 weeks. These data suggest that in noninsulin-dependent diabetics, who are inadequately controlled by sulfonylureas, an adequate insulin substitution is necessary to correct, apart from glucose metabolism, the impaired lipoprotein metabolism of diabetes mellitus. Sulfonylureas per se seem not to decrease the HDL₂ fraction nor the PHLA.     

The effects of black cohosh therapies on lipids, fibrinogen, glucose and insulin

OBJECTIVE: Black cohosh (Actaea racemosa) is an herb commonly used to treat menopausal symptoms. Little is known about its effect on other physiologic parameters that could result in untoward events. This study examines the effect of black cohosh on lipids, fibrinogen, glucose and insulin. METHODS: Three hundred and fifty-one, 45-55 years old, peri or post-menopausal women experiencing vasomotor symptoms participated in a 3-month, double blind trial with randomization to: (1) black cohosh (160 mg daily); (2) multibotanical including black cohosh (200 mg daily); (3) multibotanical plus soy diet counseling; (4) conjugated equine estrogen .625 mg, with or without medroxyprogesterone acetate 2.5mg daily, for women with or without a uterus, respectively; (5) placebo. Baseline and month 3 total cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol (calculated), triglyceride, insulin, glucose, and fibrinogen serum concentrations were measured in 310 women. Baseline information was also collected on medical history, demographic characteristics, and diet. RESULTS: There were no statistically significant differences in the adjusted mean change from baseline to 3 months between the herbal groups and placebo in total cholesterol, LDL, HDL, triglycerides, glucose, and insulin. Adjusted fibrinogen levels appear to increase in the multibotanical treatment group in comparison with the other herbal groups and placebo overall (P = .02), but there was no statistically significant difference in the pairwise test against placebo (P = .11). CONCLUSIONS: Black cohosh containing therapies had no demonstrable effects on lipids, glucose, insulin or fibrinogen.     

Leptin and adipose tissue maldistribution in HIV-infected male patients with predominant fat loss treated with antiretroviral therapy.

BACKGROUND: Metabolic disturbances and fat maldistribution are main features of the antiretroviral-related lipodystrophy syndrome (LDS). Different phenotypes of fat distribution abnormalities can be observed: fat loss, fat accumulation, or a mixed pattern. In patients with predominant loss of fat, the roles of leptin, lipids, and glucose homeostasis disturbances have not yet been clearly established. METHODS: The study comprised 34 HIV-infected male patients receiving antiretroviral treatment that included protease inhibitors. A lipoatrophic phenotype, defined as fat loss in face or extremities, both normal weight and waist:hip ratio, and absence of fat accumulation elsewhere, was present in all cases. Fat distribution disturbances were confirmed by abdominal and midthigh computed tomography-calculated adipose tissue content. Fasting plasma glucose, insulin, proinsulin, total leptin, testosterone, and lipid profiles were measured. After 2 hours, 75-g oral glucose tolerance test (OGTT), glucose, insulin, and proinsulin levels were also obtained. Insulin resistance was calculated using the homeostasis model assessment for insulin resistance (HOMA-r) method. Both healthy study subjects ( n = 385) and antiretroviral-naive HIV-positive patients ( n = 13) were used as controls. RESULTS: Of these LDS patients, 5.8% showed diagnostic criteria for diabetes and 17.8% for impaired glucose tolerance. A lipid pattern characterized by high total cholesterol and high low density lipoprotein (LDL) plasma levels, hypertriglyceridemia, and normal high density lipoprotein (HDL) levels was observed. Fasting insulin and 2-hour post OGTT insulin levels, and insulin resistance index were significantly higher in LDS patients than in antiretroviral-naive HIV-positive patients. Plasma leptin levels were significantly lower in lipoatrophic patients than in healthy control individuals. Patients with LDS presented with significant midthigh fat reduction and visceral fat accumulation compared with findings in antiretroviral-naive HIV-positive patients. A significant correlation was found between plasma leptin levels and midthigh fat content. CONCLUSION: Peripheral fat loss in extremities in LDS patients with lipoatrophic phenotype is also associated with low plasma leptin levels, visceral fat accumulation, and metabolic disturbances related to an increased cardiovascular risk. In LDS patients, plasma leptin levels could be a marker of subcutaneous adipose tissue content.     

Comparison of a high-carbohydrate diet with a high-monounsaturated-fat diet in patients with non-insulin-dependent diabetes mellitus

We compared a high-carbohydrate diet with a high-fat diet (specifically, a diet high in monounsaturated fatty acids) for effects on glycemic control and plasma lipoproteins in 10 patients with non-insulin-dependent diabetes mellitus (NIDDM) receiving insulin therapy. The patients were randomly assigned to receive first one diet and then the other, each for 28 days, in a metabolic ward. In the high-carbohydrate diet, 25 percent of the energy was in the form of fat and 60 percent in the form of carbohydrates (47 percent of the total energy was in the form of complex carbohydrates); the high-monounsaturated-fat diet was 50 percent fat (33 percent of the total energy in the form of monounsaturated fatty acids) and 35 percent carbohydrates. The two diets had the same amounts of simple carbohydrates and fiber. As compared with the high-carbohydrate diet, the high-monounsaturated-fat diet resulted in lower mean plasma glucose levels and reduced insulin requirements, lower levels of plasma triglycerides and very-low-density lipoprotein cholesterol (lower by 25 and 35 percent, respectively; P less than 0.01), and higher levels of high-density lipoprotein (HDL) cholesterol (higher by 13 percent; P less than 0.005). Levels of total cholesterol and low-density lipoprotein (LDL) cholesterol did not differ significantly in patients on the two diets. These preliminary results suggest that partial replacement of complex carbohydrates with monounsaturated fatty acids in the diets of patients with NIDDM does not increase the level of LDL cholesterol and may improve glycemic control and the levels of plasma triglycerides and HDL cholesterol.     

Plasma kinetics of an LDL-like nanoemulsion and lipid transfer to HDL in subjects with glucose intolerance

OBJECTIVE:

Glucose intolerance is frequently associated with an altered plasma lipid profile and increased cardiovascular disease risk. Nonetheless, lipid metabolism is scarcely studied in normolipidemic glucose-intolerant patients. The aim of this study was to investigate whether important lipid metabolic parameters, such as the kinetics of LDL free and esterified cholesterol and the transfer of lipids to HDL, are altered in glucose-intolerant patients with normal plasma lipids.

METHODS:

Fourteen glucose-intolerant patients and 15 control patients were studied; none of the patients had cardiovascular disease manifestations, and they were paired for age, sex, race and co-morbidities. A nanoemulsion resembling a LDL lipid composition (LDE) labeled with ¹⁴C-cholesteryl ester and ³H-free cholesterol was intravenously injected, and blood samples were collected over a 24-h period to determine the fractional clearance rate of the labels by compartmental analysis. The transfer of free and esterified cholesterol, triglycerides and phospholipids from the LDE to HDL was measured by the incubation of the LDE with plasma and radioactivity counting of the supernatant after chemical precipitation of non-HDL fractions.

RESULTS:

The levels of LDL, non-HDL and HDL cholesterol, triglycerides, apo A1 and apo B were equal in both groups. The ¹⁴C-esterified cholesterol fractional clearance rate was not different between glucose-intolerant and control patients, but the ³H-free- cholesterol fractional clearance rate was greater in glucose-intolerant patients than in control patients. The lipid transfer to HDL was equal in both groups.

CONCLUSION:

In these glucose-intolerant patients with normal plasma lipids, a faster removal of LDE free cholesterol was the only lipid metabolic alteration detected in our study. This finding suggests that the dissociation of free cholesterol from lipoprotein particles occurs in normolipidemic glucose intolerance and may participate in atherogenic signaling.     

Lipoprotein pattern in long-term diabetes of an at least 35 years' duration

Summary All diabetic patients suffering from the disease for at least 20 years and living in the closed area of the Erfurt district in 1970 have been followed prospectively since that time. In 47 of them still alive in 1985, i.e. after more than 35 years of diabetes, serum lipid and apolipoprotein concentrations were measured and compared to those of non-diabetic subjects without cardiovascular diseases (n=47) pair-matched by sex, age, and body weight. In males (n=27) significantly (p<0.01) higher levels of HDL cholesterol and apolipoprotein A–I as well as lower concentrations of triglycerides and a lower total cholesterol/HDL cholesterol risk ratio than in nondiabetic control subjects could be found. In long-term diabetic females (n=20), apolipoprotein A–I levels were also increased (p<0.02). Trends in HDL cholesterol and triglycerides were similar to those found in males but did not reach statistical significance. Higher concentrations of total cholesterol (p<0.02), LDL cholesterol (P<0.05), and apolipoprotein B (p<0.02), however, did not fit in with a beneficial lipoprotein pattern. The frequency of pathological lipoprotein patterns was not higher than among the non-diabetic control subjects (32% and 40%, respectively). According to these findings an antiatherogenic lipoprotein pattern might be considered, at least in males, as one of the determinants causing the multifactorial event of long-term survival in diabetes.Abbreviations ECG electrocardiogramm - Hb haemoglobin - HDL high density lipoproteins - LDL low density lipoproteins - SD standard deviation - VLDL very low density lipoproteins     

Hypolipidemic effect of pantothenic acid derivatives in mice with hypothalamic obesity induced by aurothioglucose

The hypolipidemic effects of pantothenic acid derivatives (phosphopantothenate, panthenol and pantethine) were studied in mice with hypothalamic obesity. Hypothalamic obesity in mice was induced by single injection of aurothioglucose (300 mg/kg body wt, i.p.). All the tested substances were administered during the last 10 days before decapitation (i.m., of dosage equivalent to 150 mg/kg body wt of phosphopantothenate). The studied substances inhibited the weight gain of the animals with hypothalamic obesity over the last 10 days of the experiment. The treatment with aurothioglucose increased food intake and mean body weight, blood glucose level; insulin, serum total cholesterol, triglyceride, the sum of LDL + VLDL and LDL-cholesterol concentration; triglyceride and cholesterol fractions in the liver; triglyceride and FFA content as well as lipoprotein lipase activity in adipose tissue of experimental mice. The administration of the assay compounds lowered food intake and mean body weight, insulin and glucose levels and decreased the content of triglycerides, total cholesterol and cholesterol esters in serum and adipose tissue as well as raised the activity of lipoprotein lipase in adipose tissue and serum lipolytic activity in obese mice. Among the compounds studied the reverse effect of panthenol was especially pronounced. The mechanism of hypolipidemic effects of pantothenic acid derivatives can be related to the reduced resistance to insulin and activation of lipolysis in serum and adipose tissue.     

Comparison of VO2max and disease risk factors between perimenopausal and postmenopausal women

OBJECTIVE: This study determines whether maximal oxygen consumption (VO2 max) is higher in perimenopausal women compared with similarly aged postmenopausal women and whether the lower VO2 max in postmenopausal women is associated with a higher total and visceral fat mass, less favorable lipid and glucose metabolism, and lower bone mineral density (BMD). DESIGN: Participants were 18 perimenopausal women (mean +/- SD; irregular menstrual cycle in the past 6 months) aged 49 +/- 4 years and 18 postmenopausal women (no menstrual cycle in the past year) aged 52 +/- 2 years who were matched for body mass index and race. Women were sedentary, and none were on hormone replacement therapy. Body composition (dual-energy x-ray absorptiometry and CT), VO2 max, fasting concentrations of sex steroid hormones, lipoproteins, insulin, and glucose were determined. RESULTS: VO2 max was 17% lower (22 +/- 3 v 27 +/- 7 mL.kg.min; P 相似文献   

Concentration of Lipid,apoprotein-B and testosterone in patients with coronarographic findings

Summary The relationship between lipid, apolipoprotein-B and testosterone concentration and indicated coronarography was followed in male patients assigned into two age groups (under and over 50 years). Patients without a positive finding on coronary vessels served as controls. Patients of both age groups with a positive coronarographic finding showed an enhanced apolipoprotein-B and a decreased cholesterol concentration in the HDL₂-high density lipoprotein subfraction. Like-wise, testosterone level was also decreased in the two age groups. It appears that a lowered testosterone level may indirectly intervene into lipoprotein metabolism, or may affect the apolipoprotein-B level.Abbreviations HDL high density lipoprotein - HDL-Ch high density lipoprotein-cholesterol - LDL low density lipoprotein - LPL lipoprotein lipase - VLDL very low density lipoprotein