糖尿病患者における HDL-コレステロール

Abstract

An inversed relationship between plasma HDL-cholesterol level and the incidence of atherosclerotic disease has been demonstrated.And patients with diabetes mellitus have a higher incident of atherosclerotic diasease than nondiabetics. The factors that increase the incidence of atherosclerotic diasease in diabetics are not well understood. Therefore, measurement of HDL-C in diabetics is important. And there are some studies about the problem whether HDL-C in diabetics is lower or higher than in healthy subjects. But the results of the studies are not yet established.In this study, we divided diabetics into three groups treated with diet only, oral agent, and insulin group, and compared HDL-C of three diabetic groups with that of healthy group.We determined HDL-C concentrations in plasma of 848 subjects (male 475, female 373) who received a routine medical check up in Meiji Life Insurence Shinjuku health testing center and 308 diabetics (diet only 136, oral agent 86, insulin 82) by the heparin-Mn2+ precipitation method. The healthy subjects, who had no abnormalities in TG, TC, obesity index, skin fold thickness, blood pressure, ECG finding, GOT, GPT, and blood sugar, were obtained from the testing center. The average HDL-C values of 127 healthy males and 160 females were 61.0±16.9mg/dl and 68.5±13.7mg/dl.Plasma HDL-C was strongly affected by TG, TC, and obesity index in both non-diabetics and diabetics. Average plasma HDL-C value of the female diabetics treated with diet only and oral agents was lower than that of healthy females. And average plasma HDL-C value of the male diabetics treated with insulin was higher than that of healthy males.But plasma HDL-C values adjusted with TG, TC, and obesity index were similar in non-diabetics and diabetics-in any three therapeutic groups. Therefore, we concluded that difference before adjustment was due to the influence of TG, TC, and obesity index. High incidence of atherosclerosis in diabetics was not accounted for by plasma HDL-C.