重构高密度脂蛋白对2型糖尿病患者的代谢影响及机制研究进展  

Progress on reconstituted high-density lipoprotein:effects on metabolism of type 2 diabetic patients and related mechanisms

作　　者：张念荣[1] 朱惠娟[1] 李乃适[1] 

机构地区：[1]中国医学科学院、北京协和医学院、北京协和医院内分泌科、卫生部内分泌重点实验室,北京100730

出　　处：《中国新药与临床杂志》2013年第9期679-684,共6页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：高密度脂蛋白(HDL)是血浆主要脂蛋白之一,高密度脂蛋白胆固醇(HDL-C)降低是动脉粥样硬化和2型糖尿病(T2DM)的独立危险因子。重构HDL(rHDL)是由内源性分离的天然载脂蛋白A-I(apoA-I)或重组的apoA-I_(Milano)与磷脂在体外重构而成的复合物,作为一种新型药物已经在急性冠脉综合征患者Ⅱ期临床试验中显示了良好的疗效。且近期研究发现rHDL能够改善T2DM患者的糖代谢、脂代谢、炎症状态、血小板高反应性及内皮功能,目前认为HDL可能通过抑制胰岛β细胞凋亡、促进β细胞胰岛素分泌、改善胰岛素抵抗、增加外周组织糖摄取等发挥调节糖代谢的作用。High- density lipoprotein （HDL） is one of the major plasma lipoproteins. Decreased HDL- cholesterol is an independent risk factor for atherosclerosis and type 2 diabetes mellitus （T2DM）. Reconstituted HDL （rHDL） is in vitro constituted by phospholipids with either endogenous native apolipoprotein A- I or mutant recombinant apolipoprotein A- I/Milaro novel lipid-modulating drug, rHDL has showed a promising efficacy on acute coronary syndrome in some phase Ⅱ clinical trials. Furthermore, evidence from clinical research suggests that rHDL can improve glucose and lipid metabolism, inhibit inflammation and platelet hyperreactivity, and protect endothelial function in T2DM patients. Some basic research indicates that HDL may regulate glucose metabolism through inhibiting β cell apoptosis, promoting insulin secretion, improving insulin sensitivity and increasing glucose uptake in peripheral tissues. In this article, we review new developments concerning effects and possible mechanisms of rHDL on metabolism in T2DM patients.

关 键 词：脂蛋白类 HDL 重构高密度脂蛋白 葡萄糖代谢障碍 糖尿病 2型 

分 类 号：R587.1[医药卫生—内分泌]