Dyslipidaemia of diabetes and the intestine  

作　　者：Gerald H Tomkin Daphne Owens 

机构地区：[1]Beacon Hospital Sandyford and Trinity College

出　　处：《World Journal of Diabetes》2015年第7期970-977,共8页世界糖尿病杂志（英文版）（电子版）

摘　　要：Atherosclerosis is the major complication of diabetes and has become a major issue in the provision of medical care.In particular the economic burden is growing at an alarming rate in parallel with the increasing worldwide prevalence of diabetes.The major disturbance of lipid metabolism in diabetes relates to the effect of insulin on fat metabolism.Raised triglycerides being the hallmark of uncontrolled diabetes,i.e.,in the presence of hyperglycaemia.The explosion of type 2 diabetes has generated increasing interest on the aetiology ofatherosclerosis in diabetic patients.The importance of the atherogenic properties of triglyceride rich lipoproteins has only recently been recognised by the majority of diabetologists and cardiologists even though experimental evidence has been strong for many years.In the post-prandial phase 50% of triglyceride rich lipoproteins come from chylomicrons produced in the intestine.Recent evidence has secured the chylomicron as a major player in the atherogenic process.In diabetes chylomicron production is increased through disturbance in cholesterol absorption,in particular Neimann Pick C1-like1 activity is increased as is intestinal synthesis of cholesterol through 3-hydroxy-3-methyl glutaryl co enzyme A reductase.ATP binding cassette proteins G5 and G8 which regulate cholesterol in the intestine is reduced leading to chylomicronaemia.The chylomicron particle itself is atherogenic but the increase in the triglyceride-rich lipoproteins lead to an atherogenic low density lipoprotein and low high density lipoprotein.The various steps in the absorption process and the disturbance in chylomicron synthesis are discussed.Atherosclerosis is the major complication of diabetes andhas become a major issue in the provision of medicalcare. In particular the economic burden is growing atan alarming rate in parallel with the increasing worldwideprevalence of diabetes. The major disturbanceof lipid metabolism in diabetes relates to the effect ofinsulin on fat metabolism. Raised triglycerides being thehallmark of uncontrolled diabetes, i.e. , in the presenceof hyperglycaemia. The explosion of type 2 diabeteshas generated increasing interest on the aetiology ofatherosclerosis in diabetic patients. The importanceof the atherogenic properties of triglyceride richlipoproteins has only recently been recognised by themajority of diabetologists and cardiologists even thoughexperimental evidence has been strong for many years.In the post-prandial phase 50% of triglyceride richlipoproteins come from chylomicrons produced in theintestine. Recent evidence has secured the chylomicronas a major player in the atherogenic process. In diabeteschylomicron production is increased through disturbancein cholesterol absorption, in particular Neimann PickC1-like1 activity is increased as is intestinal synthesisof cholesterol through 3-hydroxy-3-methyl glutaryl coenzyme A reductase. ATP binding cassette proteins G5and G8 which regulate cholesterol in the intestine isreduced leading to chylomicronaemia. The chylomicronparticle itself is atherogenic but the increase in thetriglyceride-rich lipoproteins lead to an atherogenic lowdensity lipoprotein and low high density lipoprotein.The various steps in the absorption process and thedisturbance in chylomicron synthesis are discussed.

关 键 词：TRIGLYCERIDE Cholesterol CHYLOMICRONS Microsomal TRIGLYCERIDE transfer protein Niemann PickC1-like1 LIPOPROTEINS DIABETES ATP binding cassetteproteins G5/G8 

分 类 号：R587.2[医药卫生—内分泌]