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Query: UMLS:C0011849 (diabetes)
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We measured serum lipids, lipoproteins and post-heparin plasma lipases, lipoprotein lipase and hepatic lipase, in 12 female patients with Type 1 (insulin-dependent) diabetes (postglucagon C-peptide undetectable), in 11 female insulin-treated patients with Type 2 (non-insulin-dependent) diabetes (postglucagon C-peptide greater than 0.60 nmol/l) and in 16 non-diabetic female control subjects. These three groups of subjects were similar with respect to age and obesity. Insulin dose was similar in patients with Type 1 and with Type 2 diabetes. HDL and HDL2 cholesterol were lower in patients with Type 2 diabetes than in non-diabetic control subjects (p less than 0.05) but did not differ between patients with Type 1 diabetes and non-diabetic control subjects. No difference in lipoprotein lipase activity was seen between the groups. The highest levels of lipoprotein lipase and hepatic lipase activities were observed in patients with Type 2 diabetes. Lipoprotein lipase activity correlated significantly with HDL cholesterol in patients with Type 1 diabetes (p less than 0.01) and in patients with Type 2 diabetes (p less than 0.001) but not in control subjects. Hepatic lipase activity did not correlate significantly with HDL cholesterol in any of the groups. In conclusion, postheparin plasma lipoprotein lipase and hepatic lipase activities do not seem to explain the difference in HDL cholesterol concentration between patients with Type 1 and Type 2 diabetes.
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PMID:Relationship between postheparin plasma lipases and high-density lipoprotein cholesterol in different types of diabetes. 342 2

We have examined the prevalence of hyperlipidaemia (defined as representing fasting serum cholesterol greater than 7.1 mmol/L; fasting serum triglyceride greater than 2.1 mmol/L) in 188 hypertensive type 2 diabetics of different ethnic groups. The overall prevalence of hyperlipidaemia was 36.0% with hypertriglyceridaemia at 25% being more frequent than hypercholesterolaemia at 19%. Blacks at 20.5% had strikingly less hyperlipidaemia than whites at 43.3% (p less than 0.01) and Asians, at 53.7% (p less than 0.001). This ethnic difference was noted for each variety of hyperlipidaemia, being most marked for hypertriglyceridaemia. Reflecting these data blacks had lower mean triglyceride levels than whites (p less than 0.001) and Asians (p less than 0.01). In addition, blacks had higher HDL-cholesterol than whites (p less than 0.01) and Asians (p less than 0.001) and HDL2-cholesterol was higher in blacks than Asians (p less than 0.001). In summary we have confirmed that in hypertensive type 2 diabetics similar ethnic differences of lipid and lipoprotein levels exist as that in non-diabetics. In light of the common occurrence of hyperlipidaemia in the white and Asian hypertensive type 2 diabetic, it may be appropriate to screen for this abnormality. However, in black hypertensive type 2 diabetic subjects this would be less rewarding.
Diabetes Res 1987 Apr
PMID:Differences in lipid and lipoprotein levels in white, black and Asian non-insulin dependent (type 2) diabetics with hypertension. 349 58

Since insulin modulates key enzymes of lipid metabolism, different biological activities of biosynthetic human insulin (BHI) and conventional insulins might induce different plasma lipid and apolipoprotein patterns in diabetic patients chronically treated with the former or the latter insulin preparation. In this study we have evaluated the effects of 3 months of therapy with BHI on plasma lipid and apolipoprotein concentrations in a group of type I diabetics previously treated with insulin of animal origin and the results have been compared with those from diabetics maintained on conventional insulin therapy. In the latter, no change occurred in the clinical and metabolic parameters. Patients transferred to BHI showed lower HDL-cholesterol and HDL3-cholesterol levels at 30 days from the beginning of BHI treatment, and both parameters returned to, and were maintained the basal values at subsequent controls. Total cholesterol, HDL2-cholesterol, triglycerides, apolipoproteins AI, AII and B remained substantially constant throughout the study. Glycometabolic control, which was evaluated by fasting plasma glucose and glycosylated hemoglobin, exhibited a transient, moderate deterioration at the 30-day control, and returned to basal level in the following weeks. No major change was noted as far as daily insulin dosage and relative body weight were concerned. Thus, long-term BHI treatment of type I diabetics does not cause any major change in plasma lipid and apolipoprotein patterns in comparison with animal insulin therapy, so that the validity of using BHI in the treatment of type I diabetes is confirmed.
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PMID:Biosynthetic human insulin does not modify circulating lipid and apolipoprotein concentrations in type I diabetic patients. 352 Nov 80

There is a very high probability that lipoprotein metabolism plays a central role in the etiology of coronary heart disease. In sedentary persons one way to favorably alter lipoprotein metabolism and possibly delay the progression of coronary atherosclerosis is by an increase in their habitual physical activity. More physically active persons tend to have lower plasma triglycerides and very low density lipoprotein concentrations, and a greater high-density lipoprotein mass due to higher concentrations of the subfraction HDL2 and apoprotein A-I. Plasma low-density lipoprotein concentrations usually are not significantly reduced by exercise unless accompanied by weight loss, but there may be important changes in the distribution among the low-density subfractions. These exercise effects are most likely mediated by alterations in the activity of enzymes involved in the synthesis, transport and catabolism of the various lipoproteins including lipoprotein lipase, hepatic lipase and lecithin: cholesterol acyltransferase. In healthy persons as well as in patients with ischemic heart disease, diabetes and renal failure, an increase in moderate-intensity, endurance-type activity requiring an expenditure of approximately 4 MJ (1,000 kcal) per week usually produce favorable lipoprotein changes. Above this level a dose-response relationship exists, with greater changes occurring up to energy expenditures of 19 MJ (4,500 kcal) per week.
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PMID:The influence of exercise training on plasma lipids and lipoproteins in health and disease. 353 12

Atherosclerosis is the major cause of death in diabetic patients. Lipoproteins and lipids are frequently altered in non-insulin-dependent diabetes. These lipoprotein alterations are of interest because of their possible role in the origin of the accelerated atherosclerosis found in diabetes. Because of the link between lipoproteins and diabetes, serum lipids and lipoproteins were measured in 215 middle-aged patients (107 female, 108 male) with varying degrees of glucose tolerance: control subjects, subjects with impaired glucose tolerance (IGT), and patients with non-insulin-dependent diabetes mellitus (NIDDM). In male subjects, levels of fasting total triglycerides were significantly greater in those with NIDDM compared with control subjects. In female subjects, fasting total cholesterol levels were significantly greater in NIDDM compared with IGT. Both high-density lipoprotein (HDL) cholesterol and HDL2 cholesterol values were significantly lower in both sexes with NIDDM compared with control subjects. Low-density lipoprotein (LDL) cholesterol levels were elevated in the male subjects with IGT. No differences in HDL cholesterol or its subfractions were seen in both sexes with IGT compared with control subjects. Bivariate analyses showed that the reduced HDL cholesterol and HDL subfraction levels were most closely associated with both total triglycerides and weight. This study shows that reduced HDL cholesterol and HDL2 cholesterol levels occur in NIDDM, whereas persons with "impaired glucose tolerance" do not have the dramatic alterations in HDL levels.
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PMID:Lipoprotein analyses in varying degrees of glucose tolerance. Comparison between non-insulin-dependent diabetic, impaired glucose tolerant, and control populations. 367 53

The effects of glipizide on HDL subclass levels were prospectively evaluated in 7 women and 2 men with non-insulin dependent (Type 2) diabetes. Total HDL, HDL2 and HDL3 levels were unchanged during the treatment period. Baseline HDL levels were lower when compared to a control population which may have been due to the elevated body weight present in most subjects. Mean blood glucose and HbA1 levels were unchanged for the entire group although significant improvement was noted in 5 individuals. Triglyceride and cholesterol levels were not affected by treatment with glipizide. In conclusion, glipizide does not have an adverse affect on HDL lipoprotein levels when patients are followed prospectively.
Diabetes Res 1986 Jun
PMID:The effect of glipizide on HDL and HDL subclasses. 374 45

Different types of diabetes mellitus have different effects on high density lipoprotein (HDL) metabolism. Impaired glucose tolerance may be associated with no change or a slight decrease in HDL cholesterol. Type I diabetes may have normal or elevated HDL cholesterol levels. This HDL elevation may be due to an increase in HDL2 or HDL3. Apo A-I/Apo A-II ratio is also higher in these diabetics. Type II diabetics may have normal or low HDL cholesterol levels as well as normal or decreased Apo A-I levels. In gestational diabetics, the mean HDL cholesterol is lower than controls. Dietary therapy resulting in greater than 10% weight loss in obese diabetics leads to an increase in their HDL-cholesterol levels, although the effect on the latter is controversial. Intensive insulin therapy (for 2-3 weeks) increases serum apo A-I and HDL-cholesterol levels. End-stage renal disease also affects HDL metabolism. In general, patients with this disorder have a decrease of cholesterol and an increase in triglyceride in their HDL. There is an increase in apo E and a decrease in apo CII in their HDL. Apo A-I levels are unaffected whereas apo A-II levels are decreased. Renal transplant patients may have low, normal or high HDL cholesterol and normal or high apo-I levels. In non-diabetic, normotriglyceridemic patients peritoneal dialysis increases their HDL-cholesterol. In non-diabetic hypertriglyceridemic and diabetic patients, peritoneal dialysis causes no change in their HDL-cholesterol.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effect of diabetes mellitus and end-stage renal disease on HDL metabolism. 379 61

Lipoproteins were isolated by sequential ultracentrifugation, and the concentrations and compositions were determined in nondiabetic (ND), borderline diabetic (BD), and diabetic (D) Macaca nigra males consuming a chow ration. The total concentrations and components of the VLDL and IDL increased significantly with metabolic deterioration (P less than 0.01). Concentrations and components of LDL increased in the BD and D monkeys, but changes were not statistically significant. The HDL2 and HDL3 particles were virtually unchanged among the three different metabolic groups. The VLDL was the major carrier of the triglycerides, especially in D monkeys. Cholesterol was present predominantly in the LDL. The LDL-cholesterol to HDL-cholesterol ratio increased in the BD and D monkeys, owing mainly to increases in the LDL-cholesterol content. Apoprotein antisera showed apoprotein B in the VLDL, IDL, and LDL, apoprotein E in the VLDL and IDL, and apoprotein A-I in the HDL2 and HDL3 fractions. Because Macaca nigra consume a nonatherogenic, low-cholesterol, low-fat ration, the changes in lipoproteins, particularly in VLDL and IDL, are attributable to metabolic alterations associated with diabetes.
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PMID:Lipoprotein patterns in nondiabetic, borderline diabetic, and diabetic Macaca nigra. 382 73

Serum lipids and lipoproteins were measured in 170 insulin-treated diabetics (90 females, 80 males) and in 124 nondiabetic control subjects (59 females, 65 males) aged 45 to 64 years. Plasma C-peptide response to intravenous (IV) glucagon was measured in order to classify the patients according to their capacity of endogenous insulin secretion. In both sexes, HDL and HDL2 cholesterol were higher in diabetics with no C-peptide response than in controls, whereas diabetics with high C-peptide response (postglucagon C-peptide level greater than 0.60 nmol/L) showed lower levels of HDL and HDL2 than nondiabetic controls. When adjustment for age, alcohol consumption, physical activity, body mass index, and insulin dose was made by analysis of covariance, the highly significant difference in HDL and HDL2 cholesterol level between diabetics with no C-peptide response and diabetics with high C-peptide response still remained in both sexes. This study gives support to the hypothesis that elevated HDL and HDL2 cholesterol levels in insulin-treated diabetics are not explained by effects of treatment with exogenous insulin, but rather are associated with the type of diabetes characterized by deficient endogenous insulin secretion.
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PMID:Inverse relationship of serum HDL and HDL2 cholesterol to C-peptide level in middle-aged insulin-treated diabetics. 389 77

Serum lipids and lipoproteins were measured in 277 non-insulin-dependent diabetics (NIDDs) and in 124 non-diabetic control subjects (65 males, 59 females), aged 45-64 years. Altogether 88 of the diabetics were treated with diet (48 males, 40 females), 134 with oral drugs (56 males and 49 females treated with sulphonylureas, 14 males and 15 females treated with a combination therapy of sulphonylurea drug and metformin) and 55 with insulin (17 males, 38 females). The postglucagon C-peptide concentration in insulin-treated diabetics exceeded 0.60 nmol/l. The diabetics had lower levels of HDL and HDL2 cholesterol and higher levels of total and VLDL triglycerides than non-diabetic control subjects irrespective of the mode of treatment. The HDL2 subfraction seemed to be alone responsible for the decrease of HDL cholesterol. In the whole group of diabetics body mass index had a significant negative correlation to HDL cholesterol and a positive correlation to total triglyceride concentration in both sexes but plasma glucose failed to show any consistent association to HDL cholesterol concentration. The difference in HDL cholesterol between diabetics and non-diabetics persisted after adjustment for age, physical activity, alcohol intake and body mass index. In conclusion, the dyslipoproteinaemia in non-insulin-dependent diabetes is principally characterized by decreased HDL and HDL2 cholesterol concentrations and by increased total and VLDL triglycerides. These manifestations of dyslipoproteinaemia are little influenced by the degree of glycaemia and obesity.
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PMID:Serum lipids and lipoproteins in middle-aged non-insulin-dependent diabetics. 390 37


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