Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011854 (type 1 diabetes)
 20,749 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Lp(a) has been considered as an independent risk factor for atherosclerosis, mainly for coronary heart disease. Recent epidemiologic studies have demonstrated elevation of Lp(a) serum concentration in diabetes mellitus. Atherosclerosis is the most common cause of death in diabetic patients, but there is little information available concerning the importance of Lp(a) in these patients. We investigated the relationship between Lp(a) serum concentration and the presence of chronic diabetic complications. Lp(a) was determined in 14 IDDM patients and 62 NIDDM patients. Median Lp(a) serum concentration in diabetics was 21.8 mg/dl, which was significantly higher than in nondiabetic controls described before. Glucose, HbA1c, fructosamine, total cholesterol, triglycerides, HDL-cholesterol, apolipoprotein A1, B and E were not associated with raised Lp(a) values. With increasing Lp(a) levels, higher prevalences of retinopathy and of albuminuria were observed. We conclude that in diabetic patients, Lp(a) levels are elevated compared with non-diabetic subjects, and that higher Lp(a) levels are associated with higher prevalences of retinopathy and of albuminuria.
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PMID:[Lp(a) serum concentrations in diabetes mellitus]. 786 92

Plasma lipids and VLDL and HDL composition were studied in a control group of 20 non diabetic subjects and in 31 male middle-age patients with non-insulin dependent diabetes treated by oral hypoglycemic agent glibenclamide and a weight maintaining diet. Data for the diabetics were separated based on haemoglobin A1c of less or greater than 7%. VLDL composition abnormalities were more frequent in the diabetic patients with HbA1c of > 7%. VLDL-cholesterol, VLDL-triglycerides and VLDL-phospholipids were high in all diabetics whereas VLDL-apo B increased only in diabetics with HbA1c > 7%. Apo CII and apo CIII levels and also apo CII/apo CIII ratio were also reduced in the diabetic patients with HbA1c levels of more than 7%. Increases in the apo E and apo E/apo C ratio were also seen in the more hyperglycemic diabetics with HbA1c levels > 7%. In contrast apo CII and apo CIII levels and also Apo CII/Apo CIII ratio remained unaltered in diabetic patients with less than 7% HbA1c levels. In these patients increases in the apo E levels were found while the apo E/apo C ratio remained unaltered. All diabetic patients showed increases in HDL-triglycerides and triglyceride/total cholesterol ratio with respect to control. Decreases in HDL-apo AI were also seen in both groups of diabetics, but the HDL-apo AI/HDL-apo AII ratio did not differ from control.
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PMID:Relation of abnormal composition of lipoproteins to HbA1c levels in non-insulin dependent diabetes. 788 71

Chronic renal failure (CRF) in nondiabetics is associated with a number of lipoprotein abnormalities that place these patients at high risk for atherosclerosis. This study compared the lipoprotein composition of nondiabetic controls (n = 68) with that of patients with insulin-dependent diabetes mellitus ([IDDM] n = 13) and of patients with IDDM and CRF ([IDDM + CRF] n = 74). Six lipoprotein subfractions (very-low-density lipoprotein [VLDL], intermediate-density lipoprotein [IDL], low-density lipoprotein [LDL], high-density lipoprotein-light [HDL-L], HDL-medium [HDL-M], and HDL-dense [HDL-D]) were isolated by rapid gradient ultracentrifugation using a fixed-angle rotor. The apolipoprotein (by reverse-phase high-performance liquid chromatography [HPLC]) and lipid (by enzymatic assays) composition of each subfraction was determined. The only abnormalities found in IDDM patients were increases in IDL and HDL-L triglyceride (TG) levels and an increase in the HDL-L free cholesterol (FC) level. The IDDM + CRF group had multiple abnormalities including (1) elevated TG, apolipoprotein (apo) C-II, and apo C-III levels in all lipid subfractions; (2) elevated VLDL and IDL apo B, TG, FC, cholesterol ester (CE), and phospholipid (PL) levels (with an increased CE/TG ratio in VLDL only); (3) decreased HDL-M apo A-I, apo A-II, CE, and PL levels, but an increased HDL-D apo A-I level; and (4) decreased lecithin:cholesterol acyltransferase (LCAT) activity. Twenty-five of the IDDM + CRF patients underwent combined pancreas and kidney (P + K) transplantation, and 12 patients received only a kidney transplant. Lipoprotein composition was determined at 3, 6, and 12 months posttransplant. Both types of transplantation resulted in similar alterations in lipoprotein composition, even though there was essential normalization of blood glucose levels in most of the patients who received a pancreas transplant (hemoglobin A1C [HbA1C], 9.1% +/- 1.1% v 5.7% +/- 0.3% at 12 months, P < .01). These posttransplant changes included (1) no improvement in the elevated TG level in any lipid subfraction even though there was some reduction in apo C-III levels in VLDL; (2) reductions in levels of VLDL and IDL apo B but increases in LDL apo B; (3) increases in HDL apo C-III and FC concentrations despite an increase in LCAT activity; and (4) increases in apo A-I levels in HDL-L and HDL-M. The addition of a pancreas to a kidney transplant had no obvious impact on the lipoproteins.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Lipoprotein composition in insulin-dependent diabetes mellitus with chronic renal failure: effect of kidney and pancreas transplantation. 813 82

Cholesterol, triglycerides and lipoprotein levels were assayed in serum of 152 children and teenagers with IDDM and in 228 non-diabetic siblings. A poor control of diabetes, reflected by high levels of glycosylated hemoglobin and/or high fasting blood glucose, was associated with statistically significant increases in total cholesterol, LDL-cholesterol and triglycerides, and a reduction in HDL-cholesterol. Mean total cholesterol levels in diabetic patients (171 +/- 33 mg/dL for males and 199 +/- 53 mg/dL for females) were statistically higher than those in their siblings (158 +/- 30 mg/dL and 164 +/- 33 mg/dL respectively). The prevalence of hypercholesterolemia (HC) and hypertriglyceridemia (HTG) were higher in the diabetic patients but statistically significant exclusively in females (prevalences of 40% vs 12% for HC and 30% vs 9% for HTG with a p value < 0.005). The diabetic patients in good metabolic control had similar lipid levels to those of their non-diabetic siblings. These data support the hypothesis that poor control of blood glucose is associated with atherogenic lipid profiles. The prevalence of hypercholesterolemia is impressively high in our diabetic population and indicates that all IDDM patients should have a serum lipid and lipoprotein analysis done annually; blood glucose control and dietary guidelines should be improved in these cases.
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PMID:[Metabolic control and the prevalence of dyslipidemia in children and adolescents with insulin-dependent diabetes mellitus]. 815 74

Diabetic patients have a 2 to 4 times higher risk of development of atherosclerosis than non-diabetic subjects. One of the risk factors of atherosclerosis is an impaired lipid and lipoprotein metabolism which is influenced by the type of diabetes, the degree of its metabolic compensation, character of treatment and other concurrently present metabolic abnormalities. In metabolically balanced type 1 diabetes the levels of commonly assessed lipoproteins do not differ from those in non-diabetic subjects, the HDL-cholesterol level can be even higher. The lipid profile of type 2 diabetics is not very homogeneous, however, usually elevated levels of VLDL-triglycerides and of apoprotein B and a reduced HDL-cholesterol level are found. At present there are no unequivocal views on the role of the lipoprotein (a) ratio in the increased risk of atherosclerosis in diabetics as investigations devoted to the lipoprotein (a) level and its relation to macrovascular complications in diabetes did not give unequivocal results. The scope of dyslipidemia in diabetics with nephropathy is in addition to the effect of the basic disease influenced also by the extent of renal damage. The lipid disorder, on the other hand, leads to deterioration of albuminuria and progression of the renal disease.
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PMID:[Changes in lipoprotein metabolism in patients with diabetes mellitus and the effect on lipid profile in diabetics]. 818 88

A reduction in total plasma cholesterol concentration has been reported in insulin-dependent diabetic (IDDM) pregnant women in early gestation. To determine if this reduction extends throughout gestation and which lipoprotein fractions may be responsible, we measured plasma triglyceride, cholesterol (C), high density lipoprotein cholesterol (HDL-C) and HDL2 and HDL3-C subfractions between 6 and 36 weeks' gestation in normal and IDDM women. Total plasma C was significantly lower in IDDM pregnant subjects between 20 and 36 weeks' gestation as compared to nondiabetic controls, while plasma triglyceride concentrations were not significantly different in this interval. Very low and low density lipoprotein (VLDL, LDL) C concentrations were not statistically significantly different from controls at any of the times studied, while HDL-C was lower throughout diabetic pregnancy as compared to controls, significantly so between 20 and 36 weeks' gestation. The lower HDL-C in IDDM women was associated with a significantly lower HDL3-C level. Plasma apoprotein A-I and A-II concentrations, markers of the HDL2 and HDL3 subclasses, respectively, were measured to corroborate the HDL subfraction changes. Apo A-I and A-II increased significantly between 12 and 28 weeks' gestation in control but not in diabetic pregnant subjects, consistent with a higher HDL3 in normal than in diabetic pregnant subjects. It appears that plasma triglyceride, VLDL and LDL-C, and HDL2-C concentrations are similar in IDDM and normal pregnancy, while total-C, HDL-C and HDL3-C and its associated apoproteins are lower than in normal subjects in late gestation. The mechanism of these changes and their significance for fetal growth and development deserve further study.
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PMID:Effect of insulin-dependent diabetes on plasma lipoproteins in diabetic pregnancy. 825 93

In IDDM or NIDDM, the total plasma cholesterol and triglycerides are usually within normal limits when the blood glucose is controlled. Marked hypertriglyceridemia can develop with loss of glycemic control and is often due to superimposed genetic abnormalities in lipoprotein metabolism. Tight control in IDDM usually reduces LDL and VLDL to normal levels and may raise HDL above the normal range. Low HDL cholesterol and mild to moderate elevations of VLDL triglyceride are common in NIDDM if obesity or proteinuria is also present. Both HDL and LDL may be smaller and more dense and may be enriched with triglyceride as compared with cholesterol. These abnormalities may require weight loss for control. The increased incidence of cardiovascular disease in diabetes is unexplained but is amplified by the well-defined cardiovascular risk factors. The new American Diabetes Association guidelines call for treatment of high triglycerides and LDL cholesterol to be aggressively reduced. Triglycerides should be under 200 mg/dL, are considered borderline high between 200 and 400 mg/dL, and high when above 400 mg/dL. Low HDL is defined as less than 35 mg/dL. Control of obesity with diet and exercise and reduced intake of saturated fat and cholesterol are important first steps. If needed, drug therapy is appropriate to reduce LDL to levels below 130 mg/dL in all adult diabetics and below 100 mg/dL in those with cardiovascular disease.
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PMID:Lipoprotein disorders in diabetes mellitus. 828 28

Serum levels of total cholesterol, triglycerides, lipoproteins (VLDL, LDL, HDL) and apoproteins (apo-AI, apo-AII, apo-B) were measured in 112 children (70 boys, 42 girls) aged 6 to 13 with type I diabetes mellitus and healthy controls. Poorly controllable diabetes was associated with elevated concentrations of total cholesterol and low-density lipoproteins C and lowered levels of high-density lipoproteins C, apo AI and apo-AII, while differences in triglyceride, very low density lipoproteins, and apo-B were insignificant. Children with a good metabolic control (HbA1 8.8 +/- 1.2%) had a much more favorable lipid profile. The differences may be explained by lipid-reducing effects of diets and insulin therapy. Deficiency of HDL-C, apo-AI and apo-AII in type I diabetes in children indicates the importance of HDL subclasses and of lipolytic enzymes evaluation for an early detection of atherosclerosis risk.
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PMID:[Serum apoproteins and lipoproteins in diabetic children]. 841 18

OBJECTIVE--Increased physical activity and physical fitness are recommended therapeutic modalities in addition to insulin and diet in the management of children with IDDM. The aim of this study was to assess the fitness levels of adolescents with IDDM compared with healthy control subjects and to evaluate the relationship between physical fitness and metabolic control. RESEARCH DESIGN AND METHODS--We studied 59 patients with IDDM, 28 boys and 31 girls, age 15.6 +/- 2.5 yr, duration of diabetes 7.6 +/- 3.5 yr, HbA1 10.6 +/- 2.1% (mean +/- SD), and compared them with 18 healthy, nondiabetic control subjects, 9 boys and 9 girls, matched for age, BMI, and Tanner stage. Physical fitness was measured by VO2max during progressive bicycle ergometry. HbA1 was used to determine glycemic control. Lipid profile included fasting total cholesterol, HDL, LDL, Lp(a), and TG levels. RESULTS--Patients with IDDM had lower VO2max levels than control subjects (33.7 +/- 7.0 vs. 41.0 +/- 10.4 ml.kg-1.min-1, P = 0.001). Males with IDDM had lower VO2max than male control subjects, but diabetic and control females showed no difference. In IDDM patients, VO2max correlated inversely with HbA1, insulin dose, cholesterol, LDL, TGs, and Lp(a), but did not correlate with HDL, which correlated inversely with BMI. CONCLUSIONS--We conclude that the state of physical fitness is an important correlate of lipid levels and Lp(a) in adolescents with IDDM. We speculate that higher physical fitness levels in adolescents with IDDM may decrease the risk of CVD through modulating lipid levels.
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PMID:The relationship of physical fitness to lipid and lipoprotein(a) levels in adolescents with IDDM. 826 1

Epidemiologic studies have identified lipoprotein(a) (Lp(a)) as an independent risk factor for atherosclerosis, mainly for coronary heart disease. Atherosclerosis is the most common cause of death in diabetic patients, but there is little information available concerning the importance of Lp(a) in these patients. We compared the presence or absence of late diabetic complications with Lp(a) serum concentrations in 224 patients (82 IDDM, 142 NIDDM). Lp(a) distribution was skewed as described for non-diabetic patients. Despite highly significant differences for total cholesterol, total triglycerides, HDL-cholesterol, VLDL-cholesterol and VLDL-triglycerides (P < 0.001) and for LDL-cholesterol (P < 0.01) Lp(a) concentrations were similar in NIDDM and IDDM (mean: 27 vs. 30, median: 12 vs. 21 mg/dl, P = 0.10). Diabetic polyneuropathy, autonomic neuropathy, nephropathy, peripheral occlusive disease, diabetic gangrene and coronary heart disease were not associated with raised Lp(a) values. Non-insulin-dependent patients with retinopathy exhibited higher Lp(a) concentrations in serum than those without this complication. This significant association was lost when duration of diabetes was taken into account by logistic regression. We conclude, that other risk factors surpass the significance of Lp(a) in diabetic patients.
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PMID:Lipoprotein(a) in diabetes mellitus. 845 77


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