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美国卫生研究院文献>Journal of Lipid Research
>Associations between intensive diabetes therapy and NMR-determined lipoprotein subclass profiles in type 1 diabetes
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Associations between intensive diabetes therapy and NMR-determined lipoprotein subclass profiles in type 1 diabetes
Our objective is to define differences in circulating lipoprotein subclasses between intensive versus conventional management of type 1 diabetes during the randomization phase of the Diabetes Control and Complications Trial (DCCT). NMR-determined lipoprotein subclass profiles (NMR-LSPs), which estimate molar subclass concentrations and mean particle diameters, were determined in 1,294 DCCT subjects after a median of 5 years (interquartile range: 4–6 years) of randomization to intensive or conventional diabetes management. In cross-sectional analyses, we compared standard lipids and NMR-LSPs between treatment groups. Standard total, LDL, and HDL cholesterol levels were similar between randomization groups, while triglyceride levels were lower in the intensively treated group. NMR-LSPs showed that intensive therapy was associated with larger LDL diameter (20.7 vs. 20.6 nm, P = 0.01) and lower levels of small LDL (median: 465 vs. 552 nmol/l, P = 0.007), total IDL/LDL (mean: 1,000 vs. 1,053 nmol/l, P = 0.01), and small HDL (mean: 17.3 vs. 18.6 μmol/l, P < 0.0001), the latter accounting for reduced total HDL (mean: 33.8 vs. 34.8 μmol/l, P = 0.01). In conclusion, intensive diabetes therapy was associated with potentially favorable changes in LDL and HDL subclasses in sera. Further research will determine whether these changes contribute to the beneficial effects of intensive diabetes management on vascular complications.
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机译:我们的目标是在糖尿病控制和并发症试验(DCCT)的随机化阶段中,确定1型糖尿病强化治疗与常规治疗之间循环脂蛋白亚类的差异。在中位数为5年(四分位数范围:4-6年)的随机分组后,由1,294名DCCT受试者确定了由NMR确定的脂蛋白亚类概况(NMR-LSPs),用于估计摩尔亚类的浓度和平均粒径,方法是将其随机分配至重症或常规糖尿病的中位数管理。在横断面分析中,我们比较了治疗组之间的标准脂质和NMR-LSPs。随机分组之间的标准总胆固醇,LDL和HDL胆固醇水平相似,而强化治疗组的甘油三酸酯水平较低。 NMR-LSPs显示强化治疗与更大的LDL直径(20.7 vs. 20.6 nm,P = 0.01)和较低的小LDL水平(中位数:465 vs. 552 nmol / l,P = 0.007),总IDL / LDL相关(平均值:1,000 vs. 1,053 nmol / l,P = 0.01)和较小的HDL(平均值:17.3 vs. 18.6μmol/ l,P <0.0001),后者说明总HDL降低(平均值:33.8 vs.34.8μmol / l,P = 0.01)。总之,强化糖尿病治疗与血清中LDL和HDL亚类的潜在有利变化有关。进一步的研究将确定这些变化是否有助于强化糖尿病管理对血管并发症的有益作用。
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