新诊断1型糖尿病的临床缓解和HDL功能对胆固醇外排能力的影响:前瞻性InLipoDiab1研究

IF 2.8 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM
Endocrine Connections Pub Date : 2025-06-17 Print Date: 2025-06-01 DOI:10.1530/EC-24-0704
Aleksandra Uruska, Maja Mietkiewska-Dolecka, Agata Grzelka-Wozniak, Justyna Flotynska, Suzanne Saldanha, Anand Rohatgi, Dorota Zozulinska-Ziolkiewicz
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引用次数: 0

摘要

1型糖尿病(DM1)的特点是血清高密度脂蛋白水平高,但这并不能转化为更好的预后。这可能与HDL颗粒功能受损有关。HDL的功能之一是逆向胆固醇转运(胆固醇外排能力- cec)。部分临床缓解(pCR)的出现有利于DM1的治疗和预后。目前尚不清楚CEC的变化是否与pCR的存在有关。目的:目的是评估新诊断的DM1在12个月内CEC和pCR的关系。方法:分析127例新诊断为DM1的成年人(68%为男性)。德克萨斯大学西南医学中心通过测量小鼠J774巨噬细胞放射标记胆固醇向缺载脂蛋白b血清的外排来评估CEC。研究在两个时间点进行:发病时和一年后。pCR定义胰岛素剂量调整A1C为A1C(百分比)+[4 ×胰岛素剂量]≤9。结果:观察1年后,全组血清HDL浓度显著升高,CEC无变化[1.28(1.11-1.41)vs 1.23(1.14-1.42), p=0.6]。pCR治疗1年后CEC改善的女性为1.28(1.04-1.38)vs 1.31(1.08-1.42), p=0.05。pCR与CEC无相关性[OR 1.8 (CI95%0.12-26.8), p=0.7]。结论:在DM1中,在疾病的第一年,尽管血清高密度脂蛋白胆固醇浓度显著升高,但CEC没有改善。CEC与pCR无相关性。pCR中良好的代谢控制对CEC有有益的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Clinical remission in newly diagnosed type 1 diabetes mellitus and HDL function on cholesterol efflux capacity: prospective InLipoDiab1 study.

Clinical remission in newly diagnosed type 1 diabetes mellitus and HDL function on cholesterol efflux capacity: prospective InLipoDiab1 study.

Summary: Type 1 diabetes mellitus (DM1) is characterized by high serum HDL, which does not translate into a better prognosis. It is probably related to the impaired function of HDL particles. One of the functions of HDL is reverse cholesterol transport (cholesterol efflux capacity, CEC). Beneficial for management and prognosis in DM1 is the occurrence of partial clinical remission (pCR). It is not known whether the changes in CEC are related to the presence of pCR. The aim was to evaluate the relationship between CEC and pCR in newly diagnosed DM1 during 12 months. The analysis comprised 127 adults (68% men) with newly diagnosed DM1. CEC was assessed in UT Southwestern Medical Center by measuring the efflux of radiolabeled cholesterol from murine J774 macrophages to apolipoprotein B-depleted serum. The study was performed at two points: at disease onset and after 1 year. pCR was defined as insulin dose-adjusted A1C as A1C (percent) + (4 × insulin dose) ≤9. After 1 year of observation, a significant increase in serum HDL concentration and no change in CEC were demonstrated in the whole group (1.28 (1.11-1.41) vs 1.23 (1.14-1.42), P = 0.6). There was a CEC improvement in women with pCR after 1 year 1.28 (1.04-1.38) vs 1.31 (1.08-1.42), P = 0.05. No relationship was revealed between pCR and CEC (OR 1.8 (CI 95% 0.12-26.8), P = 0.7). In DM1, during the first year of the disease, there was no improvement in CEC despite a significant increase in serum HDL cholesterol concentration. There was no relationship between CEC and pCR. Good metabolic control in pCR has a beneficial impact on CEC.

Article highlights: Increased HDL serum cholesterol concentration is not associated with improved HDL function. HDL particles are functionally impaired from the onset of type 1 diabetes. There is no relationship between cholesterol efflux capacity and clinical remission of type 1 diabetes. A change in viewpoint on high HDL cholesterol levels in people with type 1 diabetes as a protective factor for the development of diabetes complications and the awareness that HDL cholesterol levels alone are insufficient to assess the cardiovascular risk in this group of patients.

Clinicaltrials number: NCT02306005.

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来源期刊
Endocrine Connections
Endocrine Connections Medicine-Internal Medicine
CiteScore
5.00
自引率
3.40%
发文量
361
审稿时长
6 weeks
期刊介绍: Endocrine Connections publishes original quality research and reviews in all areas of endocrinology, including papers that deal with non-classical tissues as source or targets of hormones and endocrine papers that have relevance to endocrine-related and intersecting disciplines and the wider biomedical community.
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