抄録
Plasma lipids such as cholesterol, triglycerides and free fatty acid were observed in a correlation with atherosclerosis or ischemic heart disease (IHD). However, we described that the abnormal lipoprotein metabolism regardless of plasma lipids concentration was more important problem in the patients with IHD. On the other hand, atherosclerosis and IHD occur more frequently in the patients with diabetes mellitus. Therefore, it take an interest in a characteristics of lipoprotein metabolism with abnormal GTT in a patients with IHD.
In this study, we attempted to investigate the relationship between abnormal glucose tolerance test (abnormal GTT) and lipoprotein metabolism in the 64 patients with IHD. Particularly, lipoprotein metabolism was the metabolic pathway of VLDL to LDL.
Frequency of the abnormal GTT was observed in the 42 patients (65.6%), but the dietary treatment for four weeks reduced the incidence of the patients with abnormal GTT from 65.6% to 32.8%. Similar changes of the frequency were observed in each of three groups according to the analysis of plasma lipids concentration: normolipoproteinemias (N=21) or hyperlipoproteineimas (N=23) before and after the dietary treatment were from 66.7% to 33.3% or from 65.0% to 35.0%, and twenty patients whose plasma lipids concentration were changed from hyper to normolipoproteinemia by our dietary treatment were from 65.2% to 30.4%. According to these results, relationship between the frequency of abnormal GTT and the concentration of plasma lipids was not observed in the patient with IHD. On the other hand, lipoprotein metabolism such as the metabolic pathway of VLDL to LDL was reduced in the patients who were still hyperlipoproteinemia after the dietary treatment: proportion of VLDL-triglycerides decreased with an increase in VLDL-protein, and a decrease in LDL-protein was observed simultaneously. Additionally, 66.7% of the patients with abnormal GTT had the Beta-K band using polyacrylamide gel-disc electrophoresis (the patients without abnormal GTT were 14.8%). The abnormal metabolic pathway of VLDL to LDL and the Beta-K band were not correlation with plasma lipids concentration. According to these results, lipoprotein metabolism with abnormal GTT was abnormal lipoprotein metabolism regardless of plasma lipids concentration in the patients with IHD. This abnormal lipoprotein metabolism is produced by incomplete hydrolysis of VLDLtriglycerides and another metabolic pathway as a remnant lipoprotein, Beta-K band.
