糖尿病発症に占める脂質の役割について

第2報臨床的考察

抄録

Lipid and carbohydrate metabolism in diabetics were compared with those in obese subjects, patients with hyperlipemia and aged normal persons and an etiological relationship between the development of the diabetic state and an abnormal lipid metabolism was studied.
The experiments gave the following results.
1) The levels of the fasting non-esterified fatty acids in the serum was significantly elevated with degree of obesity but there was not such a correlation in β-lipoprotein, total cholersterol, triglyceride or phospholipids.
2) The NEFA in the serum was measured in the fasting state, at 30 min.and at hourly intervals for 3 hours after the intravenous injection of 0.5g of glucose per kg body weight (Glucose-NEFA Test).The NEFA in the serum was transiently decreased by this glucose loading.
a) The fasting NEFA in the serum of obese subjects and those having coronary disease with hyperlipemia were significantly higher than normal and emaciated groups.
b) In the diabetic group, the fasting NEFA in the serum was highest and the NEFA response after glucose loading was most delayed.
c) The NEFA response of the aged group above 65 years of age was similar to that of diabetics.
3) When 9 mg of Δ'17α-methyltestosterone per kg body weight was administered orally to twenty patients with hyperlipemia, following changes were observed.
a) Among serum lipids, triglyceride prominently decreased.The fasting blood sugar was elevated and glucose tolerance was impaired.
b) In 7 of the 20 cases a diabetic state was caused.The values for serum triglyceride of this group before treatment with Δ'17α-methyltesterone were significantly higher than those of the group whose glucose tolerance remained normal.The reduction of serum triglyceride in the former was also significantl yhigher than that of the latter. There was no significant different in the periods of administration.
c) The Glucose-NEFA Test showed a significantly delayed NEFA response.
d) The concentration of serum ketone bodies was elevated and urinary excretion of these was increased.These two values almost reached to those observed in diabetic patients.
4) Based on these results, it was suggested that abnormality of lipid metabolism, especially accelerated catabolism of fatty acids, played an important role as a precipitating factor in some of the diabetic patients.