Bozadjieva, E.

Chankova, P.

Danev, I.

Radeva, S.

Varbanov, G.

English

Varna Medical University Press: Journals

Е. Bozadjieva, S. Radeva, G. Varbanov, P. Chankova, I . Danev L I P I D METABOLISM IN DIABETICS W I T H AND WITHOUT BLOOD PRESSURE INCREASE It is generally known that in certain aspects, uncontrolled diabetes re­sembles the state of fasting: the oxidation of fatty acids in the tissues is intensified while that of carbohydrates is lowered, the mobilization of free fatty acids by the adipose tissue is intensified and, not infrequently, a rise of the triglycerides' blood content occurs (3). Substantial changes in the lipid metabolism are likewise observed in atherosclerosis (1 , 2). Diabetes mellitus is characterized by speeded up development of athero­sclerosis and often, it runs a course associated with increased blood pres­sure and furthermore, it is a well known fact that a definite interdepen­dence exists between atherosclerosis and hypertonic disease. We set out to find out whether or not increased blood pressure exerts influence on the lipid metabolism and on the lipoprotein-lipase activity in diabetes mellitus. Investigation was performed on a total of 38 patients with diabetes mel­litus, of which 16 with increase, and 22 —without increase of the blood pressure, as well as on 45 patients with hypertonic disease of which 12 (males only) in the first, and 33 in the third stage of disease, according to Lang, and on 17 practically healthy, normotonic subjects. The age of the diabe­tics without increase of the blood pressure ranged from 23 to 67 years, or 49 y. average, in diabetics with blood pressure increase — from 22 to 70 y., or 50 y. average, in hypertonic patients, stage I according to Lang — 19 to 22 y., or 19.5 y. average, in hypertonic patients, stage I I I according to Lang — 28 to 61 y., or 49 y. average and the subjects considered as practi­cally healthy were 20 to 56 y. old, or 36 y. in the average. Al l patients were fed on the respective for their particular affection diet. The heparin test was performed in the following manner: in the morn­ing, before meal, 150 mg heparin were administered over a four-hour period by drop infusion of 500 ml physiological serum. Just prior to and after the infusion, blood sugar, serum lipids and endogenous heparin were examined. Blood-sugar determination was made after the method of Haggedorn—Jensen, cholesterol — after Ilko, total lipids — after Brag-don-Bloor, phospholipids — after Svanberg-Swanerholm, beta-lipoprote-ins — after Burstein, non-esterified fatty acids — after Dancomb, hepa­rin —- after Pipta and lipoprotein-lipase activity — after Lukasik. Material and Methods 62 Е. Bozadjieva, S. Radeva, G. Varbanov. Results and Discussions The results of our studies show that in diabetics with increased blood pressure, besides blood sugar level, also the concentrations of cholesterol, total lipids, phospholipids, tri-glycerides, beta-lipoproteins and ncn-este-rified fatty acids are considerably elevated, whilst the content of endcgencus heparin is much lower than in healthy persons. No significant difference is established in terms of lipoprotein lipase activity (Table 1). Identica T a b l e 1 The Ratio between Blood Sugar and Serum Lipids in Healthy Persons and Diabetics with and without Hypertension H e a l t h y per ­sons n = 17 M±a D i a b e t i c s w i t h ­out h y p e r ­t e n s i o n n = 22 M ± a p D i a b e t i c s w i t h h y p e r t e n s i o n n = 1 6 M ± o P 1. Blood sugar mg % 2. Cholesterol rag % 3. Total lipids mg % 4. Phospholipides mg % 5. Triglycerides mg % 6. Beta-lipoproteins PU 7. Non-esterified fatty acids [i M/ml 8. Lipoprotein lipase |i M/ml 9. Endogenous heparin U/ml 105±14 223 + 37 568 ± 7 3 196 ± 2 в 153 ± 4 4 4 0 ± 1 1 0.52 ±0.1 2.40 ±0.42 9±0 .61 231 ± 8 2 271 ± 5 4 707 + 146 227 ± 3 7 204 + 109 6 0 ± 1 9 0.72 ±0.1 1,94 ±0.28 7 ±2 .4 <0.00l < 0.001 < 0.001 < 0.001 <0.01 < 0.001 < 0.001 <0.1 < 0.001 203 ± 5 5 287 + 60 736 ±121 228 ± 2 7 2 ' 5 ± 7 9 6 4 ± 1 6 0.72 ±0 .2 1.88 ±0.34 7 ±2 .2 < 0.001 <0.00l <C.0)1 я^О.001 <0.001 < 0.001 <0.01 <0.01 < 0.001 dependence is discovered also among diabetics with increased blood pres­sure (Table 1). The content of serum lipid fractions, endogenous heparin and lipoprotein-lipase disclosed no differences whatsoever between the two groups of diabetic patients studied (Table 1). The comparative study of the content of lipid fractions, endogenous heparin and lipoprotein-lipase activity in diabetics without increased blood pressure with that in patients with hypertonic disease, first and third stage according to Lang, shows that the concentrations of the single lipid frac­tions and lipoprotein-lipase activity are significantly higher, whilst the endogenous heparin content in diabetic patients is substantially reduced (Table 2). The same dependence is established in comparison with patients suffering from hypertonia (third stage), except for endogenous heparin which reveals a substantial decrease in the latter group. Identical dependence is established also between the group of diabetics with increased blood pres­sure and those with hypertension, stage I and I I I (Table 3). The lipolytic effect of heparin is approximately equally manifested in both groups of diabetics (Table 4). In general outline, our studies of the lipid metabolism in diabetes fail to show any differences in the metabolism of lipids, dependent upon the blood sugar level, or, in other words, the increased blood pressure in dia-Lipid Metabolism in Diabetics with and. 63 T a b 1 е 2 The Ratio between Blood and Serum Lipids in Diabetics without Hypertension and Hypertonic Disease I and I I I Stage D i a b e t i c s w i t h - 1 . . л . out h y p e r t e n - I H y p e r t o n i c d i -s i o n ! s e a s e 1 s t a 8 e n = 22 M ± a I 11 = 1 2 M ± ° 1. Blood sugar mg % 2. Cholesterol mg. % 3. Total lipids mg % 4. Phospholipids mg 5. Triglycerides mg % 6. Beta-lipr poteins P U 7. Non-esterified fatty acids ц. M/ml 8. Lipoprotein lipase | i M/ml 9. Endogenous heparin U/ml 231 ± 8 2 271 ± 5 4 707 ±146 227 ± 3 7 204 ±109 60 ± 1 9 0.72 ±0 .2 1.94 ±0.28 7 ±2 .4 66 ± 1 8 l . r 3±32 474 ± 8 9 163 ± 2 9 158±56 3 9 ± 1 3 0.44 ±0.16 0.62 ±0 .5 10±6.6 < 0.001 < 0.001 < 0.001 < 0 ( 0 l <0.02 < 0.001 < 0.001 <0 00l < 0.001 H y p e r t o n i c d i ­sease III s tage n = 33 M ± 3 3 99 ± 3 7 244 ± 4 6 579±119 2 1 0 ± 3 5 124 ± 7 3 43 ± 1 6 0.43 ±0.25 0.51 ±0.04 5 ± 1 T a b 1 е 3 The Ratio between Blood Sugar and Serum Lipids in Diabetics with Hypertension and Hypertonic Disease I and I I I Stage D i a b e t i c w i t h h y p e r t e n s i o n n = 1 6 M ± a H y p e r t o n i c d i ­sease I s t a g e n = 1 2 M ± a H y p e r t o n i c d i ­sease I I I s tage n = 3 3 M ± a 1. Blood sugar mg % 2. Cholesterol mg % 3. Total lipids mg % 4. Phospholipids mg % 5. Triglycerides mg % Beta-lipoproteins P U Non-esterified fatty acids \i M/ml Lipoprotein lipase ji M/ml Endogenous heparin U/ml 203 ± 5 5 287 ± 6 0 736±121 2 :8±27 215±79 6 4 ± 1 6 6 6 ± 1 8 153±32 474 ± 8 9 163 ± 2 9 158 ± 5 6 3 9 ± 1 3 <0 001 !< 0.001 I < 0.001 I < 0.001 <0.02 < 0.001 0.72±0.2 0.44±0.16 <0.001 1.88 ±0.34 ! 0.62 ±0 .5 < 0.001 7 ± 2 . 2 10±6.6 |<0.001 99 ± 3 7 244 ± 4 6 579±119 2 1 0 ± 3 5 124 ± 7 3 43 ± 1 6 0.43 ± 0 25 0.51 ±0.04 5 ± 1 < 0.001 < 0.001 < 0.001 <0.05 < 0.001 < 0.001 < 0.001 <0 001 < 0.001 stes is by no means reflected by the lipid fractions, endogenous heparin and lipoprotein-lipase activity, while variations in the lipid metabolism are conditioned by the basic affection exclusively. Up to a certain extent, the latter circumstance warrants the assumption that increased blood pressure, observed in some patients with diabetes mel­litus, should by no means be considered as essential hypertension or else in this particular case, no combination between diabetes mellitus and hyper­tonic disease is concerned, but rather diabetes mellitus with concomitant hypertension, which, most likely, has its own, different from the hyper­tonic condition, genesis. 64 Е. Bozadjieva, S. Radeva, G. Varbanov.. T a b l e 4 The Influence of Heparin upon the Level of Blood Sugar and Serum Lipids in Diabetics with and without Hypertension D i a b e t i s w i t h o u t h y p e r t e n s i o n n = 2 2 D i a b e t i c s w i t h h y p e r t e n s i o n n = l 6 v a l u e befo­re h e p a r i n M ± o v a l u e after h e p a r i n M ± a P v a l u e befo­re h e p a r i n M ± < J v a l u e af ter h e p a r i n M ± a P 1. Blood sugar mg % 2. Cholesterol mg % о 3. Total lipids mg % 4. Phospholipids mg % 5. Triglycerides mg % 6. Beta-lipoproteins P U 7. Non-esterified fatty acids \i M/ml 8 Lipcpotein lipase M/ml 9. Endogenous heparin U/ml 231 ± 8 2 271 ± 5 4 707 ±146 227 ± 3 7 204 ±109 60 ± 1 9 0.72±0.17 7 ± 2 185±83 254 ± 5 8 639 ±129 227 ± 3 7 159±109 45 ± 1 3 0.95 ±0.18 1.94 ±0.38 8 ± 3 <0 001 > 0 0 0 l < 0.001 >0.01 > 0.001 < 0.001 < 0.001 < 0.001 203 ± 5 5 287 ± 6 0 736±121 228 ± 2 7 215±79 6 4 ± 1 6 0.72 ±0 .2 7 ±2 .2 159±40 265 ± 5 5 678 ±120 215±27 192±9* 5 4 ± 1 3 1.02 ±0.34 1.88±0.S4 9 ± 1 . 7 <0.01 <0.02 < 0.001 <0.05 <0.05 < 0.001 < 0.001 < 0.001 Л И П О И Д Н Ы Й ОБМЕН У ДИАБЕТИКОВ С П О В Ы Ш Е Н Н Ы М И С НОРМАЛЬНЫМ КРОВЯНЫМ Д А В Л Е Н И Е М Е. Бозаджиева, С. Радева, Г. Варбанов, П. Чанкова, И. Цанев Р Е З Ю М Е Липопротеин-липазная активность и влияние гепарина на уровень сахара крови и липиды сыворотки исследовали у 38 больных сахарной болезнью, у 16 из которых кровяное давление было повышено, а у 22 — в норме, 45 больных гипертонической болезнью и 17 практически здо­ровых нормотонических лиц. У диабетиков с повышенным и с нормальным кровяным давлением по сравнению с больными гипертонической болезнью и нормотониками обнаружили более высокое содержание не только сахара крови, но и липидных фракций сыворотки, а содержание эндсгеннсго гепарина ока­залось пониженным. В результатах исследования липиднсго обмена при диабете не отме­чалось различий в обмене липидов в зависимости от уровня кровянсго давления. 

LIPID METABOLISM IN DIABETICS WITH AND WITHOUT BLOOD PRESSURE INCREASE

https://journals.mu-varna.bg/index.php/ssm/article/download/3547/3002

LIPID METABOLISM IN DIABETICS WITH AND WITHOUT BLOOD PRESSURE INCREASE

Abstract

Similar works

Full text

Available Versions

Varna Medical University Press: Journals