Bozadjieva, E.

Chankova, P.

Danev, I.

Radeva, S.

Varbanov, G.

English

Varna Medical University Press: Journals

LIPID METABOLISM IN D I A B E T I C P A T I E N T S WITH AND WITHOUT BLOOD PRESSURE INCREASE E . Bozadjieva, S. Radeva, G. Varbanov, P. Chankova, I . Danev As wel l known, in certain aspects uncontrolled diabetes mellitus resem-bles a fasting state — fatty acids oxidation wi th in the tissues is intensified whereas the oxidation of carbohydrates is decreased, mobilization of free fatty acids from the adipose tissue is enhanced and, not infrequent-l y , the blood triglyceride level is higher (3) . Considerable changes in l i -pid metaboli m are likewise observed in atherosclerosis ( 1 , 2 ) Diabetes mellitus is distinguished for the speeded up development of atherosclerosis, and often.it runs a course characterized by blood pres-sure increase; on the other hand, it is a wel l known fact that there is a de-finite interdependence between atherosclerosis and hypertension. We set out to verify whether or not the increase of blood pressure exerts ef-fect on l ipid metabolism and lipoprotein-lipase ac t iv i ty in diabetes mellitus. Material and Methods Studies were performed on a series including 38 patients wi th diabetes mellitus (16 wi th increased and 22 without increased blood pressure), 45 hypertensive patients (12 of them, a l l males, w i th I degree, and 33 wi th I I I degree of the disease according to Lang) and 17 pract ical ly healthy normotensive subjects. The diabetics without blood pressure increase were aged 23—67 years or 49 years in the average, diabetics wi th blood pres-sure increase — 22 to 70, average 50 years, patients wi th I degree hyper-tension according to Lang•— from 19 to 22 years, average 19.5, patients wi th I I I degree hypertension according to Lang — from 28 to 61 years, average 49, and the pract ical ly healthy persons — from 20 to 56 years, average 36 years* Patients were maintained on diets suitable for their af-fection. The heparin test was performed according to the following schedule: in the morning, before meal, . 150 mg heparin was administered through i . v . drip infusion of 500 ml physiologic saline over a period of four hours. Determination of blood sugar, serum lipids and endogenic heparin was made just prior to and immediately after the infusion* Blood sugar was determined after the method of Haggedorn-Jensen', cholesterol — after I lko , total l ip i l s — after Braggdcn-Bloor, phospholipids — after Svan-berg-Svannerholm, beta-lipoproteins — after Burnstein, non-esterified fatty acids — after Dancon^b, heparin — according to Pipta and lipo-protein-lipase act iv i ty — according to Lucasik. 1 90 Е. Bozadjieva, S. Radeva, G. Varbanov, P. Chankova, I . Danev Results and Discussion The results of our studies show that in diabetics without blood pressure increase, apart from the blood sugar content, the levels of cholesterol, to* ta l l ipids , phospholipids, triglycerides, beta-lipoproteins and non-esteri-fied fatty acids are also substantially higher, while the content of endo­genic heparin is considerably lower compared wi th healthy persons. No difference worth noting in the ac t iv i ty of lipoprotein lipase is recorded (Table 1). An analogical relationship is established among diabetics wi th increased blood pressure (Table 2 ) . No difference is established between the two groups of diabetic patients in terms of serum l ip id fractions, en­dogenic heparin and lipoprotein-lipase ac t iv i ty (Table 2 ) . T a b l e 1 Correlation between Blood Sugar and Serum Lipids in Diabetics without Hypertension and in Healthy Individuals Diabetics ! f I . . . . J t without hyper- I Healthy mdi-tension \l$uil* n = 22 M ± a 1 1 = 1 7 М ± * 1. Blood sugar in rag % 231 ± 8 2 2. Cholesterol in mg % 271 ± 5 4 3. Total lipids in mg % 707 ±146 4. Phospholipids in mg % 1 227±37 5. Triglycerides in mg % 204 ±109 6. Beta lipoproteins in F . E . 6 0 ± 1 9 7. Non-esterified fatty acids in ixM,ml 0.72±0.2 8. Lipoprotein-lipase in цМ/ml 1.94±0.28 9. Heparin in U/ml 7 ± 2 . 4 105±14 223 ± 3 7 568 ± 7 3 196 ± 2 6 153 ± 4 4 40±11 0.52 ±0.1 2.40 ±0.42 9±0.61 11.55 6.9 9.2 3.3 3.0 9.0 3.3 1.6 8.6 < 0.001 < 0.001 < 0.001 я«0.001 ; 0.01 < 0.001 я«0.001 0.10 0.001 T a b l e 2 Correlation between Blood Sugar and Serum Lipids in Diabetics with and without Hypertension and in Healthy Individuals Diabetics with hyper­tension n=16 M4~a Diabetics without hyperten- . sion n = 22 Healthy indivi­duals n=17 1. Blood sugar in mg % 2. Cholesterol in mg % 3. Total lipids in mg % ! 203 ± 5 5 ; 287 ± 6 0 736±121 4. Phospholipids in mg % 228 ± 2 7 5. Triglycerides in mg % 215 ± 7 9 6. Beta-lipoproteins in F . Е. I 6 4 ± 1 6 7. Non-esterified fattv acids in jiM/ml 0.72±0.2 Lipoprotein lipase in jiM/ml Heparin in U/ml ,231 ± 8 2 271 ± 5 4 707 ±146 227 ± 3 7 204 ±109 6 0 ± 1 9 0.72 ±0.2 2 . K 0 . 0 5 105±14 0.88 > 0.101223 ± 3 7 1.8 < 0.10 568 ± 7 3 0.23>0.10i 196±26 0.6>0.10 153±44 1.33>0.10| 40±11 0.10>0.10 0.52±0.1 i 1.88 ± 0.34 1.94 ± 0.28 0.13 > 0.10 2.40 ± 0.42 7 ± 2 . 2 7±2 .4 I 1.2>0.10| 9±0.61 I i i 10.9 < 0.001 6.7 < 0.001 11.5 < 0.001 3.8 > 0.001 3.7 > 0.001 8;8< 0.001 2.8 > 0.01 1.2>0.1 7.4 < 0.001 Lipid Metabolism in Diabetic Patients with. 91 Upon comparison of the content of l ip id fractions, endogenic heparin and lipoprotein-lipase ac t iv i ty in diabetics without increase of the blood pressure, and in hypertensive patients, I and I I I degree according to Lang , i t is demonstrated that the content of individual l ip id fractions is consi­derably elevated, and the content of endogenic heparin and lipoprotein-T a b l e 3 Correlation between Blood Sugar and Serum Lipids in Diabetics without Hypertension and Patients with Hypertension, Stage I and III Diabetics without hyperten­sion n = 22 M ± < 7 Hyperten­sion I stage n=12 M ± < 7 i Hyperten-] sion t P I I I stage n=33 M + a t p 1. Blood sugar in mg % 2. Cholesterol in mg % 3. Total lipids in mg % 4. Phospholipids in mg % 5. Triglycerides in mg % 6. P-lipoproteins in F . E . 7. Non-esterified fatty acids in jiM/ml 8. Lipoprotein lipase in jiM/ml 9. Heparin in U/ml 231 ± 8 2 271 ± 5 4 707 ±146 227 ± 3 7 204 ±109 6 0 ± 1 9 0.72 ±0 .2 1.94 ±0.28 7 ±2 .4 66 ± 1 8 153±32 474 ± 8 9 163 ± 2 9 158 ± 5 6 3 9 ± 1 3 0.44 ±0.16 0.62 ±0 .5 10 + 6.6 13.7 < 0.001 11.8 < 0.001 8.6 < 0.001 6.4 < 0.001 2.6 < 0.02 4.95 < 0.001 5.6 < 0.001 4.3 < 0.001 4.5 < 0.001 9 9 ± 3 7 IKO.OOl 244 ± 4 6 3<0.01 579 ±119 5.5 < 0.001 210±35 1.9^0.05 124 ± 7 3 4.44 < 0.001 43 ± 1 6 5<^0.001 0.43 ±0.25 6 < 0.001 0.51 ±0.04 4.9 < 0.001 5 ± 1 7^0.001 ipase ac t iv i ty are significantly lowered among the diabetic patients (Table 3) . The same dependence is also established between the group of diabetic patients w i th increased blood pressure and the patients wi th hypertension, I and I I I degree (Table 4 ) . T a b l e 4 Correlation between Blood Sugar and Serum Lipids in Diabetics with Hypertension and in Patients with Hypertension, Stage I and III Diabetics H yperten-wlth hyper- s i o n s t a g e j tension j n - 1 2 IT16 i M + a t p Hyperten­sion stage I I I n = M M + a t Р 1. Blood sugar in mg % 2. Cholesterol in mg % 3. Total lfpids in mg % 4. Phospholipids in mg % 5. Triglycerides in mg % 6. p-lipoproteins in F . E . 7. Non-esterified fatty acids in jiM/ml 203 ± 5 5 287 ± 6 0 736 ±121 228 ± 2 7 215±79 6 4 ± 1 6 0.72 ±0 .2 6 6 ± 1 8 153 ± 3 2 474 + 89 163 ± 2 9 158 ± 5 6 39 ± 1 3 0.44 ±0.16 9.13<0.001 i 9 9 ± 3 7 . 7.4 < 0.001 1 244 ± 4 6 6.7.< 0*001 j 579 ±119 6.0 < 0.001 I 210 ± 3 5 2.89 < 0.02 124 + 73 4.46 < 0.001 s 43 ± 1 6 4.00 < 0.001 ,0.43 ±0.25 10.4 < 0.001 4.0 < 0.001 6.7 < 0.001 2.25 < 0.05 5.0 < 0.001 5.53 < 0.001 6.0 < 0.001 8. Lipoprotein lipase 9. Heperin in U/ml 1.88 + 0.34 0.62 ±0 .5 7 ± 2 . 2 ! 10±6.6 6.6 < 0.001 4.43 < 0.001 0.51 ±0.04 5±;1 4.0 < 0.001 6.5 < 0.001 92 In general outline, the studies performed on the l ipid metabolism in diabetics fai l to show any difference in the metabolism of l ipids, depend­ent upon the degree of blood pressure, or in other words, the increase of blood pressure in diabetic patients has no repercussions whatsoever on the l ip id fractions, endogenic heparin and lipoprotein-lipase a c t i v i t y , and any variat ions in l ip id metabolism should be attributed pr imar i ly to the basic disease (Table 5) . T a b l e 5 Heparin Effect on the Level of Blood Sugar and Serum Lipids in Diabetic Patients without Hypertension • Pre-heparin values n = 22 М±т Post-heparin values n = 22 M ± r t p 1. Blood sugar in mg % 2. Cholesterol in mg % 3. Total lipids in mg % 4. Phospholipids in mg % 5. Triglycerides in mg % 6. p-lipoproteins in F. E . 7. Non-esterified fatty acids in jiM/ml 8. Lipoprotein lipase in {iM/ml 9. Heparin in U/ml 231 ± 8 2 271 ± 5 4 707 ±146 227 ± 3 7 204 ±109 6 0 ± 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 4.4 < 0.001 3.6 > 0.001 6.0 < 0.001 0.75>0.10 . 3.4>0.00l 7.2 < 0.001 10.5 < 0.001 5.0 < 0.001 T a b 1 е 6 Heparin Effect on Blood Sugar and Serum Lipids in Diabetics with Hypertension Pre-heparin values n = 16 М- г Post-heparta values n = 16 M ± r t * p 1. Blood sugar in mg % 2. Cholesterol in mg % 3. Total lipids in mg % 4. Phospholipids in mg % 5. Triglycerides in mg % 6. ^-lipoproteins in F . E -7. Non-esterified fatty acid*in jiM/ml 8. Lipoprotein lipase in jiM/ml 9. Heparin in U/ml 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 ± 4 0 265 ± 5 5 678 ±120 215±27 ! 9 2 ± 9 4 54 ± 1 3 1.02 ±0.34 1.88 ±0.34 9 ± 1 . 7 3 . 4 K 0 . 0 1 2.53 < 0.02 5.27 < 0.001 2.20 > 0.05 2.15<005 4.10<0.00l 10<000l 8.3 < 0.001 The latter circumstance, up to a certain degree, warrants the ass-ump" t i c n that the increase of blood pressure, observed in some of the patients Lipid Metabolism in Diabetic Patients with. 93 wi th diabetes mellitus, by no means represents essential hypertension, or else, in this ease it is not a matter of a combination between diabetes melli tus and hypertension, but rather of hypertension concomitant to diabetes mellitus which , in a l l l ikelihood, has its proper genesis, dif­ferent from that of the hypertensive disease. R E F E R E N C E S 1. М я с н и к о в , А . Л . Гипертсническая болезнь и атерссклероз. Москва, Медицина, 1965. — 2. Р а д е в а, С., Е. Б о з а д ж и е в а, В. П е т р о в а , П. Ч а н к о в а, Е. Р у с и н о в . Научна сесия на ВМИ — София, 1969. — 3. R о b i n s о n, D. S. Advances in lipid research., I , 1963, 133—182. ОБМЕН ЛИПИДОВ У ДИАБЕТИКОВ С И БЕЗ ЛОВЫШЕННОГО КРОВЯНОГО ДАВЛЕНИЯ Э. Бозаджиева, С. Радева, Г. Вырбанов, П. Чанкова, Я . Ranee Р Е З Ю М Е Липопротеийлипазная активность и влияние гепарина на уровень с а х а р а в крови и липидов сыворотки крови исследованы у 38 больных сахарной болезнью (16 из них с повышенным и 22 без повышенного кро­в я н о г о д а в л е н и я ) , 45 больных гипертонической болезнью и 17 прак­тически ^ здоровых лиц с нормотонией. У диабетиков с и без гипертонии, в сравнении с больными гиперто­нической болезйью и здоровыми лицами устанавливается более высокое содержание не т о л ь к о сахара в крови, но и липидйых ф р а к ц и й в сыво­ротке крови, а содержание эндогенного гепарина — более низкое. Р е з у л ь т а т ы исследования липидного обкена при диабете не показы­вает р а з л и ч и я в метаболизме липиДов, в зависимости от высоты арте­риального кровяного д а в л е н и я . 

LIPID METABOLISM IN DIABETIC PATIENTS WITH AND WITHOUT BLOOD PRESSURE INCREASE

https://journals.mu-varna.bg/index.php/ssm/article/download/3490/2948

LIPID METABOLISM IN DIABETIC PATIENTS WITH AND WITHOUT BLOOD PRESSURE INCREASE

Abstract

Similar works

Full text

Available Versions

Varna Medical University Press: Journals