极低密度脂蛋白与胰岛素抵抗患者的脂代谢紊乱

Very low density lipoprotein and dyslipidemia in patients with insulin resistance

极低密度脂蛋白(VLDL)是机体转运内源性甘油三酯的主要形式,可分为大颗粒的VLDL1和小颗粒的VLDL2。VLDL血浓度升高是胰岛素抵抗(IR)脂代谢紊乱的主要特征,以VLDL1升高为主。其升高的机制与IR密切相关,包括:磷脂酰肌醇3激酶信号转导途径受损,固醇调节元件结合蛋白-C表达上调,游离脂肪酸大量内流,载脂蛋白(apo)B-100稳定性增加、肠内apoB-48水平升高,脂蛋白脂酶活性下降及低密度脂蛋白受体清除途径受损,导致VLDL生成过度、清除减弱,从而使其血浓度升高。

Very low density lipoprotein （VLDL） is the major carrier for the transfer of the endogenous triglyceride in body. It includes VLDL1 and VLDL2, VLDL1 is larger particle and VLDL2 is smaller particle. The elevation of plasma VLDL, especially VLDL1, is the main characteristic of dyslipidemia and strongly associated with insulin resistance. The mechanisms include： impaired signaling transduction of phosphafidylinositol-3 kinase, up-regulated expression of sterol regulatory element-binding protein 1 C, overflow of free fatty acids, increased stabilization of apoB-100 and overproduction of intestinal apoB-48, decreased activity of lipoprotein lipase and impaired pathway for removal of VLDL receptor. All these abnormalities result in the overproduction and reduced clearance of VLDL and lead to the elevation of plasma VLDL finally.