Metabolism of cholesterol in obese patients with diabetes mellitus type 1 - impact of weight reduction
Abstract
Objective: Diabetes mellitus type 1 is characterized with an absolute insulin deficiency. Deterioration of cholesterol metabolism is well known in this disease - cholesterol absorption is typically elevated.Obesity, on the other hand, is typically accompanied with lower insulin sensitivity, that is known to increase cholesterol synthesis and decrease cholesterol absorption.
The aim of this study was to characterize cholesterol metabolism in obese type 1 diabetics and to characterize its dynamics during weight reduction programme. Design: interventional, prospective.
Materiál and methods: Total cholesterol, HDL-cholesterol, LDL-cholesterol, and triacylglycerols were estimated in obese type diabetic patients (n=14, BMI )30 kg/m2) enzymatically. Glycated hemoglobin was estimated by HPLC (high-performance liquid chromatography).
Measurements were repeated in Phase I (before intervention). Phase II (after one week of fasting + three weeks on a diet with 150g saccharides per day) and in Phase III (after one year on a diet with 225g saccharides per day).
Gas chromatography with the flame ionisation detector was used to estimate squalene and non-cholesterol sterols (lathosterol, campesterol, and beta-sitosterol). One-time, the control group of non-obese patients with type 1 diabetes ((n=14, BMI (24) was investigated.
Markers of cholesterol metabolism were compared with the control group of lean non-diabetics.Data are presented as median (percentile (25;75)). Results:In Phase I, significant (PLESS-THAN OR EQUAL TO0,05) elevation of campesterol in obese diabetics was found in comparison to lean sujects.In non-diabetic subjects, significantly (PLESS-THAN OR EQUAL TO0,001) lower levels of sitosterol were found.
During the weight reduction programme (Phase III) significant decrease in lathosterol (PLESS-THAN OR EQUAL TO0,001) and campesterol (PLESS-THAN OR EQUAL TO0,05) was found. Conclusion:Compared study subgroups significantly differed in markers of cholesterol absorption.