Effects of diabetes mellitus on cholesterol metabolism in man

L. J. Bennion, Scott M Grundy

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Abstract

In view of the reported excess prevalence of artherosclerosis and cholelithiasis in diabetes, the authors investigated several aspects of cholesterol metabolism under metabolic ward conditions in six Pima Indians with maturity-onset diabetes mellitus. Cholesterol balance (13.5 versus 11.0 mg per kilogram per day, P<0.05), fecal bile acid excretion (415 versus 261 mg per day, P<0.05), bile acid pool size (3150 versus 1950 mg, P<0.05), fasting plasma cholesterol (193 versus 160 mg per deciliter, P<0.05) and plasma triglycerides (251 versus 150 mg per deciliter, P<0.05) were higher during uncontrolled hyperglycemia than during relative euglycemia on insulin. The increased plasma lipid levels and total cholesterol synthesis during hyperglycemia may contribute to the acceleration of atherosclerosis in diabetes mellitus. Gallbladder bile was significantly more saturated with cholesterol (181 percent versus 114 percent, P<0.05) during insulin treatment than during uncontrolled hyperglycemia. Bile lipid composition was thus more favorable to cholestrol precipitation and gallstone formation during insulin treatment than in the untreated diabetic state.

Original languageEnglish (US)
Pages (from-to)1365-1371
Number of pages7
JournalNew England Journal of Medicine
Volume296
Issue number24
StatePublished - 1977

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Diabetes Mellitus
Cholesterol
Hyperglycemia
Insulin
Bile Acids and Salts
Bile
Lipids
Potassium Iodide
Cholelithiasis
Gallstones
Gallbladder
Type 2 Diabetes Mellitus
Fasting
Atherosclerosis
Triglycerides
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Effects of diabetes mellitus on cholesterol metabolism in man. / Bennion, L. J.; Grundy, Scott M.

In: New England Journal of Medicine, Vol. 296, No. 24, 1977, p. 1365-1371.

Research output: Contribution to journalArticle

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