Klinische Wochenschrift

, Volume 66, Issue 15, pp 694–698 | Cite as

Lipoprotein pattern in long-term diabetes of an at least 35 years' duration

Results of the Erfurt study
  • U. J. W. Schauer
  • G. Panzram
  • D. Pißarek
  • K. Rühling
  • L. Winkler
  • R. Lundershausen


All diabetic patients suffering from the disease for at least 20 years and living in the closed area of the Erfurt district in 1970 have been followed prospectively since that time. In 47 of them still alive in 1985, i.e. after more than 35 years of diabetes, serum lipid and apolipoprotein concentrations were measured and compared to those of non-diabetic subjects without cardiovascular diseases (n=47) pair-matched by sex, age, and body weight. In males (n=27) significantly (p<0.01) higher levels of HDL cholesterol and apolipoprotein A–I as well as lower concentrations of triglycerides and a lower total cholesterol/HDL cholesterol risk ratio than in nondiabetic control subjects could be found. In long-term diabetic females (n=20), apolipoprotein A–I levels were also increased (p<0.02). Trends in HDL cholesterol and triglycerides were similar to those found in males but did not reach statistical significance. Higher concentrations of total cholesterol (p<0.02), LDL cholesterol (P<0.05), and apolipoprotein B (p<0.02), however, did not fit in with a beneficial lipoprotein pattern. The frequency of pathological lipoprotein patterns was not higher than among the non-diabetic control subjects (32% and 40%, respectively). According to these findings an antiatherogenic lipoprotein pattern might be considered, at least in males, as one of the determinants causing the multifactorial event of long-term survival in diabetes.

Key words

Diabetes mellitus Long-term diabetes Lipoproteins Apolipoproteins HDL cholesterol Triglycerides 







high density lipoproteins


low density lipoproteins


standard deviation


very low density lipoproteins


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Asmal AC, Ganda OP, Busick EJ, Kosinski E (1982) Plasma lipid profiles in IDD of 20, 30, 40 years duration and their relationship to coronary artery disease (CAD). Diabetes 31 (Suppl 2): 157AGoogle Scholar
  2. 2.
    Assmann G (1982) Lipidstoffwechsel und Atherosklerose. Schattauer, Stuttgart New YorkGoogle Scholar
  3. 3.
    Barrett-Connor E, Orchard TJ (1985) Insulin-dependent diabetes mellitus and ischemic heart disease. Diabetes Care 8 (Suppl 1):65–70Google Scholar
  4. 4.
    Bon GB, Cazzolato G, Avogaro P (1984) Lipids, lipoproteins and apolipoproteins in type 1 (insulin-dependent) and type 2 (non-insulin-dependent) diabetes mellitus. Acta diabetol lat 21:315–324Google Scholar
  5. 5.
    Carlson LA, Böttiger LE (1985) Risk factors for ischaemic heart disease in men and women. Acta med Scand 218:207–211Google Scholar
  6. 6.
    Demacker PN, Hijmans AG, Brenninkmeijer BJ, Jansen AP, van't Laar A (1984) Five methods for determining low-density lipoprotein cholesterol compared. Clin Chem 30:1797–1800Google Scholar
  7. 7.
    Dunn FL, Caroll PB, Beltz WF (1987) Treatment with artificial beta-cell decreases very-low-density lipoprotein triglyceride synthesis in Type I diabetes. Diabetes 36:661–666Google Scholar
  8. 8.
    Eisenberg S (1984) High density lipoprotein metabolism. J Lipid Res 25:1017–1058Google Scholar
  9. 9.
    Friedewald WT, Levy RI, Fredrickson DS (1972) Estimation of the concentration of low density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 18:499–502Google Scholar
  10. 10.
    Gibbons GF (1986) Hyperlipidaemia of diabetes. Clin Sci 71:477–486Google Scholar
  11. 11.
    Gordon T, Castelli WP, Hjortland MC, Kannel WB, Dawber TR (1977) Diabetes, blood lipids, and the role of obesity in coronary heart disease risk for women. The Framingham study. Ann Intern Med 87:393–397Google Scholar
  12. 12.
    Howard BV (1987) Lipoprotein metabolism in diabetes mellitus. J Lipid Res 28:613–628Google Scholar
  13. 13.
    Janka HV (1985) Five year incidence of major macrovascular complications in diabetes mellitus. In: Janka HV, Mehnert H, Standl E (eds) Macrovascular disease in diabetes mellitus, pathogenesis and prevention. Georg Thieme, Stuttgart New York, pp 16–19Google Scholar
  14. 14.
    Kostner GM, Schernthaner G (1985) Apolipoproteins in diabetes mellitus. Monogr Atheroscler, vol 13. Karger, Basel München Paris New York, pp 12–24Google Scholar
  15. 15.
    Laakso M, Voutilainen E, Pyörälä K, Sarlund H (1985) Association of low HDL and HDL2 cholesterol with coronary heart disease in non-insulin-dependent diabetics. Atherosclerosis 5:653–658Google Scholar
  16. 16.
    Laakso M, Pyörälä K, Sarlund H, Voutilainen E (1986) Lipid and lipoprotein abnormalities associated with coronary heart disease in patients with insulin-dependent diabetes mellitus. Arteriosclerosis 6:679–684Google Scholar
  17. 17.
    Lopez-Virella MF, Stone P, Ellis S, Colwell JA (1977) Cholesterol determination in high density lipoproteins separated by three different methods. Clin Chem 23:882–884Google Scholar
  18. 18.
    Masarei JRL, Kiiveri HT, Stanton K (1986) Risk factors for cardiovascular disease in a diabetic population. Pathology 18:89–93Google Scholar
  19. 19.
    Nikkilä EA, Hormila P (1978) Serum lipids and lipoproteins in insulin-treated diabetes. Diabetes 27:1078–1086Google Scholar
  20. 20.
    Nikkilä EA (1984) Plasma lipid and lipoprotein abnormalities in diabetes. In: Jarrett RJ (ed) Diabetes and heart disease. Elsevier, Amsterdam, pp 133–167Google Scholar
  21. 21.
    Panzram G, Pißarek D (1985) Long-term diabetes — associated factors in survivorship and mortality. Horm Metabol Res, Suppl 15:10–15Google Scholar
  22. 22.
    Panzram G, Pißarek D, Lundershausen R, Schauer UJW (1987) Prospektive Verlaufsbeobachtungen beim Langzeitdiabetes — Ergebnisse der Erfurt-Studie. Dtsch Med Wochenschr 112:1283–1287Google Scholar
  23. 23.
    Pense G, Panzram G, Pißarek D, Meinhold J, Müller W, Leder H, Kaselow D, Adolph W (1973) Qualität der Stoffwechselführung und Angiopathie bei 180 Langzeitdiabetikern mit mindestens 20jähriger Krankheitsdauer. Schweiz Med Wochenschr 103:1125–1129Google Scholar
  24. 24.
    Pietri AO, Dunn FL, Grundy SM, Raskin P (1983) The effect of continuous subcutaneous insulin infusion on very-low-density lipoprotein triglyceride metabolism in Type I diabetes mellitus. Diabetes 32:75–81Google Scholar
  25. 25.
    Pontiroli AE, Calderara A, Bonisolli L, Maffi P, de Pasqua A, Margonato A, Radaelli G, Gallus G, Pozza G (1986) Genetic and metabolic risk factors for the development of late complications in type 1 (insulin-dependent) diabetes. Acta diabetol lat 23:351–366Google Scholar
  26. 26.
    Sadur CN, Eckel RH (1982) Insulin stimulation of adipose tissue lipoprotein lipase. J Clin Invest 69:1119–1125Google Scholar
  27. 27.
    Taskinen MR, Nikkilä EA, Nousiainen R, Gordin A (1981) Lipoprotein lipase activity in adipose tissue and skeletal muscle of human diabetics during insulin deprivation and restoration. Scand J clin Lab Invest 41:263–268Google Scholar
  28. 28.
    Walden CE, Knopp RH, Wahl PW, Beach KW, Strandness E (1984) Sex differences in the effect of diabetes mellitus on lipoprotein triglyceride and cholesterol concentrations. New Engl J Med 311:953–959Google Scholar
  29. 29.
    Wallbraun O, Fiedler H, Gottschling H-D (1982) Photo-metrische Mikromethode zur Bestimmung der glykosylierten Hämoglobine (HbAg). Z med Labor-Diagn 23:219–225Google Scholar
  30. 30.
    West KM, Ahuja MMS, Bennett PH, et al. (1983) The role of circulating glucose and triglyceride concentrations and their interactions with other “risk factors” as determinants of arterial disease in nine diabetic population samples from the WHO multinational study. Diabetes Care 6:361–369Google Scholar
  31. 31.
    Winkler L, Schlag B, Rüger HJ, Dargel R (1986) Eine Methodenvariante zur immunturbidimetrischen Bestimmung der Apolipoproteine AI und B im Serum. Z med Labor-Diagn 27:372–376Google Scholar
  32. 32.
    Yki-Järvinen H, Taskinen MR, Koivisto VA, Nikkilä EA (1984) Response of adipose tissue lipoprotein lipase activity and serum lipoproteins to acute hyperinsulinaemia in man. Diabetologia 27:364–369Google Scholar

Copyright information

© Springer-Verlag 1988

Authors and Affiliations

  • U. J. W. Schauer
    • 1
  • G. Panzram
    • 1
  • D. Pißarek
    • 1
  • K. Rühling
    • 2
  • L. Winkler
    • 3
  • R. Lundershausen
    • 1
  1. 1.Poliklinik für Innere MedizinMedizinische AkademieErfurt
  2. 2.Institut für Pathologische BiochemieMedizinische AkademieErfurt
  3. 3.Institut für Pathologische BiochemieFriedrich-Schiller-UniversitätJenaDDR

Personalised recommendations