mid test journal (exercise)

7/28/2019 Mid Test Journal (Exercise)

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The Prevalence Rate of Peripheral Arterial Disease in Type 2 Diabetes Mellitus and

In this study, no significant correlation was found

betweenHDL levels andPAD.This result supports stud-ies by Kazunari et al,5Asakawa et and Gregor et a1,*who did not find a significant correlation between HDLlevels and PAD in type 2 diabetes mellitus. O'Neal on

the other hand, found a significant correlation betweenthe two conditions?HDL carries cholesterol from peripheral tissues

through the plasma to the liver to be converted into fatty

acids and then excreted through the bile duct. Thus, HDL

has an anti-atherogenic characteristic. Reverse choles-

terol transport occurs when cholesterols leave the cell

and enters a more dense HDL subclass. In this case,

lecithin cholesterol acyl transferase (LCAT) esterifizes

the cholesterol particle of HDL by transferring unsatur-

ated fatty acids (linoleats from lesithin) into cholesterol

to form cholesterol esters. HDL-derived cholesterol es-

ters are immediately transferred to the liver through 2

mechanisms, LDL receptor uptake in the liver, and bybeing transferred into VLDL by cholesterol ester trans-ferase proteins (CTEPs).These cholesterol esters wouldthen also be sent to the liver to be excreted. These

mechanisms thus inhibit atherogenesis. In this study, there

was no significant correlation between HDL cholesterollevels in type 2 diabetes mellitus with or without PAD.

The reason for the lack of correlation is that in this study,no analysis was performed on weight reduction, calorie

restriction, or activity. Weight reduction, calorie restric-

tion, and increased activity could increase HDL levels.In type2diabetes mellitus, administration of insulin andoral anti-diabetic agents do not play much of a role in

increasing HDL levels.20Hypemiglyceride is often found in type 2 diabetesmellitus. In this study, there was no significant correla-tion between triglyceride levels and PAD. This result

supports studies conducted by O'Neal et a1,6 Asakawaet a1,8and Gregor et al? Increased triglyceride levels intype 2 diabetes mellitus through 3 mechanisms. The firstmechanism is through the secretion of large particle

cretion by the liver. The V

has a smaller particle size

In this mechanism, Apo B

thus causing hypertriglycehydrolyzed by LPL, increas

LDL levels. In type 2diabe

production by the liver pla

triglyceride levels compar

Obesity has a close c

tance and type 2diabetes m

aside from the presence o

hypertension and hyperinsstudy, the chi square test d

lation between a BMI of o

lence of PAD, which is in

et a1,6Asakawa et a1,8andlogistic regression analysi

a significant correlation w

over 25 kg/m2and the preIncreased prevalence

not only associated with in

to ethnic and racial backgr

ciated with insulin resistan

sity. Visceral obesity could

hip ratio. Waist to hip ratio

ccra! obesity compared tofrom adipose tissue is th

and insulin resistance. Vi

role, since it is metabolica

subcutaneous fat, particul

ids. Free fatty acids incre

and hyperglycemia during

free fatty acids in the perip

lin action in tissue^.^'Hyperglycemia could

the polyol pathway, auto-o

These three processes in

stimulate the release of fre

causes reduced NO releas


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