Ｃｈｙｌｏｍｉｃｒｏｎｅｍｉａ　ｓｙｎｄｒｏｍｅを伴ったインスリン依存型糖尿病の１例

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  • A Case of Insulin-Dependent Diabetes Mellitus with Chylomicronemia Syndrome.

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A 25-year-old man who presented with eruptive xanthomas, hyperglycemia and hyperlipidemia was admitted to our hospital. Fasting plasma glucose, plasma total cholesterol (T-Ch) and plasma triglyceride (TG) were 286mg/dl, 420mg/dl and 1960mg/dl, respectively. Eruptive xanthomas were observed on his elbows, knees and hip. We diagnosed him as having insulin-dependent diabetes mellitus complicated with type V hyperlipoproteinemia; chylomicronemia syndrome. Following the reduction of plasma glucose level by conventional insulin therapy, T-Ch and TG were decreased and eruptive xanthomas diminished rapidly. Finally his plasma glucose level was normalized without insulin therapy. T-Ch decreased to normal range, but TG was still around 200mg/dl showing mild type IV hyperlipoproteinemia. His mother, who suffered from non-insulin-dependent diabetes mellitus, and his pregnant elder sister showed moderate hypertriglyceridemia. The Apo E isoform of the subject was E3/E3. His lipoprotein lipase (LPL) mass content was reduced to the level of heterozygous LPL deficiency even after normalization of plasma glucose. His parents' LPL mass contents were within normal range.<BR>Although we could not definitely diagnose this subject as having heterozygous LPL deficiency, the insulin-dependent diabetic state seemed to have augmented the genetic hypertriglyceridemia.

収録刊行物

  • 糖尿病

    糖尿病 35 (9), 779-785, 1992

    一般社団法人 日本糖尿病学会

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