Biochemischer und mikromorphologischer Nachweis von Lipiden in der Dünndarmschleimhaut von Patienten mit Diabetes mellitus

Abstract

Hyperlipemia is a frequent finding in diabetes mellitus. As not only the liver, but intestinal mucosa as well synthesizes endogenous lipoproteins, we have investigated the small intestinal mucosal lipid content in 11 adult patients with juvenile onset diabetes and in 7 patients with maturity onset diabetes. Eleven non-diabetic patients served as controls. After a fasting period of 12-14 h blood was drawn for determination of glucose, lipids and glycosylated hemoglobin AI. Then several small bowel biopsies were performed by an hydraulic multiple biopsy tube or endoscopically and the specimens were processed immediately for further biochemical, histochemical and electronmicroscopical workup. Patients with juvenile and with maturity onset diabetes did not differ from controls with regard to serum lipids and to intestinal mucosal lipids determined biochemically. Surprisingly, patients with maturity onset diabetes exhibited a significantly (p less than 0,005) higher concentration of intestinal mucosal triglycerides than patients with juvenile onset diabetes. Fasting blood glucose and hemoglobin AI levels were slightly elevated in both groups of diabetic patients. Histochemically lipid particles were demonstrable in intestinal mucosa of diabetics and of controls with equal variability. The electronmicroscopical appearance of intestinal mucosa did not differ between diabetic patients and controls. Only in one patient with juvenile onset diabetes an accumulation of lipid particles within the cisternae of the Golgi apparatus was observed. In conclusion, neither biochemically, nor histochemically, nor electronmicroscopically an abnormal accumulation of lipids could be found in the small intestinal mucosa of patients with well controlled diabetes mellitus.