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Gerberich SG

IDL components (cholesterol, triglycerides, apo B-48, and apo B-100) tended to decrease after the meal without significant differences between diabetic patients and controls except for apo B-48 ( Table 2 ). In fact, the apo B-48 incremental area was significantly less negative in diabetic patients compared with controls ( P < 0.05; Table 2 ). No significant differences in LDL and HDL lipid responses to the meal were observed between the two groups ( Table 2 ).

Plasma postheparin LPL activity, evaluated 6 h after the meal, was very similar in the diabetic and the control subjects (76 ± 6 vs. 80 ± 12 mU/liter, respectively). Plasma postheparin hepatic lipase activity was instead significantly higher in the diabetic patients compared with the controls (257 ± 23 vs. 153 ± 22 mU/liter; P < 0.05).

As shown in Fig. 4 , preheparin LPL plasma activity, obtained without heparin stimulation, was higher in diabetic patients, significantly so at the end of the test meal.

F ig . 4.
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LPL activity in preheparin plasma before and after a standard meal in patients with type 2 diabetes and nondiabetic controls (mean ± sem ; *, < 0.05).

F ig . 4.
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LPL activity in preheparin plasma before and after a standard meal in patients with type 2 diabetes and nondiabetic controls (mean ± sem ; *, < 0.05).

This study shows that even mild type 2 diabetic patients with very good blood glucose control and low fasting plasma triglyceride levels, well below 150 mg/dl (1.7 mmol/liter), which was indicated as optimal to reduce cardiovascular risk in diabetic patients ( 21 ), present abnormalities in the plasma lipid response to a standard mixed meal. These abnormalities concern lipoproteins of both endogenous (in particular, large VLDL) and exogenous (in particular, chylomicron remnants) origin as indicated by the increase in apo B-100 in the Sf 60–400 fraction and of apo B-48 in both Sf 60–400 and Sf 20–60 fractions.

Our data on exogenous lipoproteins are in agreement with those reported by Chen et al. ( 3 ), who found in a group of type 2 diabetic patients, similar to our subjects with regard to optimal blood glucose control and fasting normotriglyceridemia, a significant increase in retinyl palmitate in the nonchylomicronemic triglyceride-rich fraction. Our results are, instead, in contrast with data presented by Lewis et al. ( 7 ), who found postprandial lipid abnormalities only in the type 2 diabetic patients with fasting hypertriglyceridemia (serum triglycerides, >150 mg/dl; >1.7 mmol/liter).

It was in the American colonies where European powers – first the Dutch and then the British, seeking peace among their colonists – instituted protection of individual religious conscience. Contrary to American national mythology, tolerance was not a distinct virtue carried to America by those who built their imagined city upon a hill: it was imposed by European colonial powers to better administer their overseas empires. The ideal of religious tolerance was sewn further in the colonies by transplanted Londoners such as William Penn and Roger Williams, but always to protect Christianity from politics, and not the other way around.

The US, from its birth, marked groups for tolerance and intolerance. The country attempted to conquer, control and Christianise the native people and, until the Indian Citizenship Act of 1924, the very minimum tolerance – the simple ability to live – was denied to them in most places, and in others was the most they received. Africans fell into an entirely different category; slavery reflects neither tolerance nor intolerance, but rather inhumanity. Even so, the idea that the foundation of the American polity is a multiplicity of ideals – religious and political – was a tension among the founders of the early republic who themselves debated which Enlightenment principles should stand at the forefront of their ideological experiment. It was Thomas Jefferson and James Madison’s vision that an enlightened state must resist creating a religious foundation upon which other dissenting views are dependent for toleration. Jefferson’s view of the political community failed to include women, African Americans or native people, but he grasped the danger of premising citizenship on the tolerance of one religious group by another.

T he Enlightenment, the rise of nation states, two world wars and post-war European decolonisation transformed tolerance from a legal concept that regulated the privileges and disabilities of minority religions to a philosophical and ethical ideal. With the ascension of international human rights law following the Second World War, states stopped articulating the protection of minorities in edicts of tolerance or guarantees of minority rights. They instead created legal protections for speech and conscience and laws protecting against discrimination. Many of the old compromises of early modern toleration live on in state churches, officially recognised religious minorities and the accommodations to religion (especially in family law) that remain in many states. But for the most part, as the political theorist Wendy Brown has free shipping discount pictures sale online Gant Men’s Major Trainers Blue Navy reliable cheap online discount low shipping gPKKWQm
in Regulating Aversion (2008), the sites of tolerance have changed. Tolerance is discussed today as a moral rather than a legal question, and as a matter of civic and cultural life rather than as a practical answer to theological problems.

In fact, tolerance has never escaped its origins as a means for the majority to regulate the minority. It continues to be the case that in today’s national state system the overwhelming majority of governments associate the state directly or indirectly with the majority religion. This is even true in states with legal neutrality on matters of religion such as the US and France. As such, tolerance remains a one-way relationship between the tolerating and the tolerated that, intended or not, keeps the tolerated outside of full membership in the dominant group. In contrast to tolerance, reciprocity recognises that strong and dynamic societies are based on social and cultural exchange.

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