Postprandial chylomicrons and adipose tissue lipoprotein lipase are altered in type 2 diabetes independently of obesity and whole-body insulin resistance

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• 作者：Giovanni Annuzzi ; Rosalba Giacco ; Lidia Patti ; Lucrezia Di Marino ; Claudia De Natale ; Giuseppina Costabile ; Maurizio Marra ; Carmela Santangelo ; Roberta Masella ; Angela A. Rivellese
• 关键词：Postprandial lipoproteins ; Insulin resistance ; Type 2 diabetes ; Adipose tissue ; Lipoprotein lipase
• 刊名：Nutrition, Metabolism and Cardiovascular Diseases
• 出版年：2008
• 出版时间：October 2008
• 年：2008
• 卷：18
• 期：8
• 页码：531-538
• 全文大小：263 K

文摘

Background and aims

Postprandial lipoprotein abnormalities in type 2 diabetes are associated with insulin resistance. The role of other diabetes-related factors is still not clear. The aim of this study is to differentiate the effects of whole-body insulin resistance, obesity, and type 2 diabetes on postprandial dyslipidaemia and lipoprotein lipase (LPL) in adipose tissue.

Methods and results

Ten subjects with obesity and diabetes (OD), 11 with obesity alone (O), and 11 normal-weight controls (C) – males, aged 26–59 years, with fasting normo-triglyceridaemia underwent measurements of cholesterol, triglycerides, apo B-48 and apo B-100 concentrations in plasma lipoproteins separated by density gradient ultracentrifugation before and after a fat-rich meal. Fasting and postprandial (6 h) LPL activity was determined in abdominal subcutaneous adipose tissue biopsy samples. Insulin sensitivity was measured by hyperinsulinaemic euglycaemic clamp. OD and O subjects had similar degrees of adiposity (BMI, waist circumference, fat mass) and insulin resistance (insulin stimulated glucose disposal and M/I). They also showed a similarly higher postprandial increase in large VLDL lipids (triglyceride incremental AUC 188 ± 28 and 135 ± 22 mg/dl·6 h) than C (87 ± 13 mg/dl·6 h, M ± SEM, p < 0.05). OD had an increased chylomicron response compared to O (triglyceride incremental AUC 132 ± 23 vs. 75 ± 14 mg/dl·6 h, p < 0.05). OD had significantly lower fasting and postprandial adipose tissue heparin-releasable LPL activity than O and C.

Conclusions

In insulin-resistant conditions of obesity, with and without diabetes, large VLDL are increased after a fat-rich meal. In addition, diabetic patients compared to obese subjects have an increased postprandial chylomicron response and a reduced adipose tissue LPL activity.