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Interaction between Glucose and Lipid Metabolism: More than Diabetic Dyslipidemia.

Parhofer KG - Diabetes Metab J (2015)

Bottom Line: Furthermore, it is now well established that statins are associated with a small but significant increase in the risk for new onset diabetes.The underlying mechanisms are not completely understood but modulation of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG CoA)-reductase may play a central role as genetic data indicate that mutations resulting in lower HMG CoA-reductase activity are also associated with obesity, higher glucose concentrations and diabetes.Whether there is also an interaction between lipoprotein(a) and diabetes is still a matter of debate.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine 2-Grosshadern, University of Munich, Munich, Germany.

ABSTRACT
Glucose and lipid metabolism are linked to each other in many ways. The most important clinical manifestation of this interaction is diabetic dyslipidemia, characterized by elevated triglycerides, low high density lipoprotein cholesterol (HDL-C), and predominance of small-dense LDL particles. However, in the last decade we have learned that the interaction is much more complex. Hypertriglyceridemia and low HDL-C cannot only be the consequence but also the cause of a disturbed glucose metabolism. Furthermore, it is now well established that statins are associated with a small but significant increase in the risk for new onset diabetes. The underlying mechanisms are not completely understood but modulation of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG CoA)-reductase may play a central role as genetic data indicate that mutations resulting in lower HMG CoA-reductase activity are also associated with obesity, higher glucose concentrations and diabetes. Very interestingly, this statin induced increased risk for new onset type 2 diabetes is not detectable in subjects with familial hypercholesterolemia. Furthermore, patients with familial hypercholesterolemia seem to have a lower risk for type 2 diabetes, a phenomenon which seems to be dose-dependent (the higher the low density lipoprotein cholesterol, the lower the risk). Whether there is also an interaction between lipoprotein(a) and diabetes is still a matter of debate.

No MeSH data available.


Related in: MedlinePlus

High density lipoprotein (HDL) may be linked to glucose metabolism in multiple ways. HDL (at least certain subtypes) have direct anti-inflammatory properties. HDL are also the central component of reverse cholesterol transport and mediate cholesterol efflux from many tissues. This may change the micro environment such that insulin sensitivity and insulin secretion improve.
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Figure 1: High density lipoprotein (HDL) may be linked to glucose metabolism in multiple ways. HDL (at least certain subtypes) have direct anti-inflammatory properties. HDL are also the central component of reverse cholesterol transport and mediate cholesterol efflux from many tissues. This may change the micro environment such that insulin sensitivity and insulin secretion improve.

Mentions: More recently it was shown that also HDL may directly affect glucose metabolism [18]. In a study evaluating the cholesterylester transfer protein inhibitor torcetrapib it was observed that higher HDL-C concentrations were associated with less hyperglycemia [19]. Also it was demonstrated that the infusion of recombinant HDL can improve glucose metabolism in patients with type 2 diabetes [20]. Since then a number of studies have tried to shed light on the underlying pathophysiology and several mechanisms were identified (Fig. 1) [2122]. HDL induce reverse cholesterol transport and the altered intracellular lipid environment is believed to reduce micro-inflammation. Furthermore, direct anti-inflammatory properties of HDL may also play a role.


Interaction between Glucose and Lipid Metabolism: More than Diabetic Dyslipidemia.

Parhofer KG - Diabetes Metab J (2015)

High density lipoprotein (HDL) may be linked to glucose metabolism in multiple ways. HDL (at least certain subtypes) have direct anti-inflammatory properties. HDL are also the central component of reverse cholesterol transport and mediate cholesterol efflux from many tissues. This may change the micro environment such that insulin sensitivity and insulin secretion improve.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4641964&req=5

Figure 1: High density lipoprotein (HDL) may be linked to glucose metabolism in multiple ways. HDL (at least certain subtypes) have direct anti-inflammatory properties. HDL are also the central component of reverse cholesterol transport and mediate cholesterol efflux from many tissues. This may change the micro environment such that insulin sensitivity and insulin secretion improve.
Mentions: More recently it was shown that also HDL may directly affect glucose metabolism [18]. In a study evaluating the cholesterylester transfer protein inhibitor torcetrapib it was observed that higher HDL-C concentrations were associated with less hyperglycemia [19]. Also it was demonstrated that the infusion of recombinant HDL can improve glucose metabolism in patients with type 2 diabetes [20]. Since then a number of studies have tried to shed light on the underlying pathophysiology and several mechanisms were identified (Fig. 1) [2122]. HDL induce reverse cholesterol transport and the altered intracellular lipid environment is believed to reduce micro-inflammation. Furthermore, direct anti-inflammatory properties of HDL may also play a role.

Bottom Line: Furthermore, it is now well established that statins are associated with a small but significant increase in the risk for new onset diabetes.The underlying mechanisms are not completely understood but modulation of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG CoA)-reductase may play a central role as genetic data indicate that mutations resulting in lower HMG CoA-reductase activity are also associated with obesity, higher glucose concentrations and diabetes.Whether there is also an interaction between lipoprotein(a) and diabetes is still a matter of debate.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine 2-Grosshadern, University of Munich, Munich, Germany.

ABSTRACT
Glucose and lipid metabolism are linked to each other in many ways. The most important clinical manifestation of this interaction is diabetic dyslipidemia, characterized by elevated triglycerides, low high density lipoprotein cholesterol (HDL-C), and predominance of small-dense LDL particles. However, in the last decade we have learned that the interaction is much more complex. Hypertriglyceridemia and low HDL-C cannot only be the consequence but also the cause of a disturbed glucose metabolism. Furthermore, it is now well established that statins are associated with a small but significant increase in the risk for new onset diabetes. The underlying mechanisms are not completely understood but modulation of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG CoA)-reductase may play a central role as genetic data indicate that mutations resulting in lower HMG CoA-reductase activity are also associated with obesity, higher glucose concentrations and diabetes. Very interestingly, this statin induced increased risk for new onset type 2 diabetes is not detectable in subjects with familial hypercholesterolemia. Furthermore, patients with familial hypercholesterolemia seem to have a lower risk for type 2 diabetes, a phenomenon which seems to be dose-dependent (the higher the low density lipoprotein cholesterol, the lower the risk). Whether there is also an interaction between lipoprotein(a) and diabetes is still a matter of debate.

No MeSH data available.


Related in: MedlinePlus