Limits...
Hepatic insulin resistance both in prediabetic and diabetic patients determines postprandial lipoprotein metabolism: from the CORDIOPREV study.

Leon-Acuña A, Alcala-Diaz JF, Delgado-Lista J, Torres-Peña JD, Lopez-Moreno J, Camargo A, Garcia-Rios A, Marin C, Gomez-Delgado F, Caballero J, Van-Ommen B, Malagon MM, Perez-Martinez P, Lopez-Miranda J - Cardiovasc Diabetol (2016)

Bottom Line: Moreover, the area under the curve (AUC) of TG and AUC of TRLs-TG was greater in the prediabetic group compared with non-diabetic patients (p < 0.001 and p < 0.005 respectively).Patients with liver insulin resistance (liver-IR) showed higher postprandial response of TG compared with those patients with muscle-IR or without any insulin-resistance respectively (p < 0.001).Our findings demonstrate that prediabetic patients show a lower phenotypic flexibility after external aggression, such as OFTT compared with nondiabetic patients.

View Article: PubMed Central - PubMed

Affiliation: Lipid and Atherosclerosis Unit, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain.

ABSTRACT

Background/aims: Previous evidences have shown the presence of a prolonged and exaggerated postprandial response in type 2 diabetes mellitus (T2DM) and its relation with an increase of cardiovascular risk. However, the response in prediabetes population has not been established. The objective was to analyze the degree of postprandial lipemia response in the CORDIOPREV clinical trial (NCT00924937) according to the diabetic status.

Methods: 1002 patients were submitted to an oral fat load test meal (OFTT) with 0.7 g fat/kg body weight [12 % saturated fatty acids (SFA), 10 % polyunsaturated fatty acids (PUFA), 43 % monounsaturated fatty acids (MUFA), 10 % protein and 25 % carbohydrates]. Serial blood test analyzing lipid fractions were drawn at 0, 1, 2, 3 and 4 h during postprandial state. Postprandial triglycerides (TG) concentration at any point >2.5 mmol/L (220 mg/dL) has been established as undesirable response. We explored the dynamic response in 57 non-diabetic, 364 prediabetic and 581 type 2 diabetic patients. Additionally, the postprandial response was evaluated according to basal insulin resistance subgroups in patients non-diabetic and diabetic without pharmacological treatment (N = 642).

Results: Prevalence of undesirable postprandial TG was 35 % in non-diabetic, 48 % in prediabetic and 59 % in diabetic subgroup, respectively (p < 0.001). Interestingly, prediabetic patients displayed higher plasma TG and large triacylglycerol-rich lipoproteins (TRLs-TG) postprandial response compared with those non-diabetic patients (p < 0.001 and p = 0.003 respectively). Moreover, the area under the curve (AUC) of TG and AUC of TRLs-TG was greater in the prediabetic group compared with non-diabetic patients (p < 0.001 and p < 0.005 respectively). Patients with liver insulin resistance (liver-IR) showed higher postprandial response of TG compared with those patients with muscle-IR or without any insulin-resistance respectively (p < 0.001).

Conclusions: Our findings demonstrate that prediabetic patients show a lower phenotypic flexibility after external aggression, such as OFTT compared with nondiabetic patients. The postprandial response increases progressively according to non-diabetic, prediabetic and type 2 diabetic state and it is higher in patients with liver insulin-resistance. To identify this subgroup of patients is important to treat more intensively in order to avoid future cardiometabolic complications.

No MeSH data available.


Related in: MedlinePlus

Prevalence of undesirable postprandial triglycerides (TG) in the CORDIOPREV population according to diabetic status: non-diabetic, prediabetic and diabetic subgroups. The black bars represent the percentage of patients with postprandial TG concentration at any point >220 mg/dL within each group
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4837552&req=5

Fig1: Prevalence of undesirable postprandial triglycerides (TG) in the CORDIOPREV population according to diabetic status: non-diabetic, prediabetic and diabetic subgroups. The black bars represent the percentage of patients with postprandial TG concentration at any point >220 mg/dL within each group

Mentions: We explored the dynamic response during the OFTT in order to identify those subjects with undesirable postprandial TG concentration at any point >2.5 mmol/L or 220 mg/dL. Thus, the prevalence an unsiderable response after the OFTT was 35 % in non-diabetic, 48 % in prediabetic, and 59 % in diabetic subgroup (p < 0.001) (Fig. 1). After the OFTT, diabetic patients showed greater postprandial response of TG (p < 0.001) and large triacylglycerol-rich lipoproteins (TRLs)-TG (p = 0.002) compared with the prediabetic subgroup. Consistently, the AUC-TG and AUC TRLs-TG was significative greater in diabetic patients (p < 0.001 and p = 0.002 respectively) compared with those prediabetic patients (Table 2). Interestingly, prediabetic patients showed higher postprandial response compared with those non-diabetic (p < 0.001). Consequently, non-diabetic patients displayed lower postprandial response of TRLs-TG and AUC-TG, compared with prediabetic and diabetic patients, (p = 0.003 and p < 0.002) (Table 2).Fig. 1


Hepatic insulin resistance both in prediabetic and diabetic patients determines postprandial lipoprotein metabolism: from the CORDIOPREV study.

Leon-Acuña A, Alcala-Diaz JF, Delgado-Lista J, Torres-Peña JD, Lopez-Moreno J, Camargo A, Garcia-Rios A, Marin C, Gomez-Delgado F, Caballero J, Van-Ommen B, Malagon MM, Perez-Martinez P, Lopez-Miranda J - Cardiovasc Diabetol (2016)

Prevalence of undesirable postprandial triglycerides (TG) in the CORDIOPREV population according to diabetic status: non-diabetic, prediabetic and diabetic subgroups. The black bars represent the percentage of patients with postprandial TG concentration at any point >220 mg/dL within each group
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4837552&req=5

Fig1: Prevalence of undesirable postprandial triglycerides (TG) in the CORDIOPREV population according to diabetic status: non-diabetic, prediabetic and diabetic subgroups. The black bars represent the percentage of patients with postprandial TG concentration at any point >220 mg/dL within each group
Mentions: We explored the dynamic response during the OFTT in order to identify those subjects with undesirable postprandial TG concentration at any point >2.5 mmol/L or 220 mg/dL. Thus, the prevalence an unsiderable response after the OFTT was 35 % in non-diabetic, 48 % in prediabetic, and 59 % in diabetic subgroup (p < 0.001) (Fig. 1). After the OFTT, diabetic patients showed greater postprandial response of TG (p < 0.001) and large triacylglycerol-rich lipoproteins (TRLs)-TG (p = 0.002) compared with the prediabetic subgroup. Consistently, the AUC-TG and AUC TRLs-TG was significative greater in diabetic patients (p < 0.001 and p = 0.002 respectively) compared with those prediabetic patients (Table 2). Interestingly, prediabetic patients showed higher postprandial response compared with those non-diabetic (p < 0.001). Consequently, non-diabetic patients displayed lower postprandial response of TRLs-TG and AUC-TG, compared with prediabetic and diabetic patients, (p = 0.003 and p < 0.002) (Table 2).Fig. 1

Bottom Line: Moreover, the area under the curve (AUC) of TG and AUC of TRLs-TG was greater in the prediabetic group compared with non-diabetic patients (p < 0.001 and p < 0.005 respectively).Patients with liver insulin resistance (liver-IR) showed higher postprandial response of TG compared with those patients with muscle-IR or without any insulin-resistance respectively (p < 0.001).Our findings demonstrate that prediabetic patients show a lower phenotypic flexibility after external aggression, such as OFTT compared with nondiabetic patients.

View Article: PubMed Central - PubMed

Affiliation: Lipid and Atherosclerosis Unit, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain.

ABSTRACT

Background/aims: Previous evidences have shown the presence of a prolonged and exaggerated postprandial response in type 2 diabetes mellitus (T2DM) and its relation with an increase of cardiovascular risk. However, the response in prediabetes population has not been established. The objective was to analyze the degree of postprandial lipemia response in the CORDIOPREV clinical trial (NCT00924937) according to the diabetic status.

Methods: 1002 patients were submitted to an oral fat load test meal (OFTT) with 0.7 g fat/kg body weight [12 % saturated fatty acids (SFA), 10 % polyunsaturated fatty acids (PUFA), 43 % monounsaturated fatty acids (MUFA), 10 % protein and 25 % carbohydrates]. Serial blood test analyzing lipid fractions were drawn at 0, 1, 2, 3 and 4 h during postprandial state. Postprandial triglycerides (TG) concentration at any point >2.5 mmol/L (220 mg/dL) has been established as undesirable response. We explored the dynamic response in 57 non-diabetic, 364 prediabetic and 581 type 2 diabetic patients. Additionally, the postprandial response was evaluated according to basal insulin resistance subgroups in patients non-diabetic and diabetic without pharmacological treatment (N = 642).

Results: Prevalence of undesirable postprandial TG was 35 % in non-diabetic, 48 % in prediabetic and 59 % in diabetic subgroup, respectively (p < 0.001). Interestingly, prediabetic patients displayed higher plasma TG and large triacylglycerol-rich lipoproteins (TRLs-TG) postprandial response compared with those non-diabetic patients (p < 0.001 and p = 0.003 respectively). Moreover, the area under the curve (AUC) of TG and AUC of TRLs-TG was greater in the prediabetic group compared with non-diabetic patients (p < 0.001 and p < 0.005 respectively). Patients with liver insulin resistance (liver-IR) showed higher postprandial response of TG compared with those patients with muscle-IR or without any insulin-resistance respectively (p < 0.001).

Conclusions: Our findings demonstrate that prediabetic patients show a lower phenotypic flexibility after external aggression, such as OFTT compared with nondiabetic patients. The postprandial response increases progressively according to non-diabetic, prediabetic and type 2 diabetic state and it is higher in patients with liver insulin-resistance. To identify this subgroup of patients is important to treat more intensively in order to avoid future cardiometabolic complications.

No MeSH data available.


Related in: MedlinePlus