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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

Evolution of (a) triglycerides (TG) and (b) large triacylglycerol-rich lipoproteins (TRLs)-TG after the oral fat tolerance test, according to the presence of prediabetes, non-diabetes or diabetes state. Results are plotted as mean ± SD. Variables were compared using repeated measured ANOVA, with age, gender and BMI as covariates
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Fig2: Evolution of (a) triglycerides (TG) and (b) large triacylglycerol-rich lipoproteins (TRLs)-TG after the oral fat tolerance test, according to the presence of prediabetes, non-diabetes or diabetes state. Results are plotted as mean ± SD. Variables were compared using repeated measured ANOVA, with age, gender and BMI as covariates

Mentions: In addition, the magnitude of the postprandial response increased progressively in relation to non-diabetic, prediabetic and diabetic state groups (p < 0.001) (Fig. 2a, b). Moreover, AUC-TG and AUC TRLs-TG showed the same effect (p < 0.001 and p < 0.001 respectively) (Table 2). Likewise, diabetic patients compared with prediabetic and non-diabetic subgroups showed higher increase of AUC (iAUC) of TG and iAUC-TRLs-TG (p < 0.001 and p = 0.04 respectively).Fig. 2


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)

Evolution of (a) triglycerides (TG) and (b) large triacylglycerol-rich lipoproteins (TRLs)-TG after the oral fat tolerance test, according to the presence of prediabetes, non-diabetes or diabetes state. Results are plotted as mean ± SD. Variables were compared using repeated measured ANOVA, with age, gender and BMI as covariates
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig2: Evolution of (a) triglycerides (TG) and (b) large triacylglycerol-rich lipoproteins (TRLs)-TG after the oral fat tolerance test, according to the presence of prediabetes, non-diabetes or diabetes state. Results are plotted as mean ± SD. Variables were compared using repeated measured ANOVA, with age, gender and BMI as covariates
Mentions: In addition, the magnitude of the postprandial response increased progressively in relation to non-diabetic, prediabetic and diabetic state groups (p < 0.001) (Fig. 2a, b). Moreover, AUC-TG and AUC TRLs-TG showed the same effect (p < 0.001 and p < 0.001 respectively) (Table 2). Likewise, diabetic patients compared with prediabetic and non-diabetic subgroups showed higher increase of AUC (iAUC) of TG and iAUC-TRLs-TG (p < 0.001 and p = 0.04 respectively).Fig. 2

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