Differences in postprandial lipemia between patients with normal glucose tolerance and noninsulin-dependent diabetes mellitus.

Chen, Y D; Swami, Srilatha; Skowroński, Roman; Coulston, Ann M.; Reaven, G. M.

doi:10.1210/jcem.76.1.8421086

Cited by 76 publications

(69 citation statements)

References 27 publications

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“…Isolated lipoprotein fractions have a smaller inter-assay variance of 5 %. The intra-assay variance of ten repeated injections of retinyl acetate is 2 %, as we have demonstrated previously [2]. When vitamin A is given with lunch at noon, 4 h after a standard breakfast, the peak appearance of RP in plasma occurs 2--4 h post-lunch, and the majority of RP is present in the Sf > 400 fraction throughout most of the 10-h period of measurement with very little RP present in the Sf < 20 fraction until the end of the study (the 12th h).…”

Section: Methodssupporting

confidence: 77%

“…These results are of significant clinical relevance in that they demonstrate that the previously defined defect in the metabolism of triglyceride-rich lipoproteins in patients with NIDDM [2] can be at least partially reversed when glycaemic control is improved with glipizide. There is considerable evidence indicating that plasma triglyceride concentrations are higher than normal in patients with NIDDM [32], and that this change is associated with increased risk of CHD in these patients [33,34].…”

Section: Discussionmentioning

confidence: 63%

“…These data indicate that glipizide-induced improvement in glycaemic control was associated with changes in the metabolism of triglyceride-rich lipoproteins of intestinal origin that would be anticipated to reduce risk of coronary heart disease in non-insulin-dependent diabetic patients. [Diabetologia (1994) proteins of intestinal origin were higher in patients with NIDDM [2]. In 1979 Zilversmit [3] suggested that triglyceride-rich lipoproteins of intestinal origin, especially the cholesteryl ester-rich chylomicron remnants, could play a very important role in atherogenesis, and since then, several reports have been published supporting this hypothesis [4][5][6][7][8][9][10].…”

Section: Discussionmentioning

confidence: 99%

“…However, the link between a high plasma triglyceride concentration and CHD is far from obvious. For example, patients with NIDDM and/or hypertriglyceridaemia have been shown to have increases in plasminogen activator inhibitor-1 [35,36], smaller, denser LDL particles [37,38], and increased postprandial lipaemia [2,39]; changes which have been proposed as increasing the risk of CHD in non-diabetic subjects [3][4][5][6][7][8][9]. It seems reasonable to speculate that a similar relationship between these changes and CHD would also exist in patients with NIDDM.…”

Section: Discussionmentioning

confidence: 99%

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Effect of glipizide treatment on postprandial lipaemia in patients with NIDDM

et al. 1994

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SummaryThe primary goal of the present study was to examine the effects of improved glycaemic control associated with glipizide treatment on postprandial lipaemia in non-insulin-dependent diabetic patients. The metabolism of triglyceride-rich lipoproteins of intestinal origin was assessed by measuring the retinyl palmitate content in plasma and the Svedberg flotation index (Sf) > 400 and Sf 20-400 lipoprotein fractions. Fasting plasma glucose concentrations (14.5 + 0.5 vs 9.0 + 0.5 mmol/1), glycated haemoglobin levels (13.1 + 0.6 vs 9.7 _+ 0.6 %), and daylong plasma glucose concentrations were all significantly lower after glipizide treatment (p < 0.001). The improvement in glycaemic control was associated with increases in insulin-mediated glucose uptake (p < 0.001) and plasma post-heparin lipoprotein and hepatic lipolytic activities Go < 0.02). Both fasting plasma triglyceride (3.09 + 0.51 vs 2.37 + 0.34 mmol/1), and postprandial triglyceride concentrations (p < 0.05-0.001) were lower following glipizide treatment, associated with a significant fall in retinyl palmitate content in all three lipoprotein fractions (p < 0.02-0.001), with the most substantial decrease seen in the Sf 20-400 fraction. These data indicate that glipizide-induced improvement in glycaemic control was associated with changes in the metabolism of triglyceride-rich lipoproteins of intestinal origin that would be anticipated to reduce risk of coronary heart disease in non-insulin-dependent diabetic patients. [Diabetologia (1994) proteins of intestinal origin were higher in patients with NIDDM [2]. In 1979 Zilversmit [3] suggested that triglyceride-rich lipoproteins of intestinal origin, especially the cholesteryl ester-rich chylomicron remnants, could play a very important role in atherogenesis, and since then, several reports have been published supporting this hypothesis [4][5][6][7][8][9][10]. Thus, our observation that postprandial lipaemia was increased in NIDDM raised the possibility that abnormalities in the metabolism of intestinally-derived lipoproteins may contribute to the increased risk of CHD in these patients. Although we could not detect any correlation in our earlier paper between the magnitude of postprandial lipaemia and the level of glycaemic control, the crosssectional nature of the study protocol was not designed to carefully explore such a relationship. Consequently, we initiated the current study to see if improved glycaemic control associated with glipizide

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Section: Methodssupporting

confidence: 77%

Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effect of glipizide treatment on postprandial lipaemia in patients with NIDDM

et al. 1994

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“…While type I diabetes is characterized by impaired insulin secretion and elevated glycaemia requiring insulin infusion, type II diabetes is mainly characterized by insulin resistance and elevated insulin concentrations. Most nutritional studies performed in this field are performed with type II diabetes patients (Chen et al, 1993;Syvanne et al, 1994;Mero et al, 1998;Tentolouris et al, 2007). According to WHO standards, they show elevated glycaemia (47 mmol/l) and some degree of hyperinsulinaemia to compensate for acquired insulin resistance.…”

Section: Subjects At Disease Risk or Patientsmentioning

confidence: 99%

Methodology for studying postprandial lipid metabolism

2007

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Background: Postprandial lipid metabolism in humans has deserved much attention during the last two decades. Although fasting lipid and lipoprotein parameters reflect body homeostasis to some extent, the transient lipid and lipoprotein accumulation that occurs in the circulation after a fat-containing meal highlights the individual capacity to handle an acute fat input. An exacerbated postprandial accumulation of triglyceride-rich lipoproteins in the circulation has been associated with an increased cardiovascular risk. Methods: The important number of studies published in this field raises the question of the methodology used for such postprandial studies, as reviewed. Results: Based on our experiences, the present review reports and discuss the numerous methodological issues involved to serve as a basis for further works. These aspects include aims of the postprandial tests, size and nutrient composition of the test meals and background diets, pre-test conditions, characteristics of subjects involved, timing of sampling, suitable markers of postprandial lipid metabolism and calculations. Conclusion: In conclusion, we stress the need for standardization of postprandial tests.

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Fasting Compared With Nonfasting Triglycerides and Risk of Cardiovascular Events in Women

Bansal

Buring²,

Rifai³

et al. 2007

JAMA

1,407

994

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N CONTRAST TO TOTAL CHOLESterol, low-density lipoprotein cholesterol (LDL-C), and highdensity lipoprotein cholesterol (HDL-C), which are well-established independent risk factors for cardiovascular disease, 1 the importance of triglycerides remains controversial. In part this controversy reflects the fact that, due to the inverse correlation of triglyceride levels with those of HDL-C, adjustment for HDL-C attenuates the relationship between triglycerides and cardiovascular disease. A recent metaanalysis suggested that the adjusted risk ratio for coronary heart disease among individuals in the highest third of triglyceride levels compared with those in the lowest third decreases from approximately 2.0 to 1.5 after accounting for HDL-C levels. 2 A second aspect of the controversy stems from the manner in which triglyceride levels are typically measured. Current national guidelines recommend that blood for lipid profiles be drawn after an 8-to 12-hour fast. 1 Because plasma triglyceride levels can increase substantially postprandially, fasting levels ostensibly avoid the variability associated with meals and provide a See also pp 299 and 336.

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Differences in postprandial lipemia between patients with normal glucose tolerance and noninsulin-dependent diabetes mellitus.

Cited by 76 publications

References 27 publications

Effect of glipizide treatment on postprandial lipaemia in patients with NIDDM

Effect of glipizide treatment on postprandial lipaemia in patients with NIDDM

Methodology for studying postprandial lipid metabolism

Fasting Compared With Nonfasting Triglycerides and Risk of Cardiovascular Events in Women

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