Abstract-This study was performed in 36 healthy volunteers to define the relationship between plasma concentrations of partially oxidized low density lipoprotein (poxLDL), plasma glucose and insulin responses to oral glucose, and steady-state plasma glucose (SSPG) concentrations after a 180-minute infusion of somatostatin, insulin, and glucose. The concentration of poxLDL was estimated by determining the amount of conjugated dienes formed during in vitro LDL oxidation in the presence or absence of alanine. Under these conditions, the greater the in vitro antioxidant effect of alanine, the lower the amount of poxLDL that was present in plasma. Key Words: oxidized LDL Ⅲ insulin resistance Ⅲ cardiovascular disease risk factors P revious reports from our laboratory have emphasized the potential link between insulin resistance, a cluster of associated abnormalities, and atherosclerosis in nondiabetic subjects.1,2 An important component of the metabolic abnormalities associated with insulin resistance is a change in LDL particle diameter, leading to the presence of smaller and denser LDL particles.3 Given the fact that such particles are more easily oxidized, 4 it seemed to be of great interest to know whether there were any associations between insulin resistance and the oxidative states of circulating LDL. Approaching this problem is complicated by the fact that oxLDL has been detected in the arterial wall, but not in the circulation.5 LDL oxidation has usually been assessed by determining the formation of thiobarbituric acid-reactive compounds or by the lag time for conjugated-diene formation during copper oxidation-methods that do not permit determination of the oxidized state of LDL present in the circulation. 6 In an effort to overcome this problem, Picard et al 7 have described a sensitive and reproducible method to quantify the oxidized state of LDL present in the circulation on the basis of the antioxidant properties of alanine. This effect of alanine depends on the amount of peroxides present in LDL and the fact that the greater the amount of peroxides in LDL, the less the antioxidant effect of alanine. Thus, by quantifying the antioxidant effect of alanine on isolated LDL, it is possible to gain an estimate of the amount of poxLDL that is present in the circulation. Picard et al 7 used this method to show that LDL oxidation was increased in patients with type 2 diabetes who had evidence of atherosclerosis but absent in diabetic subjects with no apparent vascular disease. Since there is increasing evidence 1,2,8 that insulin resistance or compensatory hyperinsulinemia is associated with a variety of CHD risk factors, we initiated the current study to see whether there was any relationship between the resistance of insulinmediated glucose disposal or the metabolic variables associated with insulin resistance and the amount of poxLDL in nondiabetic volunteers, all of whom were in general good health.
MethodsThe study population consisted of 36 healthy volunteers, 14 men and 22 women, who responded to a newspap...