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Lipoprotein metabolism in patients with type 1 diabetes under intensive insulin treatment

BACKGROUND: Type 1 diabetes (T1DM) is frequently accompanied by dyslipidemia related with insulin-dependent steps of the intravascular lipoprotein metabolism. T1DM dyslipidemia may predispose to precocious cardiovascular disease and the lipid status in T1DM under intensive insulin treatment has not...

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Autores principales: Feitosa, Alina C R, Feitosa-Filho, Gilson S, Freitas, Fatima R, Wajchenberg, Bernardo L, Maranhão, Raul C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3599880/
https://www.ncbi.nlm.nih.gov/pubmed/23398881
http://dx.doi.org/10.1186/1476-511X-12-15
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author Feitosa, Alina C R
Feitosa-Filho, Gilson S
Freitas, Fatima R
Wajchenberg, Bernardo L
Maranhão, Raul C
author_facet Feitosa, Alina C R
Feitosa-Filho, Gilson S
Freitas, Fatima R
Wajchenberg, Bernardo L
Maranhão, Raul C
author_sort Feitosa, Alina C R
collection PubMed
description BACKGROUND: Type 1 diabetes (T1DM) is frequently accompanied by dyslipidemia related with insulin-dependent steps of the intravascular lipoprotein metabolism. T1DM dyslipidemia may predispose to precocious cardiovascular disease and the lipid status in T1DM under intensive insulin treatment has not been sufficiently explored. The aim was to investigate the plasma lipids and the metabolism of LDL and HDL in insulin-treated T1DM patients with high glycemic levels. METHODS: Sixteen male patients with T1DM (26 ± 7 yrs) with glycated hemoglobin >7%, and 15 control subjects (28 ± 6 yrs) were injected with a lipid nanoemulsion (LDE) resembling LDL and labeled with (14)C-cholesteryl ester and (3)H-free-cholesterol for determination of fractional clearance rates (FCR, in h(-1)) and cholesterol esterification kinetics. Transfer of labeled lipids from LDE to HDL was assayed in vitro. RESULTS: LDL-cholesterol (83 ± 15 vs 100 ± 29 mg/dl, p=0.08) tended to be lower in T1DM than in controls; HDL-cholesterol and triglycerides were equal. LDE marker (14)C-cholesteryl ester was removed faster from plasma in T1DM patients than in controls (FCR=0.059 ± 0.022 vs 0.039 ± 0.022h-1, p=0.019), which may account for their lower LDL-cholesterol levels. Cholesterol esterification kinetics and transfer of non-esterified and esterified cholesterol, phospholipids and triglycerides from LDE to HDL were also equal. CONCLUSION: T1DM patients under intensive insulin treatment but with poor glycemic control had lower LDL-cholesterol with higher LDE plasma clearance, indicating that LDL plasma removal was even more efficient than in controls. Furthermore, HDL-cholesterol and triglycerides, cholesterol esterification and transfer of lipids to HDL, an important step in reverse cholesterol transport, were all normal. Coexistence of high glycemia levels with normal intravascular lipid metabolism may be related to differences in exogenous insulin bioavailabity and different insulin mechanisms of action on glucose and lipids. Those findings may have important implications for prevention of macrovascular disease by intensive insulin treatment.
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spelling pubmed-35998802013-03-17 Lipoprotein metabolism in patients with type 1 diabetes under intensive insulin treatment Feitosa, Alina C R Feitosa-Filho, Gilson S Freitas, Fatima R Wajchenberg, Bernardo L Maranhão, Raul C Lipids Health Dis Research BACKGROUND: Type 1 diabetes (T1DM) is frequently accompanied by dyslipidemia related with insulin-dependent steps of the intravascular lipoprotein metabolism. T1DM dyslipidemia may predispose to precocious cardiovascular disease and the lipid status in T1DM under intensive insulin treatment has not been sufficiently explored. The aim was to investigate the plasma lipids and the metabolism of LDL and HDL in insulin-treated T1DM patients with high glycemic levels. METHODS: Sixteen male patients with T1DM (26 ± 7 yrs) with glycated hemoglobin >7%, and 15 control subjects (28 ± 6 yrs) were injected with a lipid nanoemulsion (LDE) resembling LDL and labeled with (14)C-cholesteryl ester and (3)H-free-cholesterol for determination of fractional clearance rates (FCR, in h(-1)) and cholesterol esterification kinetics. Transfer of labeled lipids from LDE to HDL was assayed in vitro. RESULTS: LDL-cholesterol (83 ± 15 vs 100 ± 29 mg/dl, p=0.08) tended to be lower in T1DM than in controls; HDL-cholesterol and triglycerides were equal. LDE marker (14)C-cholesteryl ester was removed faster from plasma in T1DM patients than in controls (FCR=0.059 ± 0.022 vs 0.039 ± 0.022h-1, p=0.019), which may account for their lower LDL-cholesterol levels. Cholesterol esterification kinetics and transfer of non-esterified and esterified cholesterol, phospholipids and triglycerides from LDE to HDL were also equal. CONCLUSION: T1DM patients under intensive insulin treatment but with poor glycemic control had lower LDL-cholesterol with higher LDE plasma clearance, indicating that LDL plasma removal was even more efficient than in controls. Furthermore, HDL-cholesterol and triglycerides, cholesterol esterification and transfer of lipids to HDL, an important step in reverse cholesterol transport, were all normal. Coexistence of high glycemia levels with normal intravascular lipid metabolism may be related to differences in exogenous insulin bioavailabity and different insulin mechanisms of action on glucose and lipids. Those findings may have important implications for prevention of macrovascular disease by intensive insulin treatment. BioMed Central 2013-02-11 /pmc/articles/PMC3599880/ /pubmed/23398881 http://dx.doi.org/10.1186/1476-511X-12-15 Text en Copyright ©2013 Feitosa et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Feitosa, Alina C R
Feitosa-Filho, Gilson S
Freitas, Fatima R
Wajchenberg, Bernardo L
Maranhão, Raul C
Lipoprotein metabolism in patients with type 1 diabetes under intensive insulin treatment
title Lipoprotein metabolism in patients with type 1 diabetes under intensive insulin treatment
title_full Lipoprotein metabolism in patients with type 1 diabetes under intensive insulin treatment
title_fullStr Lipoprotein metabolism in patients with type 1 diabetes under intensive insulin treatment
title_full_unstemmed Lipoprotein metabolism in patients with type 1 diabetes under intensive insulin treatment
title_short Lipoprotein metabolism in patients with type 1 diabetes under intensive insulin treatment
title_sort lipoprotein metabolism in patients with type 1 diabetes under intensive insulin treatment
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3599880/
https://www.ncbi.nlm.nih.gov/pubmed/23398881
http://dx.doi.org/10.1186/1476-511X-12-15
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