Insulin sensitivity and Lp(α) concentrations in normoglycemic offspring of type 2 diabetic parents
Lipids in Health and Disease
Insulin sensitivity and Lp() concentrations in normoglycemic offspring of type 2 diabetic parents
Agathoklis Psyrogiannis 0
Ioannis Habeos 0
Venetsana Kyriazopoulou 0
0 Address: Division of Endocrinology and Diabetes, Department of Medicine, University of Patras Medical School , Patras , Greece
Background: Offspring of at least 1 parent with type 2 diabetes are more resistant to the insulin action, exhibit higher incidence of dyslipidemia and are more prone to cardiovascular diseases. The association between Lp() and coronary heart disease is well established. An association between Lp() concentration and insulin sensitivity was examined in this study. We investigated the serum LP() in 41 offspring of 41 families of type 2 diabetic subjects (group I) with normal glucose tolerance, compared to 49 offspring who their parents had no history of type 2 diabetes, matched for sex, age, BMI, WHR and blood pressure (group II). Serum Lp(), triglycerides, insulin resistant index, HDL, LDL-cholesterol and insulin were measured. Results: The offspring of type 2 diabetic subjects had higher fasting serum triglycerides (mean SD 199.3 184.2 vs. 147.1 67.9 ng/dl, p < 0.05) lower HDL-cholesterol (37.3 9.0 vs. 44.6 7.8, p < 0.001) and particularly higher Insulin resistance Index (HOMA-IR) (2.84 1.39 vs. 1.67 0.77, p < 0.001). They also had higher serum LP() concentration (15.4 6.7 vs. 8.6 6.0, p < 0.001). By simple linear analysis in the offspring of type 2 diabetic parents there was no correlation of Lp() concentration with insulin resistance index Homa-IR (r = 0,016 p = NS). Conclusions: We conclude that serum LP() is significantly increased in offspring of type 2 diabetic subjects but was not related to insulin sensitivity.
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Background
Patients with type 2 diabetes mellitus are characterized by
resistance to insulin-stimulated glucose uptake [1,2],
dyslipidemia (especially increased triglyceride and decreased
high-density lipoprotein (HDL) levels [3,4], hypertension
[5] and coronary heart disease [6,7].
Lipoprotein () [Lp()], first described by Berg [8] in
1963, is a low density lipoprotein (LDL) like substance
with a specific apoprotein, apoprotein () [apo ()],
bound to apo- 100 by disulfide bridges [9,10].
Numerous studies have suggested that lipoprotein ()
concentrations may be an independent risk factor for
coronary heart disease [1115]. However, the molecular
mechanism by which Lp() might promote
atherosclerosis has not been clarified.
Triglyceride (mg/dl)
Cholesterol (mg/dl)
HDL-cholesterol (mg/dl)
LDL-cholesterol (mg/dl)
Lp() (mg/dl)
The relationship of Lp() concentrations with insulin
resistance remains controversial. Some studies have
showed increase Lp() concentration in subjects with
NIDDM [1618] whereas other studies have showed
similar Lp() concentrations in type 2 diabetic subjects
compared with normoglycemic subjects[19]. In other studies
of nondiabetic subjects, insulin concentrations have not
been associated with Lp() concentrations [20,21]. One
study showed no elevated Lp() concentrations in
normoglycemic insulin-resistant subjects [22].
In this report, we examine the association of Lp()
concentrations to insulin sensitivity, calculated using the
Homeostasis model Assessment (HOMA-IRI) in
normoglycemic offspring of at least 1 parent with type 2 diabetes.
Results
The clinical characteristics of the study population are
shown in Table 1 and the laboratory profile of the study
population are shown in Table 2.
The group of offspring with type 2 diabetes parents as well
as the control group had a similar distribution of age, sex,
BMI, WHR systolic and diastolic BP. As expected the mean
fasting serum triglycerides, cholesterol, and
LDL-cholesterol were significantly higher in group 1 compared to the
control group. HDL-cholesterol was significantly lower in
group 1 compared to the control group.
The glucose and insulin concentrations in the fasting state
and after an oral glucose challenge are shown in Table 3.
The mean fasting glucose and insulin concentrations were
significantly higher in group I compared to group 2:
fasting glucose: 4.5 0.6 vs. 4.3 0.6 mmol/l (p < 0.05)
fasting insulin: 14.0 6.4 vs. 8.6 3.2 U/ml (p < 0.005)
Serum insulin concentration 30 min post glucose
challenge was significantly higher in the offspring group 1
(122.2 94.3 vs. 81.7 51.6 U/ml, p < 0.005) as well at
60 min post glucose challenge (134.4 103.1 vs. 99.9
48.9 U/ml, p < 0.05) whereas there was no difference at
120 min.
In the offspring of the diabetic parents the insulin
resistance index was significantly higher compared to control
group (2.84 1.39 vs. 1.67 0.77, p < 0.001). 22 (53.6%)
of the 41 subjects of group 1, had HOMA-IR values > 2.5
indicating that they were insulin resistant [2329],
compared to only 6 (12.2%) of the 49 subjects of group 2.
Lp() concentration was significantly higher in group 1
compared to group 2 (15.4 6.7 vs. 8.6 6.0 ng/dl, p <
0.001).
In (...truncated)