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Intensive insulin therapy reduces small dense low-density lipoprotein particles in patients with type 2 diabetes mellitus: relationship to triglyceride-rich lipoprotein subspecies.
Metabolism. 2006 Jul; 55(7):879-84.M

Abstract

It remains unclear whether insulin improves dyslipidemia in patients with type 2 diabetes mellitus. Small dense low-density lipoprotein (sd-LDL) particles are recognized as a powerful risk factor for coronary heart disease and are often elevated in type 2 diabetes mellitus. We examined the effect of intensive insulin therapy on sd-LDL particles and triglyceride (TG)-rich lipoprotein subspecies. Intensive insulin therapy (insulin aspart [NovoRapid, Tokyo, Japan] before each meal and isophane insulin suspension at bedtime) was given to poorly controlled type 2 diabetic patients (n = 46) who were on high doses of sulfonylureas. Fasting serum samples were collected before and 14 days after the commencement of insulin therapy. Low-density lipoprotein size was measured by gradient gel electrophoresis, and the small dense LDL cholesterol (sd-LDL-C) concentration was measured by a new precipitation method. Chylomicrons (Svedberg flotation unit >400), very low-density lipoprotein 1 (VLDL1) (Sf, 60-400), and VLDL2 (Sf, 20-60) were separated by ultracentrifugation. Serum apolipoprotein B-48 and lipoprotein lipase levels were measured by the enzyme immunoassay method. Serum glucose and glycoalbumin levels were substantially decreased by insulin treatment. The LDL size increased (25.8-26.0 nm, P < .05) and the sd-LDL-C level was significantly reduced (44-34 mg/dL, P < .005). Apolipoproteins B-48 and C-III were decreased, whereas lipoprotein lipase was increased. Triglyceride levels in chylomicrons, VLDL1, and VLDL2 all showed a decrease. Changes of sd-LDL-C or LDL size were associated with changes of the TG levels in the major TG-rich lipoprotein subspecies. These results suggest that intensive insulin therapy decreases atherogenic sd-LDL particles by reducing TG in TG-rich lipoproteins. We did not find any specific relationship between VLDL1 and sd-LDL during insulin treatment.

Authors+Show Affiliations

First Department of Internal Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8666, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16784958

Citation

Hayashi, Toshiyuki, et al. "Intensive Insulin Therapy Reduces Small Dense Low-density Lipoprotein Particles in Patients With Type 2 Diabetes Mellitus: Relationship to Triglyceride-rich Lipoprotein Subspecies." Metabolism: Clinical and Experimental, vol. 55, no. 7, 2006, pp. 879-84.
Hayashi T, Hirano T, Yamamoto T, et al. Intensive insulin therapy reduces small dense low-density lipoprotein particles in patients with type 2 diabetes mellitus: relationship to triglyceride-rich lipoprotein subspecies. Metabolism. 2006;55(7):879-84.
Hayashi, T., Hirano, T., Yamamoto, T., Ito, Y., & Adachi, M. (2006). Intensive insulin therapy reduces small dense low-density lipoprotein particles in patients with type 2 diabetes mellitus: relationship to triglyceride-rich lipoprotein subspecies. Metabolism: Clinical and Experimental, 55(7), 879-84.
Hayashi T, et al. Intensive Insulin Therapy Reduces Small Dense Low-density Lipoprotein Particles in Patients With Type 2 Diabetes Mellitus: Relationship to Triglyceride-rich Lipoprotein Subspecies. Metabolism. 2006;55(7):879-84. PubMed PMID: 16784958.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intensive insulin therapy reduces small dense low-density lipoprotein particles in patients with type 2 diabetes mellitus: relationship to triglyceride-rich lipoprotein subspecies. AU - Hayashi,Toshiyuki, AU - Hirano,Tsutomu, AU - Yamamoto,Takeshi, AU - Ito,Yasuki, AU - Adachi,Mitsuru, PY - 2005/08/29/received PY - 2006/02/03/accepted PY - 2006/6/21/pubmed PY - 2006/8/10/medline PY - 2006/6/21/entrez SP - 879 EP - 84 JF - Metabolism: clinical and experimental JO - Metabolism VL - 55 IS - 7 N2 - It remains unclear whether insulin improves dyslipidemia in patients with type 2 diabetes mellitus. Small dense low-density lipoprotein (sd-LDL) particles are recognized as a powerful risk factor for coronary heart disease and are often elevated in type 2 diabetes mellitus. We examined the effect of intensive insulin therapy on sd-LDL particles and triglyceride (TG)-rich lipoprotein subspecies. Intensive insulin therapy (insulin aspart [NovoRapid, Tokyo, Japan] before each meal and isophane insulin suspension at bedtime) was given to poorly controlled type 2 diabetic patients (n = 46) who were on high doses of sulfonylureas. Fasting serum samples were collected before and 14 days after the commencement of insulin therapy. Low-density lipoprotein size was measured by gradient gel electrophoresis, and the small dense LDL cholesterol (sd-LDL-C) concentration was measured by a new precipitation method. Chylomicrons (Svedberg flotation unit >400), very low-density lipoprotein 1 (VLDL1) (Sf, 60-400), and VLDL2 (Sf, 20-60) were separated by ultracentrifugation. Serum apolipoprotein B-48 and lipoprotein lipase levels were measured by the enzyme immunoassay method. Serum glucose and glycoalbumin levels were substantially decreased by insulin treatment. The LDL size increased (25.8-26.0 nm, P < .05) and the sd-LDL-C level was significantly reduced (44-34 mg/dL, P < .005). Apolipoproteins B-48 and C-III were decreased, whereas lipoprotein lipase was increased. Triglyceride levels in chylomicrons, VLDL1, and VLDL2 all showed a decrease. Changes of sd-LDL-C or LDL size were associated with changes of the TG levels in the major TG-rich lipoprotein subspecies. These results suggest that intensive insulin therapy decreases atherogenic sd-LDL particles by reducing TG in TG-rich lipoproteins. We did not find any specific relationship between VLDL1 and sd-LDL during insulin treatment. SN - 0026-0495 UR - https://www.unboundmedicine.com/medline/citation/16784958/Intensive_insulin_therapy_reduces_small_dense_low_density_lipoprotein_particles_in_patients_with_type_2_diabetes_mellitus:_relationship_to_triglyceride_rich_lipoprotein_subspecies_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0026-0495(06)00076-X DB - PRIME DP - Unbound Medicine ER -