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Effects of continuous insulin infusion therapy on lipoprotein surface and core lipid composition in insulin-dependent diabetes mellitus.
Metabolism. 1991 May; 40(5):445-9.M

Abstract

To determine whether intensive insulin therapy has the same beneficial effects on lipoprotein composition that it has been shown to have in insulin-dependent diabetes mellitus (IDDM) on the routinely measured plasma lipids, we studied 10 patients after 6 months of conventional therapy (CIT) and again after 6 months of therapy with continuous subcutaneous insulin infusion (CSII). While the mean of home blood glucose levels (8.1 +/- 0.5 v 7.9 +/- 0.5 mmol/L) decreased no further, plasma triglycerides (TG) (CIT, 102.7 +/- 25.0; CSII, 89.6 +/- 27.1 mg/dL; P less than .001) decreased after CSII, and high-density lipoprotein cholesterol (HDL-C) increased significantly, primarily as a consequence of an increase in HDL2 (CIT, 12.2 +/- 6.0; CSII, 18.1 +/- 6.3 mg/dL; P less than .02). Low-density lipoprotein cholesterol (LDL-C) was unchanged (CIT, 82.2 +/- 32; CSII, 84.0 +/- 27.8 mg/dL). After CIT, two indices of lipoprotein surface composition were altered: (1) the free cholesterol (FC) to lecithin ratio, which is a new cardiovascular risk factor, was abnormally increased in plasma, very-low-density lipoprotein (VLDL) + LDL, and HDL, and (2) the sphingomyelin to lecithin ratio, an index of the surface rigidity of lipoproteins, was increased in the HDL subfractions. While CSII treatment resulted in favorable changes in whole plasma lipids, it failed to correct these disturbances in composition. Since the participation of lipoproteins in certain steps in reverse cholesterol transport appears to be impaired when their surface constituents are altered, persistence of these disturbances may sustain the increased cardiovascular risk of IDDM patients, even when their clinical control is very good and their plasma lipids are normal.

Authors+Show Affiliations

Bagdade JD
Department of Medicine, Rush Medical College, Chicago, IL.
Helve E
No affiliation info available
Taskinen MR
No affiliation info available

MeSH

AdultCholesterolCholesterol, HDLDiabetes Mellitus, Type 1FemaleHumansInjectionsInsulinInsulin Infusion SystemsLipidsLipoproteinsMaleOsmolar ConcentrationPhosphatidylcholinesPhospholipids

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

2023530

Citation

Bagdade, J D., et al. "Effects of Continuous Insulin Infusion Therapy On Lipoprotein Surface and Core Lipid Composition in Insulin-dependent Diabetes Mellitus." Metabolism: Clinical and Experimental, vol. 40, no. 5, 1991, pp. 445-9.
Bagdade JD, Helve E, Taskinen MR. Effects of continuous insulin infusion therapy on lipoprotein surface and core lipid composition in insulin-dependent diabetes mellitus. Metabolism. 1991;40(5):445-9.
Bagdade, J. D., Helve, E., & Taskinen, M. R. (1991). Effects of continuous insulin infusion therapy on lipoprotein surface and core lipid composition in insulin-dependent diabetes mellitus. Metabolism: Clinical and Experimental, 40(5), 445-9.
Bagdade JD, Helve E, Taskinen MR. Effects of Continuous Insulin Infusion Therapy On Lipoprotein Surface and Core Lipid Composition in Insulin-dependent Diabetes Mellitus. Metabolism. 1991;40(5):445-9. PubMed PMID: 2023530.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of continuous insulin infusion therapy on lipoprotein surface and core lipid composition in insulin-dependent diabetes mellitus. AU - Bagdade,J D, AU - Helve,E, AU - Taskinen,M R, PY - 1991/5/1/pubmed PY - 1991/5/1/medline PY - 1991/5/1/entrez SP - 445 EP - 9 JF - Metabolism: clinical and experimental JO - Metabolism VL - 40 IS - 5 N2 - To determine whether intensive insulin therapy has the same beneficial effects on lipoprotein composition that it has been shown to have in insulin-dependent diabetes mellitus (IDDM) on the routinely measured plasma lipids, we studied 10 patients after 6 months of conventional therapy (CIT) and again after 6 months of therapy with continuous subcutaneous insulin infusion (CSII). While the mean of home blood glucose levels (8.1 +/- 0.5 v 7.9 +/- 0.5 mmol/L) decreased no further, plasma triglycerides (TG) (CIT, 102.7 +/- 25.0; CSII, 89.6 +/- 27.1 mg/dL; P less than .001) decreased after CSII, and high-density lipoprotein cholesterol (HDL-C) increased significantly, primarily as a consequence of an increase in HDL2 (CIT, 12.2 +/- 6.0; CSII, 18.1 +/- 6.3 mg/dL; P less than .02). Low-density lipoprotein cholesterol (LDL-C) was unchanged (CIT, 82.2 +/- 32; CSII, 84.0 +/- 27.8 mg/dL). After CIT, two indices of lipoprotein surface composition were altered: (1) the free cholesterol (FC) to lecithin ratio, which is a new cardiovascular risk factor, was abnormally increased in plasma, very-low-density lipoprotein (VLDL) + LDL, and HDL, and (2) the sphingomyelin to lecithin ratio, an index of the surface rigidity of lipoproteins, was increased in the HDL subfractions. While CSII treatment resulted in favorable changes in whole plasma lipids, it failed to correct these disturbances in composition. Since the participation of lipoproteins in certain steps in reverse cholesterol transport appears to be impaired when their surface constituents are altered, persistence of these disturbances may sustain the increased cardiovascular risk of IDDM patients, even when their clinical control is very good and their plasma lipids are normal. SN - 0026-0495 UR - https://www.unboundmedicine.com/medline/citation/2023530/Effects_of_continuous_insulin_infusion_therapy_on_lipoprotein_surface_and_core_lipid_composition_in_insulin_dependent_diabetes_mellitus_ DB - PRIME DP - Unbound Medicine ER -