Premium
Metabolism of chylomicrons in patients with congenital lipoatrophic diabetes: a study with emulsion models of chylomicrons
Author(s) -
Wajchenberg Bernardo L.,
Amâncio Rosângela F.,
Santomauro Ana T.,
Maranhão Raul C.
Publication year - 2004
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.2004.02103.x
Subject(s) - chylomicron , medicine , lipolysis , endocrinology , triglyceride , lipoprotein lipase , very low density lipoprotein , diabetes mellitus , lipoprotein , chemistry , postprandial , biology , cholesterol , adipose tissue
Summary background Lipoatrophic diabetes is characterized by the near absence of adipose tissue and the presence of insulin‐resistant diabetes. Fasting hypertriglyceridaemia and increased postprandial lipidaemia are also present, but the metabolism of chylomicrons, the triglyceride‐rich lipoproteins in the circulation that carry the dietary fats absorbed by the intestine, was not specifically investigated. Because both the activity of insulin‐dependent lipoprotein lipase that catalyses the chylomicron lipolysis and the storage of the lipolysis products are affected in the disease, it is important to evaluate how those changes may ultimately affect the chylomicron lipolysis and removal of chylomicron remnants from the circulation. objective The aim of the study was to evaluate the chylomicron intravascular metabolism in patients with lipoatrophic diabetes. patients S ix patients with lipoatrophic diabetes (four females, two males) aged 22·2 ± 4·4 years, with body mass index (BMI) 21·6 ± 3·6 kg/m 2 , were compared with 12 healthy control subjects (seven females, five males) aged 24·3 ± 2·1 years with BMI 22·5 ± 2·7 kg/m 2 . measurements The plasma kinetics of intravenously injected chylomicron‐like emulsions labelled with 3 H‐triglycerides ( 3 H‐TG) and with 14 C‐cholesteryl esters ( 14 C‐CE) were determined, the former tracing the chylomicron lipolysis by lipoprotein lipase and the latter the removal of chylomicron remnants from the plasma. results Triglyceride values (8·3 ± 9·2 mmol/l) in the patients were higher ( P < 0·005) and high density lipoprotein (HDL) cholesterol values (0·8 ± 0·2 mmol/l) lower ( P < 0·0005) than in controls (0·7 ± 0·2 and 1·3 ± 0·4 mmol/l, respectively) whereas total cholesterol, apoprotein B (apo B) and apo A1 were similar. The fractional clearance rate (FCR, in min −1 ) of 3 H‐TG was 0·014 ± 0·016 and the FCR of 14 C‐CE was 0·008 ± 0·012 in the patients and 0·046 ± 0·024 and 0·024 ± 0·012 in the controls, respectively ( P < 0·05). Thus FCRs of both emulsion labels were markedly reduced in the patients, indicating that lipolysis and remnant removal were diminished. Diminished remnant removal may be due to either deficient lipolysis or deficient removal mechanisms. conclusion The metabolism of chylomicrons tested by the emulsion method is impaired in lipoatrophic diabetes.