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Determinants of mild fasting hypertriglyceridaemia in non‐insulin‐dependent diabetes
Author(s) -
BAYNES C.,
HENDERSON A. D.,
HUGHES C. L.,
RICHMOND W.,
JOHNSTON D. G.,
ELKELES R. S.
Publication year - 1991
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.1991.tb00343.x
Subject(s) - nefa , medicine , endocrinology , triglyceride , hypertriglyceridemia , insulin , postprandial , basal (medicine) , diabetes mellitus , type 2 diabetes , apolipoprotein b , body mass index , lipoprotein lipase , obesity , cholesterol , adipose tissue
. Factors contributing to fasting hypertriglyceridaemia were studied in 20 patients with non‐insulin‐dependent diabetes—nine with normal triglyceride concentrations [fasting triglyceride 0.94 (range 0.58–1.23) mmol l −1 ] and eleven with mild fasting hypertriglyceridaemia [fasting triglyceride 2.4 (1.82–4.0) mmol l −1 ]. The patients with hypertriglyceridaemia were more obese [body mass index 29.0 (24.6–33.8) vs. 25.7 (21.9–30.1) kg m −2 , P < 0.05] and demonstrated impaired glucose disposal in response to exogenous insulin at isoglycaemia [insulin sensitivity index, SIp 0.7 (0.27–2.5) vs. 2.4 (0.62–5.1) ml m −2 min per mU l −1 , P < 0.01]. Basal non‐esterified fatty acid (NEFA) and glycerol concentrations were higher and were suppressed to a lesser extent during isoglycaemic hyperinsulinaemia. Fasting glucose and apolipoprotein B concentrations were higher in the hypertriglyceridaemic patients, but lipoprotein lipase activities were similar in the two groups. When the effect of obesity was removed (by weight‐matching six normotriglyceridaemic with seven hypertriglyceridaemic patients) basal NEFA and glycerol concentrations and the suppression of NEFA in response to insulin remained significantly different between the two groups. We propose that defects in both the glucoregulatory and antilipolytic actions of insulin contribute to mild fasting hypertriglyceridaemia in NIDDM, and that these defects cannot be attributed solely to obesity. These disorders of insulin action may also have important implications for the postprandial metabolism of triglyceride‐rich lipoproteins and hence atherogenesis.