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Increased Cholesteryl Ester Transfer Protein and Changes in Lipid Metabolism from Initiating Insulin Therapy
Author(s) -
AI MASUMI,
TANAKA AKIRA,
BABA TOSHIYA,
YUI KATSUMASA,
NUMANO FUJIO
Publication year - 2001
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.2001.tb03962.x
Subject(s) - cholesterylester transfer protein , medicine , endocrinology , insulin , hyperinsulinemia , cholesterol , apolipoprotein b , glycemic , chemistry , lipoprotein , insulin resistance
A bstract : Insulin therapy is often necessary for glycemic control, and its effect on plasma lipids is an important issue with respect to arteriosclerosis. Previous reports suggested that increased cholesteryl ester transfer protein (CETP) appeared in diabetic patients with hyperinsulinemia or given a lot of insulin is atherogenic. We investigated whether insulin always increases CETP and whether increased CETP by insulin is always atherogenic. In 40 patients the amount and activity of CETP were assessed before and 2 weeks after initiation of insulin therapy. After starting insulin, plasma concentrations of total cholesterol, triglycerides, LDL‐cholesterol, and remnant lipoprotein cholesterol decreased. No change occurred in HDL‐cholesterol. Starting insulin therapy increased the amount and activity of CETP. No significant correlation was observed between changes in CETP and in lipids including HDL‐cholesterol or apolipoprotein concentrations. This is the first prospective study to show increased CETP activity after initiation of insulin therapy. After initiating insulin, CETP increases without accompanying atherogenic changes in lipid metabolism. Based on the changes observed, CETP in itself does not have atherogenicity and the increase, but no excess, of CETP by appropriate insulin therapy cannot be atherogenic.