Effect of the inflammation, chronic hyperglycemia, or malabsorption on the apolipoprotein A-IV concentration in type 1 diabetes mellitus and in diabetes secondary to chronic pancreatitis.

Abstract

The metabolism of apolipoprotein (apo) A-IV in diabetes mellitus (DM) is poorly understood. Several factors, such as dietary fat intake, fat malabsorption, acute inflammation, and hormonal dysregulation can disturb the plasma apo A-IV concentration. We have compared the plasma apo A-IV concentrations in patients with type 1 DM and DM secondary to chronic pancreatitis to determine the effects of combinations of these factors. We examined 4 groups of male patients with chronic pancreatitis without diabetes (ND-CP) (n = 12), diabetes secondary to chronic pancreatitis and insulin-treated (CP-DM) (n = 32), type 1 diabetes (n = 25), and controls (n = 20). Plasma apo A-IV was significantly lower in the chronic pancreatitis patients (ND-CP and CP-DM) than in the other patients. Inflammatory proteins (fibrinogen, ceruloplasmin, and haptoglobin) were significantly elevated in the 2 chronic pancreatitis groups. The apo A-IV concentration was positively correlated with hemoglobin A(1c) (HbA(1c)) percentage in each group of diabetic patients (CP-DM, r =.35; P =.046; type 1 DM, r =.53; P =.010), in both groups of diabetic patients (r =.472; P <.0001) and negatively correlated with ceruloplasmin concentration in each group of diabetic patients (CP-DM, r = -.48; P =.0052; type 1 DM, r = -.66; P =.003), in both groups of diabetic patients (r = -.561; P <.0001), and in the whole population (r = -.463; P <.0001). Apo A-IV was also negatively correlated with haptoglobin in type 1 DM patients (r = -.434; P =.0435), in the both groups of diabetic patients (r = -.349; P =.0154), and in the whole population (r = -.351; P =.0019). Multiple linear regression analysis revealed that only HbA(1c) and ceruloplasmin were independent explanatory variables. Plasma apo A-IV is positively correlated with HbA(1c) suggesting that hyperglycemia per se selectively affects apo A-IV metabolism. The correlation between the concentrations of inflammatory protein and apo A-IV suggest a link between chronic inflammation and apo A-IV synthesis or catabolism. As apo A-IV is involved in reverse cholesterol transport, its low level in CP-DM may contribute to the accelerated development of atherosclerosis in these patients.

• Authors: D Quilliot, E Walters, B Guerci, J C Fruchart, P Duriez, P Drouin, O Ziegler
• Journal: Metabolism: clinical and experimental (Metabolism) Vol. 50 Issue 9 Pg. 1019-24 (Sep 2001) ISSN: 0026-0495 [Print] United States
• PMID: 11555832 (Publication Type: Clinical Trial, Comparative Study, Journal Article)
• Copyright: Copyright 2001 by W.B. Saunders Company

Chemical References

• Apolipoproteins A
• Biomarkers
• Blood Glucose
• Dietary Fats
• Glycated Hemoglobin A
• Haptoglobins
• apolipoprotein A-IV
• Fibrinogen
• Ceruloplasmin

Topics

• Adult
• Apolipoproteins A (blood)
• Biomarkers (blood)
• Blood Glucose (metabolism)
• Ceruloplasmin (metabolism)
• Chronic Disease
• Diabetes Mellitus, Type 1 (blood, diagnosis, etiology)
• Dietary Fats (metabolism)
• Fibrinogen (metabolism)
• Glycated Hemoglobin (metabolism)
• Haptoglobins (metabolism)
• Humans
• Hyperglycemia (blood, etiology)
• Inflammation (blood, complications)
• Linear Models
• Malabsorption Syndromes (blood, complications)
• Male
• Middle Aged
• Pancreatitis (blood, complications, diagnosis)
• Predictive Value of Tests