Impaired fasting glucose and impaired glucose tolerance have distinct lipoprotein and apolipoprotein changes: the insulin resistance atherosclerosis study.

Abstract

CONTEXT:

Cardiovascular risk is increased in individuals with impaired glucose tolerance (IGT) and impaired fasting glucose (IFG); however, those with IGT appear to be at greater risk. Lipoprotein abnormalities occur also in the prediabetic state.

OBJECTIVE:

The authors examined lipoprotein composition in IGT and IFG.

DESIGN AND SETTING:

Cross-sectional analysis of a large epidemiological study was done.

PARTICIPANTS:

The Insulin Resistance Atherosclerosis Study had a total of 1107 participants.

MAIN MEASURES:

Lipoproteins and apolipoproteins were measured by conventional methods and lipoprotein composition by nuclear magnetic resonance spectroscopy.

RESULTS:

Compared with normal glucose tolerance, apolipoprotein B (105.2 vs 99.8 mg/dL, P < .05) was high in isolated IFG, triglyceride (1.48 vs 1.16 mmol/L, P < .001) was high in isolated IGT, and high-density lipoprotein cholesterol was low in combined IFG/IGT (1.12 vs 1.26 mmol/L, P < .001). Nuclear magnetic resonance spectroscopy revealed additional changes: increased total low-density lipoprotein (LDL) particles (1190 vs 1096 nmol/L, P < .01) in isolated IFG; increased large very-low-density lipoprotein (3.61 vs 2.47 nmol/L, P < .01) and small LDL subclass particles (665 vs 541 nmol/L, P < .05) and decreased large LDL subclass particles (447 vs 513 nmol/L, P < .01) in isolated IGT; and decreased large high-density lipoprotein subclass particles in combined IFG/IGT (4.24 vs 5.39 μmol/L, P < .001).

CONCLUSIONS:

Isolated IFG is characterized by increased apolipoprotein B and total LDL particles, whereas isolated IGT is associated with increased triglycerides, large very-low-density lipoprotein subclass particles, and structural remodeling of LDL particles. These results may help to explain differences in cardiovascular disease risk in the prediabetic state.

• Authors: Carlos Lorenzo, Sara Hartnett, Anthony J Hanley, Marian J Rewers, Lynne E Wagenknecht, Andrew J Karter, Steven M Haffner
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 98 Issue 4 Pg. 1622-30 (Apr 2013) ISSN: 1945-7197 [Electronic] United States
• PMID: 23450048 (Publication Type: Journal Article, Multicenter Study, Research Support, N.I.H., Extramural)

Chemical References

• Apolipoproteins
• Blood Glucose
• Lipoproteins

Topics

• Adult
• Aged
• Apolipoproteins (blood, metabolism)
• Atherosclerosis (blood, etiology, metabolism)
• Blood Glucose (metabolism)
• Case-Control Studies
• Cross-Sectional Studies
• Fasting (blood, metabolism)
• Female
• Glucose Intolerance (blood, metabolism)
• Humans
• Insulin Resistance (physiology)
• Lipoproteins (blood, metabolism)
• Male
• Middle Aged
• Prediabetic State (blood, metabolism)