Basal and insulin mediated VLDL-triglyceride kinetics in type 2 diabetic men

Lars P Sørensen, Iben Rahbek Andersen, Svend Erik Larsen, Esben Søndergaard, Lars C Gormsen, Ole Schmitz, Jens S Christiansen, Søren Nielsen

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    Abstract

    AbstractObjective. Increased VLDL-TG concentration is a central feature of diabetic dyslipidemia. The objective was to compare basal and insulin mediated VLDL-TG kinetics, oxidation, and adipose tissue storage in type 2 diabetic and healthy men. Research Design and Methods. Eleven type 2 diabetic and 11 healthy men, matched for BMI and age, were included. Ex vivo-labeled VLDL-TG tracers, blood- and breath samples, fat biopsies, indirect calorimetry, and body composition measures were applied to determine VLDL-TG kinetics, VLDL-TG FA oxidation, and -storage in regional adipose tissue before and during a hyperinsulinemic euglycaemic clamp. Results. VLDL-TG secretion was significantly greater in diabetic compared with healthy men (Basal: 86.9 (31.0) vs. 61.9 (30.0) μmol/min, p=0.03; Clamp: 60.0 (26.2) vs. 34.2 (17.9) μmol·min(-1), p=0.01). The insulin mediated suppression of VLDL-TG secretion was significant in both groups. VLDL-TG clearance was lower in diabetic men (Basal: 84.6 (32.7) vs. 115.4 (44.3) ml·min(-1), p=0.08; Clamp: 76.3 (30.6) vs. 119.0 (50.2) ml·min(-1), p=0.03). During hyperinsulinemia fractional VLDL-TG FA oxidation was comparable, but in percent of EE, significantly higher in diabetic men. Basal VLDL-TG storage was similar, but significantly greater in abdominal compared with leg fat. Conclusions. Increased VLDL-TG in type 2 diabetic men is caused by greater VLDL-TG secretion and less so by lower VLDL-TG clearance. The ability of hyperinsulinemia to suppress VLDL-TG secretion appears preserved. During hyperinsulinemia VLDL-TG FA oxidation is significantly increased in proportion of EE in type 2 diabetic men. Greater basal abdominal VLDL-TG storage may help explain the accumulation of upper-body fat in insulin resistant individuals.
    Original languageEnglish
    JournalDiabetes
    Volume60
    Issue1
    Pages (from-to)88-96
    Number of pages9
    ISSN0012-1797
    DOIs
    Publication statusPublished - 2011

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