Alterations in composition and concentration of lipoproteins and elevated cholesteryl ester transfer in non-insulin-dependent diabetes mellitus (NIDDM)

• Published in: Atherosclerosis Vol. 123; no. 1; pp. 93 - 101
• Main Authors: Elchebly, Mounib, Porokhov, Béatrice, Pulcini, Thérèse, Berthezène, Francois, Ponsin, Gabriel
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01-06-1996; Elsevier
• Subjects: Adult; Arteriosclerosis - epidemiology; Arteriosclerosis - etiology; Atherosclerosis; Biological and medical sciences; Carrier Proteins - blood; Cholesterol - blood; Cholesterol Ester Transfer Proteins; Cholesterol Esters - blood; Cholesteryl ester transfer; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - enzymology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Glycoproteins; Humans; Hypertriglyceridemia; Hypoglycemic Agents - therapeutic use; Lipoprotein; Lipoproteins - blood; Lipoproteins, HDL - blood; Lipoproteins, LDL - blood; Lipoproteins, VLDL - blood; Male; Medical sciences; Middle Aged; NIDDM; Risk Factors; Triglycerides - blood; Lipoprotein; Cholesteryl ester transfer; Hypertriglyceridemia; Atherosclerosis; NIDDM; Endocrinopathy; Human; Metabolic diseases; Exploration; Lipids; Hyperlipoproteinemia; Enzymopathy; Non insulin dependent diabetes; Cholesterol; Proteins; Ester; Transfer; Complication
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/0021-9150(95)05789-7

Cholesteryl esters (CE) exchange between lipoproteins through the action of cholesteryl ester transfer protein (CETP). Situations at high risk for atherosclerosis are often accompanied by an accelerated net mass CE transfer (CET) from high density lipoproteins (HDL) to very low (VLDL) and low density lipoproteins (LDL). However, the question as to whether the net mass CET is increased or decreased in non-insulin-dependent diabetes mellitus (NIDDM) has led to controversial data. To clarify this point, we have undertaken a detailed study of CET in 105 NIDDM patients by comparison with 17 control subjects. Net mass CET was approximately doubled in NIDDM. Plasma CETP activity and unidirectional CET from HDL to VLDL + LDL (CET
HDL → VLDL + LDL) or from VLDL + LDL to HDL (CET
VLDL + LDL → HDL) were measured under controlled lipoprotein concentrations using radioisotopic assays. No difference was observed in plasma CETP activity between NIDDM and controls. In NIDDM, CET
HDL → VLDL + LDL and CET
VLDL + LDL → HDL were decreased by 25% and 20%, respectively, as a consequence of alterations in lipoprotein compositions. Net mass CET was highly correlated with plasma triglyceride (TG) concentration (
r = 0.66,
P < 0.001) but not with that of LDL-cholesterol (
r = 0.06,
P > 0.6). When TG levels were decreased following dietetic recommendations or insulinotherapy, the net mass CET was lowered accordingly. We conclude that net mass CET is accelerated in NIDDM in spite of a decreased unidirectional CET
HDL → VLDL + LDL. This results from a lowered CET
VLDL + LDL → HDL and from elevated TG concentration, and the latter probably reflects a concentration effect of VLDL.