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Rev Diabet Stud, 2004, 1(4):175-184 DOI 10.1900/RDS.2004.1.175

Differential Postprandial Lipoprotein Responses in Type 2 Diabetic Men with and without Clinical Evidence of a Former Myocardial Infarction

Marius Carstensen1, Claus Thomsen1, Ole Gotzsche2, Jens Juul Holst3, Jürgen Schrezenmeir4, Kjeld Hermansen1

1Department of Endocrinology and Metabolism C, Aarhus University Hospital, Aarhus Sygehus THG, Tage-Hansens Gade 2, DK-8000 Aarhus, Denmark.
2Department of Cardiology A, Aarhus University Hospital, Aarhus Sygehus THG, Tage-Hansens Gade 2, DK-8000 Aarhus, Denmark.
3Department of Medical Physiology, Panum Instituttet, University of Copenhagen, DK-2200 Copenhagen N, Denmark.
4Institute for Physiology and Biochemistry of Nutrition, Federal Dairy Research Centre, D-24103 Kiel, Germany.
Address correspondence to: Marius Carstensen, e-mail: mbc@dadlnet.dk

Keywords: lipoproteins, myocardial infarction, post-prandial period, triglycerides, type 2 diabetes


Postprandial lipemia plays an important role in the development of coronary heart disease through an elevation of triglyceride-rich lipoproteins. In type 2 diabetic male subjects, our aim was to compare postprandial lipemia in a high-risk population with former myocardial infarction (MI) with that of a lower risk population free of clinically detectable heart disease. 32 male type 2 diabetic subjects were included in the study. We matched 17 cases with a verified history of MI with 15 controls according to age, BMI, HbA1c, diabetes duration, smoking, and treatment of diabetes. Ongoing metformin, insulin, or lipid lowering pharmacological treatment were exclusion criteria. After a maximal exercise tolerance test and echocardiography, the subjects underwent a hyperinsulinemic, euglycemic clamp and a vitamin A fat loading test. Plasma triglyceride levels in the case group were significantly higher after 360 minutes (4.6 ± 3.1 vs. 2.8 ± 1.8 mmol/l, p = 0.04) and 480 minutes (3.6 ± 2.2 vs. 2.4 ± 2.4 mmol/l, p = 0.03), as was the incremental Area Under the Curve (iAUC) for the whole period (560 ± 452 vs. 297 ± 214 mmolx480min./l; p = 0.048). In addition, the retinyl palmitate responses in the chylomicron-fraction from the case group were significantly higher (iAUC 311,502 ± 194,933 vs. 187,004 ± 102,928 ngx480min./ml; p = 0.035). Type 2 diabetic males with prior MI had higher postprandial triglyceride-rich lipoprotein responses than those without MI, indicating that high responses may be a marker for a high-risk population.

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