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J Clin Endocrinol Metab. 2013 Apr;98(4):1622-30. doi: 10.1210/jc.2012-3185. Epub 2013 Feb 28.

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

Author information

1
Division of Clinical Epidemiology, Department of Medicine, University of Texas Health Science Center, San Antonio, TX 78229, USA. lorenzo@uthscsa.edu

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 ╬╝mol/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.

PMID:
23450048
PMCID:
PMC3615208
DOI:
10.1210/jc.2012-3185
[Indexed for MEDLINE]
Free PMC Article

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