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Insulin and HDL-cholesterol metabolism
1Service d'Endocrinologie et Diabétologie, USNA-CHR Lille.
Diabete & Metabolisme
|July 1, 1987
Summary
Insulin significantly impacts high-density lipoprotein (HDL) cholesterol metabolism. Both insulin deficiency and excess insulin can lead to unhealthy cholesterol levels and promote atherogenic lipoprotein disturbances.
Area of Science:
- Endocrinology
- Metabolic Science
- Lipid Metabolism
Background:
- Insulin plays a crucial role in regulating high-density lipoprotein (HDL) cholesterol.
- It influences HDL metabolism both in the liver and peripheral circulation.
Purpose of the Study:
- To elucidate the complex mechanisms by which insulin affects HDL cholesterol metabolism.
- To understand the consequences of insulin deficiency, resistance, and hyperinsulinism on HDL levels.
Main Methods:
- The study reviews the physiological actions of insulin on hepatic lipase, lipoprotein lipase (LPL), and lecithin acyl cholesterol transferase (LCAT).
- It analyzes the impact of various insulin-related conditions on HDL subfractions (HDL2 and HDL3) and triglyceride-rich lipoproteins.
Main Results:
- Insulin deficiency or resistance reduces HDL cholesterol, primarily by decreasing HDL2, linked to LPL deficiency.
- Hyperinsulinism causes intrahepatic disturbances, affecting HDL2/HDL3 ratio and promoting HDL2 triglyceride enrichment.
- Combined hepatic hyperinsulinism and peripheral insulin resistance exacerbate HDL cholesterol reduction.
Conclusions:
- Both insulinopenia and hyperinsulinism can lead to atherogenic lipoprotein disturbances.
- Optimized insulin therapy may normalize HDL cholesterol in cases of true insulin deficiency.
- Preserved insulin secretion with insulin resistance still results in lower HDL cholesterol compared to controls.