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Apolipoprotein A-IV in diabetes mellitus
1Service d'Endocrinologie, Diabétologie et Maladies Métaboliques, Hôpital du Bocage, Dijon, France.
Diabete & Metabolisme
|April 1, 1995
Summary
Apolipoprotein A-IV (apoA-IV) levels are elevated in non-insulin-dependent diabetes (NIDDM), linked to lipid changes and increased macrovascular disease risk. The protective effects of the apoA-IV 1-2 phenotype are lost in NIDDM patients.
Area of Science:
- Lipid metabolism and cardiovascular disease research.
- Endocrinology and metabolic disorders.
Background:
- Apolipoprotein A-IV (apoA-IV) influences lipid metabolism, including triglyceride-rich lipoprotein metabolism, reverse cholesterol transport, and Cholesterolyl Ester Transfer Protein (CETP) activity.
- Human apoA-IV exhibits genetic polymorphism, with two major isoproteins (apoA-IV 1 and apoA-IV 2) affecting lipid metabolism phenotypes.
- Elevated apoA-IV levels are observed in non-insulin-dependent diabetes mellitus (NIDDM), correlating with hypertriglyceridemia and HDL cholesterol levels.
Purpose of the Study:
- To investigate the relationship between apoA-IV levels, phenotype distribution, and lipid profiles in NIDDM patients.
- To examine the impact of NIDDM on the potential protective lipid profile associated with the apoA-IV 1-2 phenotype.
- To compare apoA-IV levels and their metabolic associations in NIDDM patients treated with insulin versus oral agents.
Main Methods:
- Analysis of apoA-IV levels and phenotype distribution in NIDDM patients and control groups.
- Assessment of lipid profiles, including triglyceride and HDL cholesterol levels.
- Comparison of apoA-IV associations in NIDDM patients based on treatment modality (oral vs. insulin).
Main Results:
- NIDDM patients exhibit increased apoA-IV levels, primarily associated with hypertriglyceridemia.
- The potential protective lipid profile (increased HDL and HDL2 cholesterol) linked to the apoA-IV 1-2 phenotype in controls is absent in NIDDM patients.
- In NIDDM patients treated with insulin, apoA-IV levels are increased but not significantly related to hypertriglyceridemia, suggesting different metabolic effects compared to oral treatment.
Conclusions:
- Elevated plasma apoA-IV levels in NIDDM are associated with an increased prevalence of macrovascular disease.
- The metabolic state of NIDDM negates the potential cardioprotective lipid profile associated with the apoA-IV 1-2 phenotype.
- The effect of increased apoA-IV on lipid metabolism may differ between NIDDM patients treated with oral agents and those treated with insulin.