Differences in the Metabolism of Postprandial Lipoproteins After a High-Monounsaturated-Fat Versus a High-Carbohydrate Diet in Patients With Type 1 Diabetes Mellitus

Georgopoulos, Angeliki; Bantle, John P.; Noutsou, Marina; Swaim, William R.; Parker, Shirley

doi:10.1161/01.atv.18.5.773

Cited by 25 publications

(15 citation statements)

References 47 publications

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“…This lack of correlation may be explained by the fact that our patients are in reasonably good blood glucose control (HbA1c ¼ 6.971.7). (Georgopoulos et al, 1998;Koutsari et al, 2000;Iovine et al, 2004a). Population-based studies looking at this specific aspect are very few (Sharrett et al, 2001;Van Wijk et al, 2001;Geluk et al, 2004) and none has been performed in a diabetic population.…”

Section: Discussionmentioning

confidence: 99%

“…Although this concordance of results is true for fasting TG concentrations, less is known about the effects of dietary CHO and fat on postprandial TG. The few data available on this topic have been obtained especially in acute experiments and remain substantially controversial, with some studies showing an increase after high CHO diets or high-fat meals and others just the opposite, that is, an increase in postprandial TG concentrations after high-fat diets or high-fat meals (Georgopoulos et al, 1998;Koutsari et al, 2000;Pieke et al, 2000;Iovine et al, 2004a).…”

Section: Introductionmentioning

confidence: 99%

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Nutrient determinants of postprandial triglyceride response in a population-based sample of type II diabetic patients

et al. 2006

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Background: Nutrient determinants of postprandial triglyceride (TG) are matter of debate, especially for type II diabetes. Objective: This study was performed to evaluate the impact of dietary habits on postprandial TG response in a population-based sample of type II diabetic patients. Design: One-hundred and forty type II diabetic patients (63 men/77 women, age 45-70 years) referring to the same health district, not on hypolipidemic drugs and without any other chronic disease, performed four TG profiles (at fasting, before, 2 and 3 h after lunch) with a specific device (Accutrend GCT, Roche Diagnostics Mannheim, Germany) validated previously. Dietary habits were recorded by a dietitian utilizing a previously validated semiquantitative questionnaire. Results: Triglyceride values (mmol/l, mean7s.d.) were 2.2270.93 at fasting, decreased before lunch (2.0370.81), reached peak values 3 h after lunch (2.7371.11). Postprandial TG increments (3 h after lunch minus pre-lunch concentration) significantly correlated with the intake (g/day) of animal protein (r ¼ 0.20, Po0.02), total fat (r ¼ 0.21, Po0.01), animal fat (r ¼ 0.19, Po0.03) and vegetable fat (r ¼ 0.19, Po0.03), also after adjusting for fasting TG and high-density lipoprotein cholesterol levels. Expressing nutrient intake as percentage of total calorie intake, total and animal fat remained significantly and directly related to postprandial TG increment (r ¼ 0.21, Po0.01 for total fat; r ¼ 0.19, Po0.03 for animal fat) whereas the percentage of carbohydrates was inversely related (r ¼ À0.23, Po0.007). Conclusions: Fat intake seems the major nutritional determinant of postprandial TG response in type II diabetic patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Nutrient determinants of postprandial triglyceride response in a population-based sample of type II diabetic patients

et al. 2006

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“…A delay in CM clearance would imply a prolonged postprandial hyperlipidemia, which supposedly leads to increased deposition of CM contents into the arterial wall and to an unfavorable translocation of cholesteryl-esters from HDL to CM (13,14). Delays in CM clearance are amenable to dietary intervention, by changing the intake of fish oil (long chain PUFA) (15), monounsaturated-fat (16), or carbohydrate (17). Yet, it is not known whether CM clearance is delayed in late teenagers with DM1.…”

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confidence: 99%

Postprandial Chylomicron Clearance Rate in Late Teenagers with Diabetes Mellitus Type 1

Waarde¹,

Odink²,

Rouwé³

et al. 2001

Pediatr Res

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A delayed chylomicron (CM) clearance rate, a known risk factor for atherosclerosis, has been described in adults with diabetes type 1 (DM1). We determined the CM clearance rate in late teenagers with DM1, and the relationship between CM clearance rate and elevated plasma lipid concentrations in DM1 teenagers in poor metabolic control (as characterized by HbA 1c percentage). Plasma lipids and CM clearance were determined in nine patients with DM1 (mean age Ϯ SD: 17.5 Ϯ 0.6 y) and four healthy controls (mean age Ϯ SD: 20.1 Ϯ 0.8 y), by measuring breath 13 CO 2 , plasma triglyceride, retinyl palmitate, and 13 Clabeled oleic acid concentrations, after oral administration of a fat-rich meal together with vitamin A and 13 C-oleic acid. In patients with DM1, fasting triglyceride and cholesterol concentrations were positively correlated with HbA 1c percentage (p Ͻ 0.05). Neither in DM1 patients, nor in controls, was an elevated triglyceride concentration (above 1.7 mmol/L) found. Yet, in 22% of DM1 patients, cholesterol concentration was above 5.2 mmol/L, but not in any of the controls. CM clearance rate in DM1 patients was similar to that in controls and did not signif- Diabetes mellitus type 1 (DM1) is associated with a 2-4 fold increased risk for cardiovascular disease (1). Specific diabetesrelated phenomena have been suggested to play a role in the observed association, such as glycosylation of proteins (2), presence of renal disease (3), elevated concentrations of plasma cholesterol, triglycerides, and low density lipoprotein (LDL) cholesterol (4), and altered composition of very low density lipoprotein (VLDL) and LDL (5, 6). In children and late teenagers, studies on risk factors associated with DM1 and atherosclerosis have mainly focused on cholesterol and triglyceride concentrations (7-9). Elevated concentrations of both cholesterol and triglycerides have been reported in children with DM1 in poor metabolic control, which tended to decrease to nondiabetic values upon improvement of metabolic control (7-9).A delayed chylomicron (CM) clearance has been identified as a risk factor for atherosclerosis in patients with coronary heart disease, in patients with type 2 diabetes, and in adult patients with DM1 (10 -12). Insulin enhances the metabolism of CM by stimulating the hydrolysis of CM triglycerides by lipoprotein lipase and the hepatic uptake of CM remnants (11). A relative deficiency of insulin, such as present in DM1, could therefore lead to a delay in CM clearance. A delay in CM clearance would imply a prolonged postprandial hyperlipidemia, which supposedly leads to increased deposition of CM contents into the arterial wall and to an unfavorable translocation of cholesteryl-esters from HDL to CM (13,14). Delays in CM clearance are amenable to dietary intervention, by changing the intake of fish oil (long chain PUFA) (15), monounsaturated-fat (16)

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“…Several studies have compared the effects on PPL of a diet high in total fat and MUFA (HFMUFA) (olive oil) vs. low in fat and high in carbohydrates (LFHC) and/or vs. a diet high in fat and SFA (HFSFA) (butter). Many (21,24,33,34,39,46,68,69,76,79,90), but not all (4,14,20,26,65,70,71,85), found that the HFMUFA diet was superior to the other two diets in several aspects of postprandial TAG metabolism in both healthy and nonhealthy volunteers (Tables 1 and 2).…”

Section: Amount and Type Of Fatmentioning

confidence: 99%

“…Advantages of a HFMUFA diet have also been found in subjects with metabolic syndrome (34) or type 2 diabetes (46,69). Of two studies performed in type 1 diabetics, the first (26) found that 4 wk on a HFMUFA diet increased PPL. However, a more recent study with a more prolonged intervention (6 mo) showed that 24-h TAG was lower after a HFMUFA than with a LFHC diet (79).…”

Section: Amount and Type Of Fatmentioning

confidence: 99%

Physiology in Medicine: update on lifestyle determinants of postprandial triacylglycerolemia with emphasis on the Mediterranean lifestyle

Maraki

Sidossis

2015

American Journal of Physiology-Endocrinology and Metabolism

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Maraki MI, Sidossis LS. Update on lifestyle determinants of postprandial triacylglycerolemia with emphasis on the Mediterranean lifestyle. Am J Physiol Endocrinol Metab 309: E440 -E449, 2015. First published July 7, 2015; doi:10.1152/ajpendo.00245.2015.-This review updates the effect of lifestyle on plasma triacylglycerols (TAG) in the postprandial state, commonly reported as postprandial lipemia (PPL), an independent risk factor for cardiovascular diseases (CVD). Numerous studies have shown that Mediterranean diet may reduce PPL. However, most of these studies were focused on the type of fat (i.e., monounsaturated fat from olive oil), and the other components of the Mediterranean lifestyle were neglected. Physical activity, an integral part of this lifestyle, is widely investigated on its own and shown to reduce PPL. In addition, preliminary results of studies examining other Mediterranean "ingredients", such as legumes, fish, and herbs, showed additional benefits; however, data on the long-term effects are limited. More studies are needed to confirm short-term results and investigate the effects of the whole Mediterranean lifestyle on PPL and whether these effects mediate its protective role on CVD. Moreover, investigation of the effects in nonhealthy populations and the underlying mechanisms would be clinically helpful in individualizing the appropriate intervention.triglycerides; olive; physical activity; diet; lipid metabolism FREE-LIVING HUMANS spend most of their time in a nonfasting, postprandial state; however, routine health screening is performed in the fasting state. Regarding lipids [mainly triacylglycerols (TAG) and their carriers, TAG-rich lipoproteins (TRL)], the most profound changes are taking place in the postprandial state, i.e., the hours after the consumption of dietary fat. TAG and TRL metabolism in the postprandial state are schematically shown in Fig. 1.Recent evidence suggests that elevated levels of plasma TAG in the postprandial state, commonly reported as postprandial lipemia (PPL) or nonfasting TAG, is associated with increased risk for atherosclerosis, independently of other known cardiovascular disease (CVD) risk factors (32, 61). In addition, TAG-TRL remnants [i.e., chylomicrons and VLDL with reduced amount or depleted of TAG after the action of lipoprotein lipase (LPL)] may penetrate the arterial wall and may be taken up by monocytes, forming foam cells. Several epidemiological studies have shown that CVD patients have increased levels of postprandial TRL (62), while VLDL remnants have also be found in atheromatique plaques. In addition, reduced TRL catabolism is associated with changes in the size of other lipoproteins (e.g., formation of HDL 3 and LDL 3 ; Fig. 2) that are thought to be atherogenic (66, 74), as well as oxidative stress, endothelium dysfunction, and inflammation (40, 87), thereby increasing CVD risk. Recent detailed reviews have highlighted the clinical importance of PPL (12, 37). Therefore, interventions that improve postprandial TAG and TRL metabolism may be ...

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Differences in the Metabolism of Postprandial Lipoproteins After a High-Monounsaturated-Fat Versus a High-Carbohydrate Diet in Patients With Type 1 Diabetes Mellitus

Cited by 25 publications

References 47 publications

Nutrient determinants of postprandial triglyceride response in a population-based sample of type II diabetic patients

Nutrient determinants of postprandial triglyceride response in a population-based sample of type II diabetic patients

Postprandial Chylomicron Clearance Rate in Late Teenagers with Diabetes Mellitus Type 1

Physiology in Medicine: update on lifestyle determinants of postprandial triacylglycerolemia with emphasis on the Mediterranean lifestyle

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