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Open Access 01-09-2016 | Original Article

Effect of glycemic state on postprandial hyperlipidemia and hyperinsulinemia in patients with coronary artery disease

Authors: Akihiro Nakamura, Yuto Monma, Shoko Kajitani, Kazuki Noda, Sota Nakajima, Hideaki Endo, Tohru Takahashi, Eiji Nozaki

Published in: Heart and Vessels | Issue 9/2016

Abstract

Both postprandial hyperlipidemia and hyperinsulinemia have been thought to play an important role in the development of atherosclerosis, and to be a potent risk factor for cardiovascular event. To examine effects of glycemic state on postprandial hyperlipidemia and hyperinsulinemia in patients with coronary artery disease (CAD), a total of 112 consecutive male pati ents with angiographically confirmed CAD were loaded with a high-fat and high-glucose test meal. CAD patients were divided into three groups as “non-diabetic”, “prediabetic”, and “diabetic” CAD groups. The serum triglyceride (TG) and remnant-like particle cholesterol (RLP-C) levels at the 6th hour in diabetic CAD group showed significantly higher than non-diabetic CAD group, and the incremental area under the curves (iAUCs) of these levels in diabetic CAD group were significantly greater than non-diabetic CAD group (TG, P = 0.0194; RLP-C, P = 0.0219). There were no significant differences in the iAUCs of TG or RLP-C between prediabetic and non-diabetic CAD group. The AUCs of plasma insulin levels or insulin resistance index (IRI): (AUCs of insulin) × (AUCs of glucose) as the insulin resistance marker were greater in diabetic CAD group than non-diabetic CAD group (insulin, P = 0.0373; IRI, P = 0.0228). The AUCs of serum TG or RLP-C levels showed a correlation with the AUCs of plasma insulin (AUC-TG, r = 0.5437, P < 0.0001; AUC-RLP-C, r = 0.6847, P < 0.0001), and they correlated well with the insulin resistance index (AUC-TG, r = 0.7724, P < 0.0001; AUC-RLP-C, r = 0.7645, P < 0.0001). We found that the insulin resistance showed a close relationship with postprandial hyperlipidemia in CAD patients. Diabetic, but not prediabetic state, may be a risk for postprandial impaired lipid metabolism in CAD patients.

Kannel WB, Dawber TR, Kagan A, Revotskie N, Stokes J 3rd (1961) Factors of risk in the development of coronary heart disease-six year follow-up experience. The Framingham Study. Ann Intern Med 55:33–50CrossRefPubMed

Sarwar N, Danesh J, Eiriksdottir G, Sigurdsson G, Wareham N, Bingham S, Boekholdt SM, Khaw KT, Gudnason V (2007) Triglycerides and the risk of coronary heart disease: 10,158 incident cases among 262,525 participants in 29 Western prospective studies. Circulation 115:450–458CrossRefPubMed

Iso H, Naito Y, Sato S, Kitamura A, Okamura T, Sankai T, Shimamoto T, Iida M, Komachi Y (2001) Serum triglycerides and risk of coronary heart disease among Japanese men and women. Am J Epidemiol 153:490–499CrossRefPubMed

Nordestgaard BG, Benn M, Schnohr P, Tybjaerg-Hansen A (2007) Nonfasting triglyceride and risk of myocardial infarction, ischemic heart disease, and death in man and women. JAMA 298:299–308CrossRef

Kapur S, Groves MN, Zava DT, Kapur S (2010) Postprandial insulin and triglycerides after different breakfast meal challenges: use of finger stick capillary dried blood spots to study postprandial dysmetabolism. J Diabetes Sci Technol 4:236–243CrossRefPubMedPubMedCentral

Karabulut A, Iltumur K, Toprak N, Tuzcu AK, Kara IH, Kaplan A, Aksu Y (2005) Insulin response to oral glucose loading and coronary artery disease in nondiabetics. Int Heart J 46:756–770CrossRef

Fihn SD, Gardin JM, Abrams J, Berra K, Blankenship JC, Dallas AP, Douglas PS, Foody JM, Gerber TC, Hinderliter AL, King SB 3rd, Kligfield PD, Krumholz HM, Kwong RY, Lim MJ, Linderbaum JA, Mack MJ, Munger MA, Prager RL, Sabik JF, Shaw LJ, Sikkema JD, Smith CR Jr, Smith SC Jr, Spertus JA, Williams SV, American College of Cardiology Foundation, American Heart Association Task Force on Practice Guidelines, American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons (2012) 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 60:e44–164CrossRefPubMed

American Diabetes Association (2010) Standards of medical care in diabetes—2010. Diabetes Care 33:S11–S61CrossRefPubMedCentral

Farrag A, Bakhoum S, Salem MA, El-Faramawy A, Gergis E (2013) The association between extra coronary calcification and coronary artery disease in patients with type 2 diabetes mellitus. Heart Vessels 28:12–18CrossRefPubMed

10.

Hiramitsu S, Miyagishima K, Ishii J, Matsui S, Naruse H, Shiino K, Kitagawa F, Ozaki Y (2012) The effect of ezetimibe on lipid and glucose metabolism after a fat and glucose load. J Cardiol 60:395–400CrossRef

11.

Haffner SM, Miettinen H, Stern MP (1997) The homeostasis model in the San Antonio Heart study. Diabetes Care 20:1087–1092CrossRefPubMed

12.

Lazzeri C, Valente S, Chiostri M, Attanà P, Mattesini A, Nesti M, Gensini GF (2014) Hyperglycemia, acute insulin resistance, and renal dysfunction in the early phase of ST-elevation myocardial infarction without previously known diabetes: impact on long-term prognosis. Heart Vessels 29:769–775CrossRefPubMed

13.

Kugiyama K, Doi H, Takazoe K, Kawano H, Soejima H, Mizuno Y, Tsunoda R, Sakamoto T, Nakano T, Nakajima K, Ogawa H, Sugiyama S, Yoshimura M, Yasue H (1999) Remnant lipoprotein levels in fasting serum predict coronary events in patients with coronary artery disease. Circulation 99:2858–2860CrossRefPubMed

14.

Patsch JR, Miesenbock G, Hopfewieser T, Mühlberger V, Knapp E, Dunn JK, Gotto AM Jr, Patsch W (1992) Relation of triglyceride metabolism and coronary artery disease. Studies in the postprandial state. Arterioscler Thromb 12:1336–1345CrossRef

15.

Tanaka A (2004) Postprandial hyperlipidemia and atherosclerosis. J Atheroscler Thromb 11:322–329CrossRefPubMed

16.

Schaefer EJ, McNamara JR, Shah PK, Nakajima K, Cupples LA, Ordovas JM, Wilson PW, Framingham Offspring Study (2002) Elevated remnant-like particle cholesterol and triglyceride levels in diabetic men and women in the Framingham Offspring Study. Diabetes Care 25:989–994CrossRefPubMed

17.

Jensen MD, Caruso M, Heiling V, Miles JM (1989) Insulin regulation of lipolysis in nondiabetic and IDDM subjects. Diabetes 38:1595–1601CrossRef

18.

Popper DA, Shiau YF, Reed M (1985) Role of small intestine in pathogenesis of hyperlipidemia in diabetic rats. Am J Physiol 249:G161–G167PubMed

19.

Gylling H, Miettinen TA (1996) Cholesterol absorption and lipoprotein metabolism in type II diabetes mellitus with and without coronary artery disease. Atherosclerosis 126:325–332CrossRefPubMed

20.

Matthan NR, Pencina M, LaRocque JM, Jacques PF, D’Agostino RB, Schaefer EJ, Lichtenstein AH (2009) Alterations in cholesterol absorption/synthesis markers characterize Framingham Offspring Study participants with CHD. J Lipid Res 50:1927–1935CrossRefPubMedPubMedCentral

21.

Masuda D, Sakai N, Sugimoto T, Kitazume-Taneike R, Yamashita T, Kawase R, Nakaoka H, Inagaki M, Nakatani K, Yuasa-Kawase M, Tsubakio-Yamamoto K, Ohama T, Nakagawa-Toyama Y, Nishida M, Ishigami M, Masuda Y, Matsuyama A, Komuro I, Yamashita S (2011) Fasting serum apolipoprotein B-48 can be a marker of postprandial hyperlipidemia. J Atheroscler Thromb 18:1062–1070CrossRefPubMed

22.

Roche HM, Gibney MJ (2000) The impact of postprandial lipemia in accelerating atherothrombosis. J Cardiovasc Risk 7:317–324CrossRefPubMed

23.

Haidari M, Leung N, Mahbub F, Uffelman KD, Kohen-Avramoglu R, Lewis GF, Adeli K (2002) Fasting and postprandial overproduction of intestinally derived lipoproteins in an animal model of insulin resistance. Evidence that chronic fructose feeding in the hamster is accompanied by enhanced intestinal de novo lipogenesis and ApoB48-containing lipoprotein overproduction. J Biol Chem 277:31646–31655CrossRefPubMed

24.

UK Prospective Diabetes Study (UKPDS) Group (1998) Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 352:854–865CrossRef

25.

Dormandy JA, Charbonnel B, Eckland DJ, Erdmann E, Massi-Benedetti M, Moules IK, Skene AM, Tan MH, Lefèbvre PJ, Murray GD, Standl E, Wilcox RG, Wilhelmsen L, Betteridge J, Birkeland K, Golay A, Heine RJ, Korányi L, Laakso M, Mokán M, Norkus A, Pirags V, Podar T, Scheen A, Scherbaum W, Schernthaner G, Schmitz O, Skrha J, Smith U, Taton J, PROactive investigators (2005) Secondary prevention of macro vascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitAzone Clinical Trial In macroVascular Events): a randomised controlled trial. Lancet 366:1279–1289CrossRefPubMed

26.

Sawada T, Shiotani H, Terashita D, Nagasawa Y, Kim SS, Koide M, Yokoyama M (2014) Comparison of effects of α-Glucosidase inhibitors and glinide drugs on endothelial dysfunction in diabetes patients with coronary artery disease. Circ J 78:248–255CrossRefPubMed

27.

Miettinen TA, Gylling H, Lindbohm N, Miettinen TE, Rajaratnam RA, Relas H, Finnish Treat-to-Target Study Investigators (2003) Serum noncholesterol sterols during inhibition of cholesterol synthesis by statins. J Lab Clin Med 141:131–137CrossRefPubMed

28.

Title: Effect of glycemic state on postprandial hyperlipidemia and hyperinsulinemia in patients with coronary artery disease
Authors: Akihiro Nakamura
Yuto Monma
Shoko Kajitani
Kazuki Noda
Sota Nakajima
Hideaki Endo
Tohru Takahashi
Eiji Nozaki
Publication date: 01-09-2016
Publisher: Springer Japan
Published in: Heart and Vessels / Issue 9/2016
Print ISSN: 0910-8327
Electronic ISSN: 1615-2573
DOI: https://doi.org/10.1007/s00380-015-0757-y

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Effect of glycemic state on postprandial hyperlipidemia and hyperinsulinemia in patients with coronary artery disease

Abstract

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