TY - JOUR

T1 - Sustained postprandial decrease in plasma levels of LDL cholesterol in patients with type-2 diabetes mellitus

AU - Lund, S.S.

AU - Petersen, Martin

AU - Frandsen, M.

AU - Smidt, U.M.

AU - Parving, Hans-Henrik Dyring

AU - Vaag, A.A.

AU - Jensen, T.

PY - 2008

Y1 - 2008

N2 - Objective. Low density lipoprotein cholesterol (LDL-C) is an independent and modifiable risk factor fordevelopment of cardiovascular disease (CVD). Postprandial lipid metabolism has been linked to CVD, but littleis known about the postprandial LDL-C profile in patients with type-2 diabetes (T2DM). We aimed to study thepostprandial levels of LDL-C in T2DM patients. Material and methods. After an overnight fast, 74 T2DMpatients, mean age approximately 60 years, were served a standard fat-rich meal of 3,515 kJ containing 54 % fat,13 % protein and 33 % carbohydrates. Only drinking water was allowed postprandially. Blood samples weredrawn at times 0 (fasting), 1.5, 3.0, 4.5 and 6.0 h (postprandial). In all samples, LDL-C was measured withmodified beta quantification (separation by ultracentrifugation followed by measurement of infranate highdensity lipoprotein cholesterol (HLD-C) using a homogeneous assay). Results. At all postprandial times, levels ofLDL-C showed highly significant (pv0.005) decreases compared to time 0 (mean [95 % CI] maximum change inLDL-C levels at 3.0 h: 20.16 mmol/L [20.12; 20.20]; pv0.001). Independently of fasting LDL-C levels andongoing statin therapy, LDL-C decreased significantly more in female compared to male patients postprandially(mean [95 % CI] maximum unadjusted change versus time 0 in LDL-C for men [n556] at 3.0 h: 20.14 mmol/L[20.19; 20.10], pv0.001; for women [n518] at 4.5 h: 20.26 mmol/L [20.35; 20.18], pv0.001; 20.14 mmol/L[20.24; 20.05], p50.005 between genders for the mean [95 % CI] fasting adjusted difference at 4.5 h in thechange versus time 0 in LDL-C; gender by time interaction: p50.007 (repeated measures mixed model)).Conclusions. In T2DM patients served a fat-rich meal, levels of LDL-C decreased significantly more in womencompared to men postprandially, irrespective of fasting levels or ongoing statin therapy. This might haveimplications in the atherosclerotic process and on any difference in the risk of CVD between genders.Keywords: Cholesterol; diabetes mellitus type-2; fasting; gender; hydroxymethylglutaryl-CoA reductaseinhibitors; lipoproteins; low density lipoprotein cholesterol (LDL-C); postprandial period; statins; ultracentrifugation

AB - Objective. Low density lipoprotein cholesterol (LDL-C) is an independent and modifiable risk factor fordevelopment of cardiovascular disease (CVD). Postprandial lipid metabolism has been linked to CVD, but littleis known about the postprandial LDL-C profile in patients with type-2 diabetes (T2DM). We aimed to study thepostprandial levels of LDL-C in T2DM patients. Material and methods. After an overnight fast, 74 T2DMpatients, mean age approximately 60 years, were served a standard fat-rich meal of 3,515 kJ containing 54 % fat,13 % protein and 33 % carbohydrates. Only drinking water was allowed postprandially. Blood samples weredrawn at times 0 (fasting), 1.5, 3.0, 4.5 and 6.0 h (postprandial). In all samples, LDL-C was measured withmodified beta quantification (separation by ultracentrifugation followed by measurement of infranate highdensity lipoprotein cholesterol (HLD-C) using a homogeneous assay). Results. At all postprandial times, levels ofLDL-C showed highly significant (pv0.005) decreases compared to time 0 (mean [95 % CI] maximum change inLDL-C levels at 3.0 h: 20.16 mmol/L [20.12; 20.20]; pv0.001). Independently of fasting LDL-C levels andongoing statin therapy, LDL-C decreased significantly more in female compared to male patients postprandially(mean [95 % CI] maximum unadjusted change versus time 0 in LDL-C for men [n556] at 3.0 h: 20.14 mmol/L[20.19; 20.10], pv0.001; for women [n518] at 4.5 h: 20.26 mmol/L [20.35; 20.18], pv0.001; 20.14 mmol/L[20.24; 20.05], p50.005 between genders for the mean [95 % CI] fasting adjusted difference at 4.5 h in thechange versus time 0 in LDL-C; gender by time interaction: p50.007 (repeated measures mixed model)).Conclusions. In T2DM patients served a fat-rich meal, levels of LDL-C decreased significantly more in womencompared to men postprandially, irrespective of fasting levels or ongoing statin therapy. This might haveimplications in the atherosclerotic process and on any difference in the risk of CVD between genders.Keywords: Cholesterol; diabetes mellitus type-2; fasting; gender; hydroxymethylglutaryl-CoA reductaseinhibitors; lipoproteins; low density lipoprotein cholesterol (LDL-C); postprandial period; statins; ultracentrifugation

KW - Former LIFE faculty

KW - LDL

KW - LDL cholesterol

U2 - 10.1080/00365510801995736

DO - 10.1080/00365510801995736

M3 - Journal article

VL - 68

SP - 628

EP - 640

JO - Scandinavian Journal of Clinical & Laboratory Investigation

JF - Scandinavian Journal of Clinical & Laboratory Investigation

SN - 0036-5513

IS - 7

ER -