PMID- 27095446 OWN - NLM STAT- MEDLINE DCOM- 20170224 LR - 20220331 IS - 1475-2840 (Electronic) IS - 1475-2840 (Linking) VI - 15 DP - 2016 Apr 19 TI - Hepatic insulin resistance both in prediabetic and diabetic patients determines postprandial lipoprotein metabolism: from the CORDIOPREV study. PG - 68 LID - 10.1186/s12933-016-0380-y [doi] LID - 68 AB - BACKGROUND/AIMS: Previous evidences have shown the presence of a prolonged and exaggerated postprandial response in type 2 diabetes mellitus (T2DM) and its relation with an increase of cardiovascular risk. However, the response in prediabetes population has not been established. The objective was to analyze the degree of postprandial lipemia response in the CORDIOPREV clinical trial (NCT00924937) according to the diabetic status. METHODS: 1002 patients were submitted to an oral fat load test meal (OFTT) with 0.7 g fat/kg body weight [12 % saturated fatty acids (SFA), 10 % polyunsaturated fatty acids (PUFA), 43 % monounsaturated fatty acids (MUFA), 10 % protein and 25 % carbohydrates]. Serial blood test analyzing lipid fractions were drawn at 0, 1, 2, 3 and 4 h during postprandial state. Postprandial triglycerides (TG) concentration at any point >2.5 mmol/L (220 mg/dL) has been established as undesirable response. We explored the dynamic response in 57 non-diabetic, 364 prediabetic and 581 type 2 diabetic patients. Additionally, the postprandial response was evaluated according to basal insulin resistance subgroups in patients non-diabetic and diabetic without pharmacological treatment (N = 642). RESULTS: Prevalence of undesirable postprandial TG was 35 % in non-diabetic, 48 % in prediabetic and 59 % in diabetic subgroup, respectively (p < 0.001). Interestingly, prediabetic patients displayed higher plasma TG and large triacylglycerol-rich lipoproteins (TRLs-TG) postprandial response compared with those non-diabetic patients (p < 0.001 and p = 0.003 respectively). Moreover, the area under the curve (AUC) of TG and AUC of TRLs-TG was greater in the prediabetic group compared with non-diabetic patients (p < 0.001 and p < 0.005 respectively). Patients with liver insulin resistance (liver-IR) showed higher postprandial response of TG compared with those patients with muscle-IR or without any insulin-resistance respectively (p < 0.001). CONCLUSIONS: Our findings demonstrate that prediabetic patients show a lower phenotypic flexibility after external aggression, such as OFTT compared with nondiabetic patients. The postprandial response increases progressively according to non-diabetic, prediabetic and type 2 diabetic state and it is higher in patients with liver insulin-resistance. To identify this subgroup of patients is important to treat more intensively in order to avoid future cardiometabolic complications. FAU - Leon-Acuna, A AU - Leon-Acuna A AD - Lipid and Atherosclerosis Unit, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain. AD - CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain. FAU - Alcala-Diaz, J F AU - Alcala-Diaz JF AD - Lipid and Atherosclerosis Unit, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain. AD - CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain. FAU - Delgado-Lista, J AU - Delgado-Lista J AD - Lipid and Atherosclerosis Unit, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain. AD - CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain. FAU - Torres-Pena, J D AU - Torres-Pena JD AD - Lipid and Atherosclerosis Unit, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain. AD - CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain. FAU - Lopez-Moreno, J AU - Lopez-Moreno J AD - Lipid and Atherosclerosis Unit, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain. AD - CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain. FAU - Camargo, A AU - Camargo A AD - Lipid and Atherosclerosis Unit, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain. AD - CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain. FAU - Garcia-Rios, A AU - Garcia-Rios A AD - Lipid and Atherosclerosis Unit, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain. AD - CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain. FAU - Marin, C AU - Marin C AD - Lipid and Atherosclerosis Unit, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain. AD - CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain. FAU - Gomez-Delgado, F AU - Gomez-Delgado F AD - Lipid and Atherosclerosis Unit, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain. AD - CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain. FAU - Caballero, J AU - Caballero J AD - Biochemical Laboratory, Hospital Universitario Reina Sofia, Cordoba, Spain. FAU - Van-Ommen, B AU - Van-Ommen B AD - TNO, Zeist, The Netherlands. FAU - Malagon, M M AU - Malagon MM AD - CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain. AD - Department of Cell Biology, Physiology, and Immunology, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain. FAU - Perez-Martinez, P AU - Perez-Martinez P AD - Lipid and Atherosclerosis Unit, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain. pablopermar@yahoo.es. AD - CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain. pablopermar@yahoo.es. FAU - Lopez-Miranda, J AU - Lopez-Miranda J AD - Lipid and Atherosclerosis Unit, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain. AD - CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain. LA - eng SI - ClinicalTrials.gov/NCT00924937 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20160419 PL - England TA - Cardiovasc Diabetol JT - Cardiovascular diabetology JID - 101147637 RN - 0 (Blood Glucose) RN - 0 (Insulin) RN - 0 (Lipids) RN - 0 (Triglycerides) SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Blood Glucose/metabolism MH - Diabetes Mellitus, Type 2/blood/*metabolism MH - Female MH - Humans MH - Hypertriglyceridemia/complications/*metabolism MH - Insulin/blood MH - Insulin Resistance/*physiology MH - Lipids/*blood MH - Liver/*metabolism MH - Male MH - Middle Aged MH - Obesity/complications/*metabolism MH - Postprandial Period/physiology MH - Prediabetic State/complications/*metabolism MH - Risk Factors MH - Triglycerides/blood PMC - PMC4837552 OTO - NOTNLM OT - CORDIOPREV study OT - Insulin resistance OT - Phenotypic flexibility OT - Postprandial lipemia OT - Prediabetic OT - Triglycerides EDAT- 2016/04/21 06:00 MHDA- 2017/02/25 06:00 PMCR- 2016/04/19 CRDT- 2016/04/21 06:00 PHST- 2016/01/14 00:00 [received] PHST- 2016/03/30 00:00 [accepted] PHST- 2016/04/21 06:00 [entrez] PHST- 2016/04/21 06:00 [pubmed] PHST- 2017/02/25 06:00 [medline] PHST- 2016/04/19 00:00 [pmc-release] AID - 10.1186/s12933-016-0380-y [pii] AID - 380 [pii] AID - 10.1186/s12933-016-0380-y [doi] PST - epublish SO - Cardiovasc Diabetol. 2016 Apr 19;15:68. doi: 10.1186/s12933-016-0380-y.