Impaired fasting glucose and impaired glucose tolerance have distinct lipoprotein and apolipoprotein changes: the insulin resistance atherosclerosis study

J Clin Endocrinol Metab. 2013 Apr;98(4):1622-30. doi: 10.1210/jc.2012-3185. Epub 2013 Feb 28.

Abstract

Context: Cardiovascular risk is increased in individuals with impaired glucose tolerance (IGT) and impaired fasting glucose (IFG); however, those with IGT appear to be at greater risk. Lipoprotein abnormalities occur also in the prediabetic state.

Objective: The authors examined lipoprotein composition in IGT and IFG.

Design and setting: Cross-sectional analysis of a large epidemiological study was done.

Participants: The Insulin Resistance Atherosclerosis Study had a total of 1107 participants.

Main measures: Lipoproteins and apolipoproteins were measured by conventional methods and lipoprotein composition by nuclear magnetic resonance spectroscopy.

Results: Compared with normal glucose tolerance, apolipoprotein B (105.2 vs 99.8 mg/dL, P < .05) was high in isolated IFG, triglyceride (1.48 vs 1.16 mmol/L, P < .001) was high in isolated IGT, and high-density lipoprotein cholesterol was low in combined IFG/IGT (1.12 vs 1.26 mmol/L, P < .001). Nuclear magnetic resonance spectroscopy revealed additional changes: increased total low-density lipoprotein (LDL) particles (1190 vs 1096 nmol/L, P < .01) in isolated IFG; increased large very-low-density lipoprotein (3.61 vs 2.47 nmol/L, P < .01) and small LDL subclass particles (665 vs 541 nmol/L, P < .05) and decreased large LDL subclass particles (447 vs 513 nmol/L, P < .01) in isolated IGT; and decreased large high-density lipoprotein subclass particles in combined IFG/IGT (4.24 vs 5.39 μmol/L, P < .001).

Conclusions: Isolated IFG is characterized by increased apolipoprotein B and total LDL particles, whereas isolated IGT is associated with increased triglycerides, large very-low-density lipoprotein subclass particles, and structural remodeling of LDL particles. These results may help to explain differences in cardiovascular disease risk in the prediabetic state.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Apolipoproteins / blood*
  • Apolipoproteins / metabolism
  • Atherosclerosis / blood
  • Atherosclerosis / etiology
  • Atherosclerosis / metabolism
  • Blood Glucose / metabolism
  • Case-Control Studies
  • Cross-Sectional Studies
  • Fasting / blood*
  • Fasting / metabolism
  • Female
  • Glucose Intolerance / blood*
  • Glucose Intolerance / metabolism*
  • Humans
  • Insulin Resistance / physiology
  • Lipoproteins / blood*
  • Lipoproteins / metabolism
  • Male
  • Middle Aged
  • Prediabetic State / blood
  • Prediabetic State / metabolism

Substances

  • Apolipoproteins
  • Blood Glucose
  • Lipoproteins