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Metabolism
Reduced first-phase insulin secretion increases postprandial lipidemia in subjects with impaired glucose tolerance
  1. Miguel Ángel Gómez-Sámano,
  2. Daniel Cuevas-Ramos,
  3. Mariana Grajales-Gómez,
  4. Marco Escamilla-Márquez,
  5. Angelina López-Estrada,
  6. Luz Elizabeth Guillén-Pineda,
  7. Guadalupe López-Carrasco,
  8. Francisco J Gómez-Pérez
  1. Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
  1. Correspondence to Dr Francisco J Gómez-Pérez; gomezperezfco{at}gmail.com

Abstract

Objective It is not clear which phase of insulin secretion is more important to regulate lipoprotein lipase (LPL) activity. After a meal, insulin is released and acts as a major regulator of LPL activity. Postprandial hyperlipidemia is a common comorbidity in subjects with insulin resistance (IR). Therefore this study aimed to evaluate the role of the first-phase insulin secretion (FPIS) on postprandial lipidemia in subjects with IR and impaired glucose tolerance (IGT).

Research design and methods This is a cross-sectional, observational and comparative study. We included male and female subjects between 40 and 60 years with a body mass index (BMI) between 23 and 30 kg/m2. Then, patients were divided into three groups. Group 1 consisted of control subjects with normal glucose tolerance and preserved FPIS. Group 2 included patients with IGT and a reduced FPIS. Group 3 consisted of subjects with IGT but normal FPIS. Both groups were paired by age and BMI with subjects in the control group. Subjects underwent an intravenous glucose tolerance test to classify each case, and then a load with a mixed meal load to measure postprandial lipidemia.

Results A total of 32 subjects were evaluated: 10 were control subjects, 8 subjects with IGT with a reduced FPIS and 14 subjects with IGT and preserved FPIS. After administration of a standardized meal, group 2 showed a greater glucose area under the curve (AUC) at 30 and 120 min (p=0.001, for both). This group also showed a statistically significant increase (p<0.001) in triglyceride AUC.

Conclusions A reduced FPIS is significantly and independently associated with a larger postprandial hyperlipidemia in subjects with IGT.

  • fist-phase insulin secretion
  • postprandial lipidemia

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjdrc-2016-000344

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    Footnotes

    • Contributors The authors’ responsibilities were as follows—FJGP: designed the research; MAGS, DCR, MGG, MEM, ALE, LEGP and FJGP: conducted the research; ALE, LEGP and GLC: made the laboratory analysis; MAGS, DCR, MGG, MEM and FJGP: performed the statistical analyses; MAGS, DCR, MGG, MEM, ALE, LEGP and FJGP: wrote the manuscript; all authors: read and approved the final manuscript.

    • Funding The study was funded by the Department of Endocrinology and Metabolism of the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán.

    • Competing interests None declared.

    • Patient consent The study was approved by our Institutional Human Biomedical Research Committee (reference #1092). Written and informed consent was obtained from all subjects before starting the study. All clinical investigation was conducted according to the principles stated on the Declaration of Helsinki.

    • Ethics approval Institutional Human Biomedical Research Committee.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement All authors agreed to provide additional information for further meta-analysis, including the SPSS database.