1
|
Vergès B, Vantyghem MC, Reznik Y, Duvillard L, Rouland A, Capel E, Vigouroux C. Hypertriglyceridemia Results From an Impaired Catabolism of Triglyceride-Rich Lipoproteins in PLIN1-Related Lipodystrophy. Arterioscler Thromb Vasc Biol 2024; 44:1873-1883. [PMID: 38899472 DOI: 10.1161/atvbaha.124.320774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Pathogenic variants in PLIN1-encoding PLIN1 (perilipin-1) are responsible for an autosomal dominant form of familial partial lipodystrophy (FPL) associated with severe insulin resistance, hepatic steatosis, and important hypertriglyceridemia. This study aims to decipher the mechanisms of hypertriglyceridemia associated with PLIN1-related FPL. METHODS We performed an in vivo lipoprotein kinetic study in 6 affected patients compared with 13 healthy controls and 8 patients with type 2 diabetes. Glucose and lipid parameters, including plasma LPL (lipoprotein lipase) mass, were measured. LPL mRNA and protein expression were evaluated in abdominal subcutaneous adipose tissue from patients with 5 PLIN1-mutated FPL and 3 controls. RESULTS Patients with PLIN1-mutated FPL presented with decreased fat mass, insulin resistance, and diabetes (glycated hemoglobin A1c, 6.68±0.70% versus 7.48±1.63% in patients with type 2 diabetes; mean±SD; P=0.27). Their plasma triglycerides were higher (5.96±3.08 mmol/L) than in controls (0.76±0.27 mmol/L; P<0.0001) and patients with type 2 diabetes (2.94±1.46 mmol/L, P=0.006). Compared with controls, patients with PLIN1-related FPL had a significant reduction of the indirect fractional catabolic rate of VLDL (very-low-density lipoprotein)-apoB100 toward IDL (intermediate-density lipoprotein)/LDL (low-density lipoprotein; 1.79±1.38 versus 5.34±2.45 pool/d; P=0.003) and the indirect fractional catabolic rate of IDL-apoB100 toward LDL (2.14±1.44 versus 7.51±4.07 pool/d; P=0.005). VLDL-apoB100 production was not different between patients with PLIN1-related FPL and controls. Compared with patients with type 2 diabetes, patients with PLIN1-related FPL also showed a significant reduction of the catabolism of both VLDL-apoB100 (P=0.031) and IDL-apoB100 (P=0.031). Plasma LPL mass was significantly lower in patients with PLIN1-related FPL than in controls (21.03±10.08 versus 55.76±13.10 ng/mL; P<0.0001), although the LPL protein expression in adipose tissue was similar. VLDL-apoB100 and IDL-apoB100 indirect fractional catabolic rates were negatively correlated with plasma triglycerides and positively correlated with LPL mass. CONCLUSIONS We show that hypertriglyceridemia associated with PLIN1-related FPL results from a marked decrease in the catabolism of triglyceride-rich lipoproteins (VLDL and IDL). This could be due to a pronounced reduction in LPL availability, related to the decreased adipose tissue mass.
Collapse
MESH Headings
- Humans
- Male
- Perilipin-1/genetics
- Perilipin-1/metabolism
- Perilipin-1/blood
- Triglycerides/blood
- Hypertriglyceridemia/blood
- Hypertriglyceridemia/genetics
- Female
- Adult
- Middle Aged
- Case-Control Studies
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/genetics
- Diabetes Mellitus, Type 2/complications
- Lipoproteins/blood
- Insulin Resistance
- Lipoprotein Lipase/blood
- Lipoprotein Lipase/metabolism
- Lipoprotein Lipase/genetics
- Lipodystrophy, Familial Partial/genetics
- Lipodystrophy, Familial Partial/blood
- Lipodystrophy, Familial Partial/metabolism
- Mutation
- Blood Glucose/metabolism
- Lipoproteins, VLDL/blood
- Lipoproteins, VLDL/metabolism
- Biomarkers/blood
- Phenotype
- Genetic Predisposition to Disease
- Lipolysis
- RNA, Messenger/metabolism
- RNA, Messenger/genetics
Collapse
Affiliation(s)
- Bruno Vergès
- Department of Endocrinology, Diabetology and Metabolic Diseases (B.V., A.R.), University Hospital, Dijon, France
- University of Burgundy, INSERM (Institut national de la santé et de la recherche médicale) CTM (Centre de recherche Translationnelle en Médecine moléculaire) UMR1231, Dijon, France (B.V., L.D., A.R.)
| | - Marie-Christine Vantyghem
- Department of Endocrinology, Diabetology, and Metabolism, University of Lille, CHU (Centre Hospitalier Universitaire) Lille, France (M.C.V.)
- Université Lille, U1190 Translational Research for Diabetes, INSERM, Institut Pasteur de Lille, France (M.C.V.)
| | - Yves Reznik
- Department of Endocrinology, University Hospital, Caen, France (Y.R.)
| | - Laurence Duvillard
- Department of Biochemistry (L.D.), University Hospital, Dijon, France
- University of Burgundy, INSERM (Institut national de la santé et de la recherche médicale) CTM (Centre de recherche Translationnelle en Médecine moléculaire) UMR1231, Dijon, France (B.V., L.D., A.R.)
| | - Alexia Rouland
- Department of Endocrinology, Diabetology and Metabolic Diseases (B.V., A.R.), University Hospital, Dijon, France
- University of Burgundy, INSERM (Institut national de la santé et de la recherche médicale) CTM (Centre de recherche Translationnelle en Médecine moléculaire) UMR1231, Dijon, France (B.V., L.D., A.R.)
| | - Emilie Capel
- Inserm U938, Saint-Antoine Research Centre, Institute of Cardiometabolism and Nutrition, Sorbonne University, Paris, France (E.C., C.V.)
| | - Corinne Vigouroux
- Inserm U938, Saint-Antoine Research Centre, Institute of Cardiometabolism and Nutrition, Sorbonne University, Paris, France (E.C., C.V.)
- Department of Molecular Biology and Genetics (C.V.), Assistance Publique-Hôpitaux de Paris, Saint-Antoine University Hospital, France
- Department of Endocrinology, Diabetology and Reproductive Endocrinology, National Reference Center for Rare Diseases of Insulin Secretion and Insulin Sensitivity (C.V.), Assistance Publique-Hôpitaux de Paris, Saint-Antoine University Hospital, France
| |
Collapse
|
2
|
Taskinen MR, Matikainen N, Björnson E, Söderlund S, Inkeri J, Hakkarainen A, Parviainen H, Sihlbom C, Thorsell A, Andersson L, Adiels M, Packard CJ, Borén J. Contribution of intestinal triglyceride-rich lipoproteins to residual atherosclerotic cardiovascular disease risk in individuals with type 2 diabetes on statin therapy. Diabetologia 2023; 66:2307-2319. [PMID: 37775612 PMCID: PMC10627993 DOI: 10.1007/s00125-023-06008-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/30/2023] [Indexed: 10/01/2023]
Abstract
AIMS/HYPOTHESIS This study explored the hypothesis that significant abnormalities in the metabolism of intestinally derived lipoproteins are present in individuals with type 2 diabetes on statin therapy. These abnormalities may contribute to residual CVD risk. METHODS To investigate the kinetics of ApoB-48- and ApoB-100-containing lipoproteins, we performed a secondary analysis of 11 overweight/obese individuals with type 2 diabetes who were treated with lifestyle counselling and on a stable dose of metformin who were from an earlier clinical study, and compared these with 11 control participants frequency-matched for age, BMI and sex. Participants in both groups were on a similar statin regimen during the study. Stable isotope tracers were used to determine the kinetics of the following in response to a standard fat-rich meal: (1) apolipoprotein (Apo)B-48 in chylomicrons and VLDL; (2) ApoB-100 in VLDL, intermediate-density lipoprotein (IDL) and LDL; and (3) triglyceride (TG) in VLDL. RESULTS The fasting lipid profile did not differ significantly between the two groups. Compared with control participants, in individuals with type 2 diabetes, chylomicron TG and ApoB-48 levels exhibited an approximately twofold higher response to the fat-rich meal, and a twofold higher increment was observed in ApoB-48 particles in the VLDL1 and VLDL2 density ranges (all p < 0.05). Again comparing control participants with individuals with type 2 diabetes, in the latter, total ApoB-48 production was 25% higher (556 ± 57 vs 446 ± 57 mg/day; p < 0.001), conversion (fractional transfer rate) of chylomicrons to VLDL was around 40% lower (35 ± 25 vs 82 ± 58 pools/day; p=0.034) and direct clearance of chylomicrons was 5.6-fold higher (5.6 ± 2.2 vs 1.0 ± 1.8 pools/day; p < 0.001). During the postprandial period, ApoB-48 particles accounted for a higher proportion of total VLDL in individuals with type 2 diabetes (44%) compared with control participants (25%), and these ApoB-48 VLDL particles exhibited a fivefold longer residence time in the circulation (p < 0.01). No between-group differences were seen in the kinetics of ApoB-100 and TG in VLDL, or in LDL ApoB-100 production, pool size and clearance rate. As compared with control participants, the IDL ApoB-100 pool in individuals with type 2 diabetes was higher due to increased conversion from VLDL2. CONCLUSIONS/INTERPRETATION Abnormalities in the metabolism of intestinally derived ApoB-48-containing lipoproteins in individuals with type 2 diabetes on statins may help to explain the residual risk of CVD and may be suitable targets for interventions. TRIAL REGISTRATION ClinicalTrials.gov NCT02948777.
Collapse
Affiliation(s)
- Marja-Riitta Taskinen
- Research Programs Unit, Clinical and Molecular Medicine, University of Helsinki, Helsinki, Finland
| | - Niina Matikainen
- Research Programs Unit, Clinical and Molecular Medicine, University of Helsinki, Helsinki, Finland
- Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Elias Björnson
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Sanni Söderlund
- Research Programs Unit, Clinical and Molecular Medicine, University of Helsinki, Helsinki, Finland
- Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Jussi Inkeri
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Antti Hakkarainen
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Helka Parviainen
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Carina Sihlbom
- Proteomic Core Facility at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Annika Thorsell
- Proteomic Core Facility at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Linda Andersson
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Martin Adiels
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Chris J Packard
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Jan Borén
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
- Wallenberg Laboratory, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
| |
Collapse
|
3
|
Bonilha I, Hajduch E, Luchiari B, Nadruz W, Le Goff W, Sposito AC. The Reciprocal Relationship between LDL Metabolism and Type 2 Diabetes Mellitus. Metabolites 2021; 11:metabo11120807. [PMID: 34940565 PMCID: PMC8708656 DOI: 10.3390/metabo11120807] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/25/2021] [Accepted: 11/25/2021] [Indexed: 12/14/2022] Open
Abstract
Type 2 diabetes mellitus and insulin resistance feature substantial modifications of the lipoprotein profile, including a higher proportion of smaller and denser low-density lipoprotein (LDL) particles. In addition, qualitative changes occur in the composition and structure of LDL, including changes in electrophoretic mobility, enrichment of LDL with triglycerides and ceramides, prolonged retention of modified LDL in plasma, increased uptake by macrophages, and the formation of foam cells. These modifications affect LDL functions and favor an increased risk of cardiovascular disease in diabetic individuals. In this review, we discuss the main findings regarding the structural and functional changes in LDL particles in diabetes pathophysiology and therapeutic strategies targeting LDL in patients with diabetes.
Collapse
Affiliation(s)
- Isabella Bonilha
- Cardiology Division, Atherosclerosis and Vascular Biology Laboratory (AtheroLab), State University of Campinas (Unicamp), Campinas 13083-887, Brazil; (I.B.); (B.L.)
| | - Eric Hajduch
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, F-75006 Paris, France;
| | - Beatriz Luchiari
- Cardiology Division, Atherosclerosis and Vascular Biology Laboratory (AtheroLab), State University of Campinas (Unicamp), Campinas 13083-887, Brazil; (I.B.); (B.L.)
| | - Wilson Nadruz
- Cardiology Division, Cardiovascular Pathophysiology Laboratory, State University of Campinas (Unicamp), Campinas 13083-887, Brazil;
| | - Wilfried Le Goff
- Unité de Recherche sur les Maladies Cardiovasculaires, le Métabolisme et la Nutrition, ICAN, Inserm, Sorbonne Université, F-75013 Paris, France;
| | - Andrei C. Sposito
- Cardiology Division, Atherosclerosis and Vascular Biology Laboratory (AtheroLab), State University of Campinas (Unicamp), Campinas 13083-887, Brazil; (I.B.); (B.L.)
- Correspondence: ; Tel.: +55-19-3521-7098; Fax: +55-19-3289-410
| |
Collapse
|
4
|
Vergès B, Duvillard L, Pais de Barros JP, Bouillet B, Baillot-Rudoni S, Rouland A, Petit JM, Degrace P, Demizieux L. Liraglutide Increases the Catabolism of Apolipoprotein B100-Containing Lipoproteins in Patients With Type 2 Diabetes and Reduces Proprotein Convertase Subtilisin/Kexin Type 9 Expression. Diabetes Care 2021; 44:1027-1037. [PMID: 33531418 DOI: 10.2337/dc20-1843] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/10/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Dyslipidemia observed in type 2 diabetes (T2D) is atherogenic. Important features of diabetic dyslipidemia are increased levels of triglyceride-rich lipoproteins and small dense LDL particles, which all have apolipoprotein B100 (apoB100) as a major apolipoprotein. This prompted us to study the effect of the GLP-1 agonist liraglutide on the metabolism of apoB100-containing lipoproteins. RESEARCH DESIGN AND METHODS We performed an in vivo kinetic study with stable isotopes (L-[1-13C]leucine) in 10 patients with T2D before and after 6 months of treatment with liraglutide (1.2 mg/day). We also evaluated in mice the effect of liraglutide on the expression of genes involved in apoB100-containing lipoprotein clearance. RESULTS In patients with T2D, liraglutide treatment significantly reduced plasma apoB100 (0.93 ± 0.13 vs. 1.09 ± 0.11 g/L, P = 0.011) and fasting triglycerides (1.76 ± 0.37 vs. 2.48 ± 0.69 mmol/L, P = 0.005). The kinetic study showed a significant increase in indirect catabolism of VLDL1-apoB100 (4.11 ± 1.91 vs. 2.96 ± 1.61 pools/day, P = 0.005), VLDL2-apoB100 (5.17 ± 2.53 vs. 2.84 ± 1.65 pools/day, P = 0.008), and IDL-apoB100 (5.27 ± 2.77 vs. 3.74 ± 1.85 pools/day, P = 0.017) and in catabolism of LDL-apoB100 (0.72 ± 0.22 vs. 0.56 ± 0.22 pools/day, P = 0.005). In mice, liraglutide increased lipoprotein lipase (LPL) gene expression and reduced proprotein convertase subtilisin/kexin type 9 (PCSK9), retinol-binding protein 4 (RBP4), and tumor necrosis factor-α (TNF-α) gene expression in adipose tissue and decreased PCSK9 mRNA and increased LDL receptor protein expression in liver. In vitro, liraglutide directly reduced the expression of PCSK9 in the liver. CONCLUSIONS Treatment with liraglutide induces a significant acceleration of the catabolism of triglyceride-rich lipoproteins (VLDL1, VLDL2, IDL) and LDL. Liraglutide modifies the expression of genes involved in apoB100-containing lipoprotein catabolism. These positive effects on lipoprotein metabolism may reduce cardiovascular risk in T2D.
Collapse
Affiliation(s)
- Bruno Vergès
- Department of Endocrinology-Diabetology, CHU Dijon, Dijon, France .,INSERM LNC UMR1231, University of Burgundy, Dijon, France
| | - Laurence Duvillard
- INSERM LNC UMR1231, University of Burgundy, Dijon, France.,Department of Biochemistry, CHU Dijon, Dijon, France
| | - Jean Paul Pais de Barros
- INSERM LNC UMR1231, University of Burgundy, Dijon, France.,Lipidomic Analytical Platform, University of Burgundy, Dijon, France
| | - Benjamin Bouillet
- Department of Endocrinology-Diabetology, CHU Dijon, Dijon, France.,INSERM LNC UMR1231, University of Burgundy, Dijon, France
| | | | - Alexia Rouland
- Department of Endocrinology-Diabetology, CHU Dijon, Dijon, France.,INSERM LNC UMR1231, University of Burgundy, Dijon, France
| | - Jean Michel Petit
- Department of Endocrinology-Diabetology, CHU Dijon, Dijon, France.,INSERM LNC UMR1231, University of Burgundy, Dijon, France
| | - Pascal Degrace
- INSERM LNC UMR1231, University of Burgundy, Dijon, France
| | | |
Collapse
|
5
|
Vergès B, Duvillard L, Pais de Barros JP, Bouillet B, Baillot-Rudoni S, Rouland A, Sberna AL, Petit JM, Degrace P, Demizieux L. Liraglutide Reduces Postprandial Hyperlipidemia by Increasing ApoB48 (Apolipoprotein B48) Catabolism and by Reducing ApoB48 Production in Patients With Type 2 Diabetes Mellitus. Arterioscler Thromb Vasc Biol 2018; 38:2198-2206. [DOI: 10.1161/atvbaha.118.310990] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Objective—
Treatment with liraglutide, a GLP-1 (glucagon-like peptide-1) agonist, has been shown to reduce postprandial lipidemia, an important feature of diabetic dyslipidemia. However, the underlying mechanisms for this effect remain unknown. This prompted us to study the effect of liraglutide on the metabolism of ApoB48 (apolipoprotein B48).
Approach and Results—
We performed an in vivo kinetic study with stable isotopes (D
8
-valine) in the fed state in 10 patients with type 2 diabetes mellitus before treatment and 6 months after the initiation of treatment with liraglutide (1.2 mg/d). We also evaluated, in mice, the effect of a 1-week liraglutide treatment on postload triglycerides and analysed in vitro on jejunum, the direct effect of liraglutide on the expression of genes involved in the biosynthesis of chylomicron. In diabetic patients, liraglutide treatment induced a dramatic reduction of ApoB48 pool (65±38 versus 162±87 mg;
P
=0.005) because of a significant decrease in ApoB48 production rate (3.02±1.33 versus 6.14±4.27 mg kg
-1
d
-1
;
P
=0.009) and a significant increase in ApoB48 fractional catabolic rate (5.12±1.35 versus 3.69±0.75 pool d
-1
;
P
=0.005). One-week treatment with liraglutide significantly reduced postload plasma triglycerides in mice and liraglutide, in vitro, reduced the expression of ApoB48, DGAT1 (diacylglycerol O-acyltransferase 1), and MTP (microsomal transfer protein) genes.
Conclusions—
We show that treatment with liraglutide induces a significant reduction of the ApoB48 pool because of both a reduction of ApoB48 production and an increase in ApoB48 catabolism. In vitro, liraglutide reduces the expression of genes involved in chylomicron synthesis. These effects might benefit cardiovascular health.
Clinical Trial Registration—
URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02721888.
Collapse
Affiliation(s)
- Bruno Vergès
- From the Department of Endocrinology-Diabetology (B.V., B.B, S.B.-R., A.R., A.-L.S., J.M.P.)
- INSERM LNR UMR1231, University of Burgundy and Franche-Comté, Dijon, France (B.V., L.D., J.P.P.d.B., B.B., J.-M.P., P.D., L.D.)
| | - Laurence Duvillard
- INSERM LNR UMR1231, University of Burgundy and Franche-Comté, Dijon, France (B.V., L.D., J.P.P.d.B., B.B., J.-M.P., P.D., L.D.)
| | - Jean Paul Pais de Barros
- INSERM LNR UMR1231, University of Burgundy and Franche-Comté, Dijon, France (B.V., L.D., J.P.P.d.B., B.B., J.-M.P., P.D., L.D.)
- Lipidomic Analytical Platform, Bâtiment B3, Dijon, France (J.P.P.d.B.)
| | - Benjamin Bouillet
- From the Department of Endocrinology-Diabetology (B.V., B.B, S.B.-R., A.R., A.-L.S., J.M.P.)
- INSERM LNR UMR1231, University of Burgundy and Franche-Comté, Dijon, France (B.V., L.D., J.P.P.d.B., B.B., J.-M.P., P.D., L.D.)
| | - Sabine Baillot-Rudoni
- From the Department of Endocrinology-Diabetology (B.V., B.B, S.B.-R., A.R., A.-L.S., J.M.P.)
| | - Alexia Rouland
- From the Department of Endocrinology-Diabetology (B.V., B.B, S.B.-R., A.R., A.-L.S., J.M.P.)
| | - Anne-Laure Sberna
- From the Department of Endocrinology-Diabetology (B.V., B.B, S.B.-R., A.R., A.-L.S., J.M.P.)
| | - Jean-Michel Petit
- From the Department of Endocrinology-Diabetology (B.V., B.B, S.B.-R., A.R., A.-L.S., J.M.P.)
- INSERM LNR UMR1231, University of Burgundy and Franche-Comté, Dijon, France (B.V., L.D., J.P.P.d.B., B.B., J.-M.P., P.D., L.D.)
| | - Pascal Degrace
- INSERM LNR UMR1231, University of Burgundy and Franche-Comté, Dijon, France (B.V., L.D., J.P.P.d.B., B.B., J.-M.P., P.D., L.D.)
| | - Laurent Demizieux
- Department of Biochemistry (L.D.), University Hospital, Dijon, France
- INSERM LNR UMR1231, University of Burgundy and Franche-Comté, Dijon, France (B.V., L.D., J.P.P.d.B., B.B., J.-M.P., P.D., L.D.)
| |
Collapse
|
6
|
Croyal M, Kaabia Z, León L, Ramin-Mangata S, Baty T, Fall F, Billon-Crossouard S, Aguesse A, Hollstein T, Sullivan D, Nobecourt E, Lambert G, Krempf M. Fenofibrate decreases plasma ceramide in type 2 diabetes patients: A novel marker of CVD? DIABETES & METABOLISM 2018; 44:143-149. [DOI: 10.1016/j.diabet.2017.04.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 03/30/2017] [Accepted: 04/13/2017] [Indexed: 02/05/2023]
|
7
|
Hopkins PN, Brinton EA, Nanjee MN. Hyperlipoproteinemia type 3: the forgotten phenotype. Curr Atheroscler Rep 2015; 16:440. [PMID: 25079293 DOI: 10.1007/s11883-014-0440-2] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Hyperlipoproteinemia type 3 (HLP3) is caused by impaired removal of triglyceride-rich lipoproteins (TGRL) leading to accumulation of TGRL remnants with abnormal composition. High levels of these remnants, called β-VLDL, promote lipid deposition in tuberous xanthomas, atherosclerosis, premature coronary artery disease, and early myocardial infarction. Recent genetic and molecular studies suggest more genes than previously appreciated may contribute to the expression of HLP3, both through impaired hepatic TGRL processing or removal and increased TGRL production. HLP3 is often highly amenable to appropriate treatment. Nevertheless, most HLP3 probably goes undiagnosed, in part because of lack of awareness of the relatively high prevalence (about 0.2% in women and 0.4-0.5% in men older than 20 years) and largely because of infrequent use of definitive diagnostic methods.
Collapse
Affiliation(s)
- Paul N Hopkins
- Cardiovascular Genetics, Department of Internal Medicine, University of Utah, 420 Chipeta Way, Room 1160, Salt Lake City, UT, 84108, USA,
| | | | | |
Collapse
|
8
|
Rosuvastatin Enhances the Catabolism of LDL apoB-100 in Subjects with Combined Hyperlipidemia in a Dose Dependent Manner. Lipids 2015; 50:447-58. [PMID: 25809021 DOI: 10.1007/s11745-015-4005-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 02/20/2015] [Indexed: 10/23/2022]
Abstract
Dose-associated effects of rosuvastatin on the metabolism of apolipoprotein (apo) B-100 in triacylglycerol rich lipoprotein (TRL, d < 1.019 g/ml) and low density lipoprotein (LDL) and of apoA-I in high density lipoprotein (HDL) were assessed in subjects with combined hyperlipidemia. Our primary hypothesis was that maximal dose rosuvastatin would decrease the apoB-100 production rate (PR), as well as increase apoB-100 fractional catabolic rate (FCR). Eight subjects received placebo, rosuvastatin 5 mg/day, and rosuvastatin 40 mg/day for 8 weeks each in sequential order. The kinetics of apoB-100 in TRL and LDL and apoA-I in HDL were determined at the end of each phase using stable isotope methodology, gas chromatography-mass spectrometry, and multicompartmental modeling. Rosuvastatin at 5 and 40 mg/day decreased LDL cholesterol by 44 and 54% (both P < 0.0001), triacylglycerol by 14% (ns) and 35% (P < 0.01), apoB by 30 and 36% (both P < 0.0001), respectively, and had no significant effects on HDL cholesterol or apoA-I levels. Significant decreases in plasma markers of cholesterol synthesis and increases in cholesterol absorption markers were observed. Rosuvastatin 5 and 40 mg/day increased TRL apoB-100 FCR by 36 and 46% (both ns) and LDL apoB-100 by 63 and 102% (both P < 0.05), respectively. HDL apoA-I PR increased with low dose rosuvastatin (12%, P < 0.05) but not with maximal dose rosuvastatin. Neither rosuvastatin dose altered apoB-100 PR or HDL apoA-I FCR. Our data indicate that maximal dose rosuvastatin treatment in subjects with combined hyperlipidemia resulted in significant increases in the catabolism of LDL apoB-100, with no significant effects on apoB-100 production or HDL apoA-I kinetics.
Collapse
|
9
|
Abstract
PURPOSE OF REVIEW Decreased size and increased density of LDL have been associated with increased coronary heart disease (CHD) risk. Elevated plasma concentrations of small dense LDL (sdLDL) correlate with high plasma triglycerides and low HDL cholesterol levels. This review highlights recent findings about the metabolism and composition of LDL subfractions. RECENT FINDINGS The development of an automated assay has recently made possible the assessment of the CHD risk associated with sdLDL in large clinical trials and has demonstrated convincingly that sdLDL cholesterol levels are a more significant independent determinant of CHD risk than total LDL cholesterol. Metabolic studies have revealed that sdLDL particles originate through the delipidation of larger atherogenic VLDL and large LDL and from direct de novo production by the liver. Proteins associated with LDL, in addition to apolipoprotein (apo) B, include the C apolipoproteins, apoA-I, apoA-IV, apoD, apoE, apoF, apoH, apoJ, apoL-1, apoM, α-1 antitrypsin, migration inhibitory factor-related protein 8, lysosome C, prenylcysteine oxidase 1, paraoxonase 1, transthyretin, serum amyloid A4, and fibrinogen α chain. The role of the increasing number of LDL-associated proteins remains unclear; however, the data do indicate that LDL particles not only transport lipids but also carry proteins involved in inflammation and thrombosis. The sdLDL proteome in diabetic individuals differs significantly from that of larger LDL, being enriched in apoC-III. SUMMARY Progress in our understanding of the composition and metabolism of LDL subfractions strengthens the association between sdLDL and CHD risk.
Collapse
Affiliation(s)
- Margaret R Diffenderfer
- Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
| | | |
Collapse
|
10
|
Chan DC, Barrett PHR, Watts GF. The metabolic and pharmacologic bases for treating atherogenic dyslipidaemia. Best Pract Res Clin Endocrinol Metab 2014; 28:369-85. [PMID: 24840265 DOI: 10.1016/j.beem.2013.10.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Dyslipoproteinaemia is a cardinal feature of the metabolic syndrome that accelerates atherosclerosis. It is characterized by high plasma concentrations of triglyceride-rich and apolipoprotein (apo) B-containing lipoproteins, with depressed high-density lipoprotein (HDL) and increased small dense low-density lipoprotein (LDL) particle concentrations. Dysregulation of lipoprotein metabolism in the metabolic syndrome may be due to a combination of overproduction of very-low density lipoprotein (VLDL) apoB, decreased catabolism of apoB-containing particles, and increased catabolism of HDL apoA-I particles. These abnormalities are due to a global metabolic effect of insulin resistance and visceral obesity. Lifestyle modifications (dietary restriction and increased exercise) and pharmacological treatments favourably alter lipoprotein transport by decreasing the hepatic secretion of VLDL-apoB and the catabolism of HDL apoA-I, as well as by increasing the clearance of LDL-apoB. The safety and tolerability of combination drug therapy based on statins is important and merits further investigation. There are several pipeline therapies for correcting triglyceride-rich lipoprotein and HDL metabolism. However, their clinical efficacy, safety and cost-effectiveness remain to be demonstrated.
Collapse
Affiliation(s)
- Dick C Chan
- Metabolic Research Centre, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
| | - P Hugh R Barrett
- Metabolic Research Centre, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia; Faculty of Engineering, Computing and Mathematics, University of Western Australia, Perth, Australia
| | - Gerald F Watts
- Metabolic Research Centre, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia; Lipid Disorders Clinic, Royal Perth Hospital, Perth, Australia.
| |
Collapse
|
11
|
Hamilton SJ, Watts GF. Atherogenic dyslipidemia and combination pharmacotherapy in diabetes: recent clinical trials. Rev Diabet Stud 2013; 10:191-203. [PMID: 24380092 PMCID: PMC4063096 DOI: 10.1900/rds.2013.10.191] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 06/19/2013] [Accepted: 06/19/2013] [Indexed: 01/29/2023] Open
Abstract
Patients with type 2 diabetes (T2D) are at a markedly increased risk of cardiovascular disease (CVD). Dyslipidemia is a common risk factor and a strong predictor of CVD in T2D patients. Although statins decrease the incidence of CVD in T2D, residual cardiovascular risk remains high despite the achievement of optimal or near-optimal plasma low-density lipoprotein (LDL) cholesterol concentrations. This may, in part, be due to uncorrected atherogenic dyslipidemia. Hypertriglyceridemia, the driving force behind diabetic dyslipidemia, results from hepatic overproduction and/or delayed clearance of triglyceride-rich lipoproteins. In patients treated with a statin to LDL-cholesterol goals, the addition of ezetimibe, fenofibrate, niacin, or n-3 fatty acid ethyl esters may be required to correct the persistent atherogenic dyslipidemia. Clinical trial evidence describing best practice is limited, but recent data supports the strategy of adding fenofibrate to a statin, and suggests specific benefits in dyslipidemic patients and in the improvement of diabetic retinopathy. However, based on results from a recent clinical trial, niacin should not be added to a statin in individuals with low high-density lipoprotein cholesterol and very well controlled LDL-cholesterol. Further evidence is required to support the role of ezetimibe and n-3 fatty acids in treating residual CVD risk in statin-treated T2D patients.
Collapse
Affiliation(s)
- Sandra J. Hamilton
- Combined Universities Centre for Rural Health, University of Western Australia, Geraldton, Australia
| | - Gerald F. Watts
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia, Perth, Australia
| |
Collapse
|
12
|
Hamilton SJ, Watts GF. Atherogenic dyslipidemia and combination pharmacotherapy in diabetes: recent clinical trials. Rev Diabet Stud 2013. [PMID: 24380092 DOI: 10.1002/pdi.1610] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Patients with type 2 diabetes (T2D) are at a markedly increased risk of cardiovascular disease (CVD). Dyslipidemia is a common risk factor and a strong predictor of CVD in T2D patients. Although statins decrease the incidence of CVD in T2D, residual cardiovascular risk remains high despite the achievement of optimal or near-optimal plasma low-density lipoprotein (LDL) cholesterol concentrations. This may, in part, be due to uncorrected atherogenic dyslipidemia. Hypertriglyceridemia, the driving force behind diabetic dyslipidemia, results from hepatic overproduction and/or delayed clearance of triglyceride-rich lipoproteins. In patients treated with a statin to LDL-cholesterol goals, the addition of ezetimibe, fenofibrate, niacin, or n-3 fatty acid ethyl esters may be required to correct the persistent atherogenic dyslipidemia. Clinical trial evidence describing best practice is limited, but recent data supports the strategy of adding fenofibrate to a statin, and suggests specific benefits in dyslipidemic patients and in the improvement of diabetic retinopathy. However, based on results from a recent clinical trial, niacin should not be added to a statin in individuals with low high-density lipoprotein cholesterol and very well controlled LDL-cholesterol. Further evidence is required to support the role of ezetimibe and n-3 fatty acids in treating residual CVD risk in statin-treated T2D patients.
Collapse
Affiliation(s)
- Sandra J Hamilton
- Combined Universities Centre for Rural Health, University of Western Australia, Geraldton, Australia
| | - Gerald F Watts
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia, Perth, Australia
| |
Collapse
|
13
|
Thongtang N, Diffenderfer MR, Ooi EMM, Asztalos BF, Dolnikowski GG, Lamon-Fava S, Schaefer EJ. Linkage between C-reactive protein and triglyceride-rich lipoprotein metabolism. Metabolism 2013; 62:369-75. [PMID: 23018145 PMCID: PMC4315144 DOI: 10.1016/j.metabol.2012.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Revised: 08/14/2012] [Accepted: 08/15/2012] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Inflammation plays an important role in atherosclerosis. Elevated C-reactive protein (CRP) levels are associated with a greater risk of cardiovascular disease. Our goal was to study CRP metabolism, and to determine its relationship with lipoprotein metabolism using stable isotope methodology. MATERIAL/METHODS Eight subjects with combined hyperlipidemia underwent a 15-h primed-constant infusion with deuterated leucine. CRP was purified from the plasma density fraction greater than 1.21g/ml by affinity chromatography. Lipoprotein fractions were separated by sequential ultracentrifugation. Isotope enrichment was determined by gas chromatography/mass spectrometry. RESULTS The subjects had mean LDL-C levels of 147.5mg/dl and mean CRP levels of 3.4mg/l. The mean CRP production rate (PR) was 0.050±0.012mg/kg/day and the mean CRP fractional catabolic rate (FCR) was 0.343±0.056 pools/day (residence time 2.92days). CRP pool size (PS) was significantly related to production (r=0.93; p<0.001), but not FCR. CRP PS was also related to body mass index (r=0.79; p=0.02). There was a significant association between CRP FCR and TRL apoB-100 FCR (r=0.74, p=0.04), as well as between CRP PS and TRL apoB-48 FCR (r=-0.90, p=0.002), indicating linkage between CRP and TRL metabolism. CONCLUSION The main determinant of plasma CRP levels was CRP production rate. Moreover a significant linkage between CRP metabolism and both TRL apoB-100 and apoB-48 catabolism was noted.
Collapse
|
14
|
Abstract
Vascular endothelial dysfunction is determined by both genetic and environmental factors that cause decreased bioavailability of the vasodilator nitric oxide. This is a hallmark of atherosclerosis, hypertension, and coronary heart disease, which are major complications of metabolic disorders, including diabetes and obesity. Several therapeutic interventions, including changes in lifestyle as well as pharmacologic treatments, are useful for improving endothelial dysfunction in the face of lipotoxicity. This review discusses the current understanding of molecular and physiologic mechanisms underlying lipotoxicity-mediated endothelial dysfunction as well as relevant therapeutic approaches to ameliorate dyslipidemia and consequent endothelial dysfunction that have the potential to improve cardiovascular and metabolic outcomes.
Collapse
Affiliation(s)
- Jeong-a Kim
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, UAB Comprehensive Diabetes Center, University of Alabama at Birmingham, 1808 7th Avenue South, BDB 777, Birmingham, AL 35294-0012, USA
- Department of Cell Biology, University of Alabama at Birmingham, 1808 7th Avenue South, BDB 777, Birmingham, AL 35294, USA
| | - Monica Montagnani
- Department of Biomedical Sciences and Human Oncology, Pharmacology Section, University “Aldo Moro” at Bari, Policlinico, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Sruti Chandrasekran
- Department of Medicine, Division of Endocrinology, Diabetes & Nutrition, University of Maryland at Baltimore, 660 West Redwood Street, HH 495, Baltimore, MD 21201, USA
| | - Michael J. Quon
- Department of Medicine, Division of Endocrinology, Diabetes & Nutrition, University of Maryland at Baltimore, 660 West Redwood Street, HH 495, Baltimore, MD 21201, USA
| |
Collapse
|
15
|
Chan DC, Watts GF. Dyslipidaemia in the metabolic syndrome and type 2 diabetes: pathogenesis, priorities, pharmacotherapies. Expert Opin Pharmacother 2010; 12:13-30. [PMID: 20629587 DOI: 10.1517/14656566.2010.502529] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
IMPORTANCE OF THE FIELD Dyslipoproteinaemia is a cardinal feature of the metabolic syndrome that accelerates atherosclerosis. It is usually characterized by high plasma concentrations of triglyceride-rich and apolipoprotein B (apoB)-containing lipoproteins, with depressed concentrations of high-density lipoprotein (HDL). Drug interventions are essential for normalizing metabolic dyslipidaemia. AREAS COVERED IN THIS REVIEW This review discusses the mechanisms and treatment for dyslipidaemia in the metabolic syndrome and type 2 diabetes. WHAT THE READER WILL GAIN A comprehensive understanding of the pathophysiology and pharmacotherapy of dyslipidaemia in the metabolic syndrome and diabetes. TAKE HOME MESSAGE Dysregulation of lipoprotein metabolism may be due to a combination of overproduction of triglyceride-rich lipoproteins, decreased catabolism of apoB-containing particles, and increased catabolism of HDL particles. These abnormalities may be consequent on a global metabolic effect of insulin resistance and an excess of both visceral and hepatic fat. Lifestyle modifications may favourably alter lipoprotein transport in the metabolic syndrome. Patients with dyslipidaemia and established cardiovascular disease should receive a statin as first-line therapy. Combination with other lipid-regulating agents, such as ezetimibe, fibrates, niacins and fish oils may optimize the benefit of statin on atherogenic dyslipidaemia.
Collapse
Affiliation(s)
- Dick C Chan
- University of Western Australia, Metabolic Research Centre, School of Medicine and Pharmacology, GPO Box X2213, Perth, WA 6847, Australia.
| | | |
Collapse
|
16
|
Mechanisms for therapeutic correction of dyslipidaemia in insulin resistance and diabetes. ATHEROSCLEROSIS SUPP 2010; 11:61-4. [PMID: 20452838 DOI: 10.1016/j.atherosclerosissup.2010.04.044] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Accepted: 04/21/2010] [Indexed: 11/21/2022]
Abstract
Dyslipidaemia is a common cardiovascular risk factor in insulin resistant subjects with obesity, type 2 diabetes mellitus and the metabolic syndrome. Lipoprotein metabolism is complex and abnormal plasma concentrations result from alterations in the rates of production and/or catabolism of diverse lipoprotein particles. Understanding the dysregulation and therapeutic correction of lipoprotein transport in insulin resistant states has relied on the use of stable isotope tracers and modelling methods. The effects of lifestyle and therapeutic interventions on the kinetics of apolipoproteins B-100 and A-I containing lipoproteins are reviewed.
Collapse
|
17
|
Yamashita S, Kawase R, Nakaoka H, Nakatani K, Inagaki M, Yuasa-Kawase M, Tsubakio-Yamamoto K, Sandoval JC, Masuda D, Ohama T, Nakagawa-Toyama Y, Matsuyama A, Nishida M, Ishigami M. Differential reactivities of four homogeneous assays for LDL-cholesterol in serum to intermediate-density lipoproteins and small dense LDL: Comparisons with the Friedewald equation. Clin Chim Acta 2009; 410:31-8. [DOI: 10.1016/j.cca.2009.09.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Revised: 09/04/2009] [Accepted: 09/04/2009] [Indexed: 11/25/2022]
|
18
|
Therapeutic regulation of apoB100 metabolism in insulin resistance in vivo. Pharmacol Ther 2009; 123:281-91. [DOI: 10.1016/j.pharmthera.2009.04.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2009] [Accepted: 04/16/2009] [Indexed: 11/16/2022]
|
19
|
|
20
|
Current literature in diabetes. Diabetes Metab Res Rev 2009; 25:i-x. [PMID: 19219862 DOI: 10.1002/dmrr.918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|