Preheparin lipoprotein lipase mass is a practical marker of insulin resistance in ambulatory type 2 diabetic patients treated with oral hypoglycemic agents.
BACKGROUND
Lipoprotein lipase (LPL) is a key enzyme in the metabolism of triglyceride (TG)-rich lipoproteins. LPL in the preheparin serum (Pr-LPL) mass reflects the insulin sensitivity of diabetic patients (DM) receiving neither insulin nor hypoglycemic agents.


METHODS
To determine whether Pr-LPL mass is a marker of insulin resistance in ambulatory type 2 DM receiving oral hypoglycemic agents, we measured Pr-LPL mass using an enzyme immunoassay in 107 ambulatory DM aged 64.9+/-11.5 y.


RESULTS
Pr-LPL mass was inversely correlated with the homeostasis model assessment of insulin resistance (HOMA-IR) (-0.363, p<0.001), insulin (-0.351, p<0.001), and lnTG (-0.402, p<0.001), and was positively correlated with HDL-C (0.471, p<0.001). The correlation between Pr-LPL mass and HOMA-IR was equally strong in men and women. Despite medications, hypertension, dyslipidemia, and metabolic syndrome were associated with low Pr-LPL mass. Multiple regression analysis revealed that HOMA-IR was the strongest predictor of Pr-LPL mass. Pr-LPL mass remained constant from 07:30 to 17:30 h.


CONCLUSIONS
Pr-LPL mass is a marker of insulin resistance in ambulatory type 2 DM receiving oral hypoglycemic agents, and Pr-LPL mass is stable during the daytime. Therefore, Pr-LPL mass may be more useful than HOMA-IR at diabetes clinics, especially for patients in the postprandial state.
Hanyu
Osamu
O
Division of Endocrinology and Metabolism, Department of Homeostatic Regulation and Development, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi, Niigata 951-8510, Japan.
Miida
Takashi
T
Kosuge
Keiichiro
K
Ito
Takako
T
Soda
Satoshi
S
Hirayama
Satoshi
S
Wardaningsih
Elfi
E
Fueki
Yuriko
Y
Obayashi
Konen
K
Aizawa
Yoshifusa
Y
D000553:Ambulatory Care; D015415:Biomarkers / Q000097:blood; D002940:Circadian Rhythm; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006493:Heparin / Q000737:chemistry; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007333:Insulin Resistance; D008071:Lipoprotein Lipase / Q000097:blood* / Q000737:chemistry*; D008297:Male; D008875:Middle Aged; D008970:Molecular Weight
D015415:Biomarkers; D007004:Hypoglycemic Agents; D006493:Heparin; D008071:Lipoprotein Lipase