Acute effects of casein on postprandial lipemia and incretin responses in type 2 diabetic subjects.
OBJECTIVE
Exaggerated and prolonged postprandial lipemia is potentially atherogenic and associated with type 2 diabetes. Limited data exist regarding the influence of dietary protein on postprandial lipemia in type 2 diabetes. We investigated, over 8-h, the acute effects of casein alone or in combination with carbohydrate on postprandial lipid and incretin responses to a fat-rich meal in type 2 diabetes.


RESULTS
Eleven type 2 diabetic subjects ingested four test meals in random order: an energy-free soup plus 80 g of fat (control-meal); control-meal plus 45 g carbohydrates (CHO-meal); control-meal plus 45 g of casein (PRO-meal); and PRO-meal plus 45 g carbohydrates (CHO+PRO-meal). Triglyceride and retinyl palmitate responses were measured in plasma and in a chylomicron-rich and chylomicron-poor fraction. We found no significant differences in triglyceride responses to PRO- and CHO+PRO-meal compared to the control-meal. However, the addition of casein to the CHO-meal reduced the raised triglyceride response in the chylomicron-rich fraction. Retinyl palmitate responses did not differ significantly between meals in the chylomicron-rich fraction, whereas the PRO-meal increased retinyl palmitate in the chylomicron-poor fraction. PRO- and PRO+CHO-meal increased insulin and glucagon compared to the control-meal. PRO+CHO-meal increased the glucose-dependent insulinotropic peptide response while no change in glucagon-like peptide-1 responses was detected.


CONCLUSIONS
The data presented suggest that casein per se did not modulate the postprandial triglyceride response in type 2 diabetes. When added to carbohydrate, casein suppressed the triglyceride response in the chylomicron-rich fraction, increased insulin and glucagon but did not affect the incretin responses.
Brader
L
L
Department of Endocrinology and Metabolism, Aarhus University Hospital, Aarhus Sygehus THG, Denmark.
Holm
L
L
Mortensen
L
L
Thomsen
C
C
Astrup
A
A
Holst
J J
JJ
de Vrese
M
M
Schrezenmeir
J
J
Hermansen
K
K
D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002364:Caseins / Q000008:administration & dosage* / Q000009:adverse effects; D002914:Chylomicrons / Q000097:blood; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D004040:Dietary Carbohydrates / Q000008:administration & dosage* / Q000009:adverse effects; D004041:Dietary Fats / Q000008:administration & dosage* / Q000009:adverse effects; D004044:Dietary Proteins / Q000008:administration & dosage* / Q000009:adverse effects; D004224:Diterpenes; D005260:Female; D005934:Glucagon / Q000097:blood; D052216:Glucagon-Like Peptide 1 / Q000097:blood; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000209:etiology*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D054795:Incretins / Q000097:blood*; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D000084562:Retinyl Esters; D013997:Time Factors; D014280:Triglycerides / Q000097:blood; D014801:Vitamin A / Q000031:analogs & derivatives / Q000097:blood
D015415:Biomarkers; D001786:Blood Glucose; D002364:Caseins; D002914:Chylomicrons; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins; D004224:Diterpenes; D005934:Glucagon; D052216:Glucagon-Like Peptide 1; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D054795:Incretins; D007328:Insulin; D000084562:Retinyl Esters; D014280:Triglycerides; D014801:Vitamin A; C517652:hemoglobin A1c protein, human; C014794:retinol palmitate