Jejunal wall triglyceride concentration of morbidly obese persons is lower in those with type 2 diabetes mellitus

F Soriguer,S García-Serrano,L Garrido-Sánchez,C Gutierrez-Repiso,G Rojo-Martínez,E Garcia-Escobar,J García-Arnés,J.L Gallego-Perales,V Delgado,Eduardo García-Fuentes

doi:10.1194/jlr.m007815

Abstract

The overproduction of intestinal lipoproteins may contribute to the dyslipidemia found in diabetes. We studied the influence of diabetes on the fasting jejunal lipid content and its association with plasma lipids and the expression of genes involved in the synthesis and secretion of these lipoproteins. The study was undertaken in 27 morbidly obese persons, 12 of whom had type 2 diabetes mellitus (T2DM). The morbidly obese persons with diabetes had higher levels of chylomicron (CM) triglycerides (P < 0.001) and apolipoprotein (apo)B48 (P = 0.012). The jejunum samples obtained from the subjects with diabetes had a lower jejunal triglyceride content (P = 0.012) and angiopoietin-like protein 4 (ANGPTL4) mRNA expression (P = 0.043). However, the apoA-IV mRNA expression was significantly greater (P = 0.036). The jejunal triglyceride content correlated negatively with apoA-IV mRNA expression (r = -0.587, P = 0.027). The variables that explained the jejunal triglyceride content in a multiple linear regression model were the insulin resistance state and the apoA-IV mRNA expression. Our results show that the morbidly obese subjects with diabetes had lower jejunal lipid content and that this correlated negatively with apoA-IV mRNA expression. These findings show that the jejunum appears to play an active role in lipid homeostasis in the fasting state.

Highlights

The overproduction of intestinal lipoproteins may contribute to the dyslipidemia found in diabetes
The lower content in the morbidly obese persons with type 2 diabetes mellitus (T2DM) was corroborated by the reduction in neutral lipids seen on Oil Red-O staining of the jejunum [T2DM versus non-T2DM (Fig. 2A, B); and T2DM versus non-T2DM (Fig. 2C, D)]
This study shows that the lipid content of the jejunum in morbidly obese persons varies significantly between patients with or without T2DM, and it is inversely related with the plasma levels of chylomicrons, homeostasis model assessment of insulin resistance (HOMA-IR), and apoA-IV mRNA expression

Summary

Introduction

The overproduction of intestinal lipoproteins may contribute to the dyslipidemia found in diabetes. The study was undertaken in 27 morbidly obese persons, 12 of whom had type 2 diabetes mellitus (T2DM). The jejunal triglyceride content correlated negatively with apoA-IV mRNA expression (r = ؊0.587, P = 0.027). The variables that explained the jejunal triglyceride content in a multiple linear regression model were the insulin resistance state and the apoA-IV mRNA expression. Our results show that the morbidly obese subjects with diabetes had lower jejunal lipid content and that this correlated negatively with apoA-IV mRNA expression. These findings show that the jejunum appears to play an active role in lipid homeostasis in the fasting state.—Soriguer, F., S.

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