Abstract
Recently, it has been shown that hyperinsulinemia is an independent risk factor of atherosclerosis and that non-insulin-dependent diabetic (NIDD) patients undergo transition to hyperinsulinemia due to their insulin resistance or exogenously injected insulin. Therefore, it is important to study the role of hyperinsulinemia in atherogenesis of NIDD patients in relation to their lipid metabolism to obtain a better understanding of the prognosis of these patients. Total cholesterol (TC), triglyceride, HDL-cholesterol (HDL-C) and apoproteins (Apo A-I, A-II, B, C-II, C-III, E) were examined as the parameters of lipid metabolism and the endogenous insulin secretory capacity was assessed by the c-peptide level 5 minutes after glucagon injection (5-CPR). Lipid studies were performed on 38 controls and 67 NIDD patients and glucagon test on 10 controls and 67 NIDD patients. Patients were divided into two groups based on the 5-CPR results. The low responder (LR) group consisted of 5-CPR<1.8ng/ml and the responder (R) group≥1.8ng/ml. HDL-C, Apo A-I and TC/Apo B were lower in the R group than the LR group. In contrast, Apo B, Apo E and B/A-I were higher in the R group than the LR group. These results suggest that lipid metabolism of NIDD patients with a residual endogenous insulin secretory capacity was more atherogenic than that in patients with a low endogenous insulin secretory capacity.
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