Postprandial lipid and apolipoprotein responses following three consecutive meals associate with liver fat content in type 2 diabetes and the metabolic syndrome

Tushuizen, Maarten E.; Pouwels, Petra J.; Bontemps, Saskia; Rustemeijer, Cees; Matikainen, Niina; Heine, Robert J.; Taskinen, Marja-Riitta; Diamant, Michaela

doi:10.1016/j.atherosclerosis.2010.02.002

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Volume 211, Issue 1 , Pages 308-314, July 2010

Postprandial lipid and apolipoprotein responses following three consecutive meals associate with liver fat content in type 2 diabetes and the metabolic syndrome

Maarten E. Tushuizen
- Department of Endocrinology/Diabetes Center, The Netherlands
Petra J. Pouwels
- Department of Physics & Medical Technology, VU University Medical Center, The Netherlands
Saskia Bontemps
- Department of Endocrinology/Diabetes Center, The Netherlands
Cees Rustemeijer
- Department of Internal Medicine, Hospital Amstelland, Amstelveen, The Netherlands
Niina Matikainen
- Department of Medicine, University of Helsinki, Helsinki, Finland
Robert J. Heine
- Department of Endocrinology/Diabetes Center, The Netherlands
Marja-Riitta Taskinen
- Department of Medicine, University of Helsinki, Helsinki, Finland
Michaela Diamant
- Department of Endocrinology/Diabetes Center, The Netherlands
- Corresponding author at: Department of Endocrinology/Diabetes Center, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands. Tel.: +31 204440534; fax: +31 204440530.

Received 11 May 2009; received in revised form 31 January 2010; accepted 1 February 2010. published online 15 March 2010.

Abstract

Objective

Liver fat is associated with dyslipidemia following a fat load. Previous studies demonstrated that alimentary fat is temporarily retained within enterocytes and mobilized by subsequently ingested nutrients. As this potentially contributes to cumulative postprandial hyperlipidemia, we assessed postprandial lipoprotein changes and their association with liver fat following 3 consecutive meals during a 24h period in males with type 2 diabetes, and men with the metabolic syndrome (MetS).

Methods

Plasma lipids were measured in 14 type 2 diabetic, 14 MetS and 14 healthy age-matched males, following a standardized breakfast (t=0h), lunch (t=4h) and diner (t=8h). Blood samples were collected before and at t=2, 4, 6, 8, 12, 16, 20 and 24h following breakfast. Liver fat was measured by proton magnetic resonance spectroscopy.

Results

Type 2 diabetic (mean age 55 (4.2) years; HbA1c 7.2 (1.1)%) and MetS men had similar BMI, waist, blood pressure and triglycerides. 24h-AUC triglycerides, ApoB, and cholesterol-rich-remnants, but not ApoB-48, differed significantly among groups (calculated by ANOVA, all P<0.05). Liver fat was independently associated with 24h-AUC triglycerides, ApoB and cholesterol-rich-remnants (r=0.57, P<0.001, r=0.38, P=0.017; r=0.48, P=0.002, respectively), but not with 24h-AUC ApoB-48 (r=0.22, P=0.18).

Conclusions

In type 2 diabetes and the MetS exposure to 3 consecutive meals produced exaggerated 24h triglyceride, ApoB and cholesterol-rich-remnant concentrations, which were closely associated with liver fat. Instead, ApoB-48 peak was delayed in type 2 diabetes, but not related to liver fat. In addition to liver fat, other mechanisms, including local intestinal processes, determine atherogenic postprandial lipoprotein changes following 3 consecutive meals during 24h.

Keywords: Postprandial dyslipidemia, Type 2 diabetes, Liver fat, Metabolic syndrome, Apolipoproteins, Cholesterol-rich-remnants