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Relationship between altered postprandial lipemia and insulin resistance in normolipidemic and normoglucose tolerant obese patients

International Journal of Obesity volume 24, pages 468–478 (2000)Cite this article

Abstract

OBJECTIVE: Although there are changes in the postprandial lipid responses of obese patients, these are closely associated with high fasting triglycerides (TG). This study of 17 normotriglyceridemic, normoglucose-tolerant android obese subjects (body mass index, BMI=34.3±3.1 kg/m2) and 33 normal-weight controls (BMI=21.8±1.6 kg/m2) was done to examine their postprandial responses to an oral fat loading test containing retinol (890 calories, 85% fat) and to evaluate the possible association between clinical and biological features of obesity and/or insulin resistance and postprandial lipemia.

SUBJECTS AND MEASUREMENTS: Blood samples were taken before giving the fat load and at 2,3,4,5,6 and 8 h after it. Insulin sensitivity was assessed using HOMA, and TG and retinyl palmitate (RP) in the plasma, chylomicrons and non-chylomicron fractions were measured each time.

RESULTS: The areas under the curves (AUC) of chylomicron TG for the obese and controls were not different, indicating adequate lipolytic activity. By contrast, the AUC for non-chylomicron TG was significantly greater in the obese than in the controls (512±135 vs 429±141 mmol/l min, P<0.01). In addition, the AUC for RP in this same fraction was significantly lower in the obese than in the controls (103±55 vs 157±88 mg/l min, P<0.05), suggesting that the TG from endogenous lipoproteins accounted for most of the increase in TG in the non chylomicron fraction. Parameters related to obesity showed no relationship with these postprandial abnormalities, whereas HOMA, which discriminated between the groups, partly explained (r 2=23%, P<0.01) the significant increase in non-chylomicron TG.

CONCLUSIONS: Android obese patients with a fasting TG in the normal range and not different from the fasting TG of lean controls had an abnormal postprandial lipemia response, indicated by a significantly greater TG in the non-chylomicron subfraction than in controls. These alterations may be partly due to postprandial changes in endogenous lipoproteins as a consequence of insulin resistance.

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Acknowledgements

This work was supported by a grant from the Ministère de la Santé et de la Solidarité Nationale: Projet Hospitalier de Recherche Clinique 1994. Experimental oral fat loads were supplied by Laboratories Pierre Fabre Santé, Castres, France. We thank the staff of the Centre d'Investigation Clinique du CHU de Nancy for their clinical help and the staff of the Broussais Hospital for their technical assistance. We also thank Dr Anik Girard-Globa for her constructive criticism during the preparation of this manuscript. Dr Owen Parkes checked the English text.

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  1. Centre d'Investigation Clinique (CIC-Inserm/CHU de Nancy), Service de Diabétologie, Maladies Métaboliques et Maladies de la Nutrition, Hôpital Jeanne d'Arc, Toul, 54201, France

    B Guerci, S Hadjadj & P Drouin

  2. Service d'Endocrinologie, Diabétologie et Maladies Métaboliques, CHU de Dijon, Dijon, 21000, France

    B Vergès

  3. Service d'Endocrinologie, Maladies Métaboliques et Médecine Interne, CHU de Reims, Reims, 51092, France

    V Durlach

  4. Laboratoire de Biochimie, Hôpital Broussais, AP-HP, 75014 Paris, Faculté de Pharmacie, Paris XI, Chatenay-Malabry, 92296, France

    J-L Paul

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Correspondence to B Guerci.

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Guerci, B., Vergès, B., Durlach, V. et al. Relationship between altered postprandial lipemia and insulin resistance in normolipidemic and normoglucose tolerant obese patients. Int J Obes 24, 468–478 (2000). https://doi.org/10.1038/sj.ijo.0801181

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