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Postprandial Hypertriglyceridemia and Insulin Resistance in Normoglycemic First-Degree Relatives of Patients with Type 2 Diabetes

Mette Axelsen, PhD; Ulf Smith, MD, PhD; Jan W. Eriksson, MD, PhD; Marja-Riitta Taskinen, MD, PhD; and Per-Anders Jansson, MD, PhD
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From the Lundberg Laboratory for Diabetes Research, Sahlgrenska University Hospital, Göteborg University, Göteborg, Sweden; Norrland University Hospital, Umeå, Sweden; and the University of Helsinki, Helsinki, Finland.

Acknowledgment: The authors thank Ms. Margareta Landén for technical assistance.

Grant Support: By the Swedish Medical Research Council (project B-3506), the IngaBritt and Arne Lundberg Foundation, the Swedish Diabetes Association, the European Community (BMH4-CT96-0751), the Å ke Wiberg Foundation, the Magnus Bergvall Foundation, and the Regional Health Care Authority of West Sweden.

Requests for Reprints: Mette Axelsen, PhD, The Lundberg Laboratory for Diabetes Research, Department of Internal Medicine, Sahlgrenska University Hospital/SS, S-413 45 Göteborg, Sweden.

Current Author Addresses: Drs. Axelsen, Smith, and Jansson: The Lundberg Laboratory for Diabetes Research, Department of Internal Medicine, Sahlgrenska University Hospital/SS, S-413 45 Göteborg, Sweden.

Dr. Eriksson: Department of Medicine, Norrland University Hospital, S-901 85 Umeå, Sweden.

Dr. Taskinen: Department of Medicine, University Central Hospital, 002 90 Helsinki 29, Finland.

Ann Intern Med. 1999;131(1):27-31. doi:10.7326/0003-4819-131-1-199907060-00006
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Background: Impaired ability to eliminate lipids in the postprandial state is an atherogenic trait associated with insulin resistance.

Objective: To assess insulin sensitivity and postprandial triglyceride metabolism in prediabetic persons.

Design: Cross-sectional study.

Setting: Sahlgrenska University Hospital, Göteborg, Sweden.

Participants: 13 healthy, normotriglyceridemic men with two first-degree relatives with type 2 diabetes and 13 carefully matched controls without known diabetes heredity.

Measurements: Oral glucose tolerance test, insulin sensitivity (euglycemic clamp technique), and fasting and postprandial triglyceride levels after a mixed meal.

Results: Relatives of persons with type 2 diabetes were insulin resistant but had normal glucose tolerance. They exhibited postprandial hypertriglyceridemia; the 6-hour triglyceride incremental area under the curve was 50% higher than that of the control group (P = 0.037).

Conclusions: These healthy male first-degree relatives of patients with type 2 diabetes are insulin resistant and exhibit postprandial lipid intolerance despite having normal fasting triglyceride levels. These characteristics, which occur in the absence of glucose intolerance, are associated with an increased risk for macroangiopathy.


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Metabolic variables during a meal tolerance test in 13 first-degree relatives of patients with type 2 diabetes (white circles) and 13 controls (black circles). A.B.C.D.P

Mean glucose level. Mean insulin level. Mean triglyceride level. Mean free fatty acid level. Asterisks signify that a value less than 0.05 was used for comparisons. Vertical bars represent standard error. To convert plasma glucose values to mg/dL, divide by 0.00555. IAUC = incremental area under the curve.

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