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From the Clinical Research Centers |
Stanford University School of Medicine, Stanford, California 94305; Tokyo Medical Dental University, Tokyo 113-8519, Japan; and Otsuka America Pharmaceutical, Inc., Rockville, Maryland 20850
Address all correspondence and requests for reprints to: G. M. Reaven, M.D., 213 East Grand Avenue, South San Francisco, California 94080. E-mail: greaven{at}shaman.com
This study was initiated to test the hypothesis that plasma
concentrations of remnant lipoproteins would be higher after an
overnight fast in insulin-resistant compared to insulin-sensitive
volunteers. Forty-three healthy nonobese women were studied, divided
into insulin-resistant (n = 21) and insulin-sensitive (n =
22) groups on the basis of their steady state plasma glucose (SSPG)
concentration at the end of a 180-min infusion of octreotide
acetate, insulin, and glucose. Under these conditions, steady
state plasma insulin concentrations are similar in all subjects (
60
µU/mL), and the higher the SSPG concentrations, the more insulin
resistant the individual. By selection, mean (±SEM) SSPG
concentrations were significantly higher (P <
0.001) in the insulin-resistant group (210 ± 7 vs.
78 ± 3 mg/dL). In addition, the insulin-resistant group had
higher triglycerides (198 ± 27 vs. 101 ± 12
mg/dL; P < 0.005) and lower high density
lipoprotein cholesterol (48 ± 4 vs. 60 ± 4
mg/dL; P < 0.05) concentrations. Finally, insulin
resistance was associated with higher remnant lipoprotein particle
concentrations of cholesterol (7.2 ± 0.8 vs.
4.4 ± 0.3; P < 0.005) and triglycerides
(22.2 ± 3.4 vs. 8.5 ± 1.0;
P < 0.001). All of these differences were seen
despite the fact that the two groups were similar in terms of age and
body mass index. These results identify additional abnormalities in
lipoprotein metabolism that may contribute to the increased risk of
coronary heart disease seen in insulin-resistant, nondiabetic subjects
(syndrome X).
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