DOĞAN, Serdar; ASLAN, İbrahim; KÜÇÜKSAYAN, Ertan; ASLAN, Mutay
March 2012
Turkish Journal of Biochemistry / Turk Biyokimya Dergisi;2012 Special Issue, Vol. 37 Issue S1, p134
Academic Journal
The aim of this study was to evaluate the effect of insulin analog initiation therapy on lipid metabolism and LDL subfractions in type 2 diabetic patients. Twenty four type 2 diabetic patients with HbA1c levels above 10% despite ongoing combination therapy with sulphonylurea and metformin were selected. Former treatment regimen was continued for the first day followed by substitution of sulphonylurea therapy with different insulin analogs plus metformin. Glycemic profiles were determined over 72 hours by continuous glucose monitoring system (CGMS) and blood samples were obtained from all patients at 24 and 72 hours. Cholesteryl ester transfer protein (CETP) and lecithin-cholesterol acyltransferase (LCAT) mass, apoB and apoA-I were determined by ELISA. Paraoxonase activity (PON) was measured kinetically by the formation of phenol. LDL subfraction analysis was done by polyacrylamide gel electrophoresis. Mean blood glucose, total cholesterol, triglyceride and VLDL levels were significantly decreased after insulin treatment. The significant increase in CETP mass observed after insulin treatment suggests that insulin caused rapid up-regulation of CETP. No significant difference was observed in LDL cholesterol levels but insulin treatment resulted in a significant increase in LDL-1 subgroup and a significant reduction in LDL-3 and LDL-4 subgroups. Plasma apoB levels were significantly decreased after treatment supporting VLDL reduction. These findings indicate that insulin initiation therapy activates lipid metabolism by up-regulation of CETP and shows anti-atherogenic effects via increasing LDL-1 and decreasing LDL-3 and LDL-4 subgroups in a short periodoftime. Thisworkwas supported byagrant (No:1 12S034)from TUBITAK.


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