engleski

Lipid and apolipoprotein predictors of progression from asymptomatic state or impaired glucose tolerance to type 2 diabetes mellitus

Background. To relate lipoprotein profile, conventional lipid and glycemia along with abdominal fat to explore the possible risk factors associated with the progression from a non-diabetic, asymptomatic state to IGT, IGF and type-2 DM in Maltese Canadian population. Methods. We conducted analysis of 780 subjects using the ADA and WHO criteria to classify subjects into groups based on: 1) normal glucose tolerance with FBG <6.0 and 2hBG <7.5 ; 2) isolated IFG (FBG 6.1-6.9 and 2hBG <8.0) ; 3) isolated IGT (FBG >6.1 and 2hBG 8-12) ; and 4) combined IFG/IGT (FBG 6.1- 6.9 and 2hBG 8-12).We compared the three groups for glycemia, insulin secretion, and insulin sensitivity based on their apolipoprotein levels and abdominal fat. Results. The subjects with higher apolipoprotein levels (12.8 (IGT) vs. 8.9 mg/dL (normal), P<0.001), WHR (0.91 (IfG) vs. 0.89 (normal), P<0.01) and higher abdominal fat were found to be suffering from IGF and IGT and were highly insulin resistant. There were significant differences in the 2-h glucose (5.2 for NGT vs. 9.1 for IGT and 13.4 mmol/L for T2DM, P<0.001) and insulin (37.1 vs. 89.3 vs. 53.2, ?U/mL). Conclusions. Poor glycemia was associated with potentially more atherogenic lipoprotein profiles and led to the worsening of insulin resistance and insulin secretory dysfunction. The higher apolipoprotein C-III and B levels, BMI and abdominal fat were strongly associated with metabolic abnormalities and shown to be predictors of diabetes.

metabolic syndrome; impaired fasting glucose; impaired glucose tolerance; insulin resistance; type 2 diabetes mellitus

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