Acta Diabetologica

, Volume 28, Issue 1, pp 61–69 | Cite as

Plasma lipoproteins and apolipoproteins in insulin-dependent and young non-insulin-dependent Arab women

  • Najah Al-Muhtaseb
  • Abdul Razzak Al-Yousuf
  • Jasbir Singh Bajaj
Original Contributions


Plasma lipids, lipoproteins and apolipoproteins (apo) were analysed in 30 young Arab IDDM and 50 young insulin-requiring NIDDM women. The mean age of IDDM and NIDDM groups was 20.2 and 34.5 years, and mean duration of diabetes was 5.7 and 4.6 years, respectively. Two groups of 40 and 60 healthy women (matched for age and BMI) provided corresponding control groups. In comparison with control subjects, diabetics showed marked increases in the following parameters: total cholesterol (TC), low density lipoprotein (LDL) cholesterol, total triglycerides (TG), very low density lipoprotein (VLDL) triglycerides, phospholipids, apoB, LDL apoB, glucose and glycosylated hemoglobin (HbA1c) as well as the ratios of total cholesterol/high density lipoprotein (HDL) cholesterol, LDL-cholesterol/HDL-cholesterol, LDL cholesterol/high density lipoprotein 2 (HDL2) cholesterol and apoB/apoAI. Plasma LCAT activity, concentrations of HDL3 apoAI and apoAII in plasma and lipoprotein fractions were normal in both the diabetic groups. Levels of C-peptide, HDL, HDL2 and HDL3 cholesterol, plasma apoAI, HDL apoAI and HDL2 apoAI were markedly decreased in the diabetic groups as compared to their corresponding controls. There was no significant correlation between fasting glucose or HbA1c and any of the above parameters. Despite insulin therapy in both the diabetic groups studied, abnormalities in lipids, apoB and apoAI still persisted. Our data suggest a possible higher risk of atherosclerosis in these patients.


Apolipoproteins Atherosclerosis C-peptide Coronary heart disease Glucose HDL fractions Hemoglobin A1c Insulin-dependent diabetes LCAT activity LDL Morbidity Mortality Non-insulin-dependent diabetes VLDL 


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  1. 1.
    Allain C. C., Poon L. S., Chan C. S. G., Richmond W., Fu P. C.: Enzymatic determination of total serum cholesterol—Clin. Chem.20, 470, 1974.PubMedGoogle Scholar
  2. 2.
    Al-Muhtaseb N., A-Yuosuf A. R., Abdella N., Fenech F.: Lipoproteins and apolipoproteins in unique group of young non-obese Arab women with NIDDM treated with insulin—Diabet. Care12, 325, 1989.CrossRefGoogle Scholar
  3. 3.
    Avogaro P., Bittolo B., Cazzolato G., Quinci G. B.: Plasma levels of apolipoprotein A-I and apolipoprotein B in human atherosclerosis—Artery4, 385, 1978.Google Scholar
  4. 4.
    Barrett Connor E., Witztum J. L., Holdbrook M.: A community study of high density lipoproteins in adults non-insulin dependent diabetics—Amer. J. Epidemiol.117, 186, 1983.Google Scholar
  5. 5.
    Bergman M., Gidez L. I., Eder H. A.: HDL and HDL sub-classes in diabetes—Diabetes31 (Suppl. 2), 14, 1982; Abstract no 56.Google Scholar
  6. 6.
    Briones E. R., Mao S. T., Palumbo P. J. O., Fullon W. M., Cheoweth W., Kottke A. B.: Analysis of plasma lipids and apolipoproteins in insulin-dependent diabetes—Metabolism133, 42, 1984.CrossRefGoogle Scholar
  7. 7.
    Chase P. H., Glasgow A. M.: Juvenile diabetes and serum lipids and lipoprotein levels— Amer. J. Dis. Child.130, 1113, 1976.PubMedGoogle Scholar
  8. 8.
    Cheung M. C., Albers J. J.: The measurement of apolipoprotein AI and AII levels in men and women by immunoassay—J. clin. Invest.60, 43, 1977.PubMedGoogle Scholar
  9. 9.
    Curtiss L. K., Witzum J. L.: Plasma apolipoproteins AI, AII, B, CI and E are glycosylated in hyperglycemic diabetic subjects—Diabetes34, 452, 1985.PubMedCrossRefGoogle Scholar
  10. 10.
    Dieplinger H., Kostner G.: The determination of lecithin cholesterol acyltransferase in the clinical laboratory—Clin. Chim. Acta (Amst.)106, 319, 1980.CrossRefGoogle Scholar
  11. 11.
    Eggstein M.: Eine neue Bestimmung der neutralen Fette in Blutserum und Gewebe—Klin. Wschr.44, 267, 1966.PubMedCrossRefGoogle Scholar
  12. 12.
    Elkeles R. S., Khan S. R., Nith-thyanan-than R., Seed M., Wynn V.: High density lipoprotein subfraction cholesterol in hyper-triglyceridaemia—Atherosclerosis43, 423, 1982.PubMedCrossRefGoogle Scholar
  13. 13.
    Emara M. K.: Acute myocardial infarction in diabetic patients in Kuwait—Saudi Med. J.4, 139, 1983.Google Scholar
  14. 14.
    Fielding C. J., Shore V. G., Fielding P. E.: A protein cofactor of lecithin cholesterol acyltransferase—Biochem. biophys. Res. Commun.46, 1493, 1972.PubMedCrossRefGoogle Scholar
  15. 15.
    Frohlich J., Mcleod R., Hon K.: Lecithin cholesterol acyltransferase (LCAT)—Clin. Biochem. Rev.15, 269, 1982.CrossRefGoogle Scholar
  16. 16.
    Gibbons G. F.: Hyperlipidaemia of diabetes—Clin. Sci.71, 477, 1986.PubMedGoogle Scholar
  17. 17.
    Gonen B., White B. N., Schonfeld N., Skor G., Miller D. P., Santiago J.: Plasma levels of apolipoprotein with diabetes mellitus. The effect of glycemic control—Metabolism34, 675, 1985.PubMedCrossRefGoogle Scholar
  18. 18.
    Graninger W., Schernthaner G., Conca W., Kostner G. M.: Influence of normoglycemia on apolipoproteins, Lp(a) and LCAT activity in type I diabetics. 16th Annual Meeting of the European Society of Clinical Investigation, INSERM, France; 1982; p. 14, Abstract 82.Google Scholar
  19. 19.
    Havel R. J., Eder H. A., Bragdon J. H.: The distribution and chemical composition of ultracentrifugally separated lipoproteins in human serum—J. clin. Invest.34, 1345, 1955.PubMedCrossRefGoogle Scholar
  20. 20.
    Hollenbeck C. B., Idachen Y. D., Greensfield M. S., Lardinois C. K., Reaven G. M.: Reduced plasma HDL-cholesterol concentration need not increase when hyperglycemia is controlled insulin in NIDDM—J. clin. Endocrinol. Metabol.63, 605, 1986.CrossRefGoogle Scholar
  21. 21.
    Jarrett R. J., Keen H., Chakrabarti R.: Diabetes, hyperglycemia and arterial disease. In:Jarrett R. J., Keen H. (Eds): Complication of Diabetes. 2nd Ed. Edward Arnold, London, 1982; p. 179.Google Scholar
  22. 22.
    Kalevi P.: Diabetes and coronary heart disease—Acta Endocrinol.110 (Suppl. 272), 11, 1985.Google Scholar
  23. 23.
    Kissebah A. H., Alfarsi S., Evans D. J., Adams P. W.: Integrated regulation of very low density lipoprotein triglyceride and apolipoprotein B kinetics in non-insulin-dependent diabetes mellitus—Diabetes31, 217, 1982.PubMedCrossRefGoogle Scholar
  24. 24.
    Laakso M., Kalevi P., Erkki V., Jukka M.: Plasma insulin and serum lipids and lipoproteins in middle-aged non-insulin-dependent diabetic and non-diabetic subjects—Amer. J. Epidemiol.125, 611, 1987.Google Scholar
  25. 25.
    Laakso M., Voutilainen E., Sarlund H., Aro A., Pyorala K., Penttila I.: Inverse relationship of serum HDL and HDL2 cholesterol to C-peptide level in middle-aged insulin treated diabetics —Metabolism34, 715, 1985.PubMedCrossRefGoogle Scholar
  26. 26.
    Laakso M., Voutilainen E., Sarlund H., Aro A., Pyorala K., Penttila I.: Serum lipids and lipoproteins in middle-aged non-insulin-dependent diabetes—Atherosclerosis56, 271, 1985.PubMedCrossRefGoogle Scholar
  27. 27.
    Lees R. S.: Immunoassay of plasma low density lipoproteins—Science169, 493, 1970.PubMedCrossRefGoogle Scholar
  28. 28.
    Lish H. J., Sailor S.: Lipoprotein patterns in diet, sulphonylurea and insulin treated diabetics— Diabetologia20, 118, 1981.CrossRefGoogle Scholar
  29. 29.
    Lopes-Virella M. F., Wohltmann H. J., Loadholt C. B., Buse M. G.: Plasma lipids and lipoproteins in young insulin-dependent-diabetic patients: relationship with control—Diabetologia21, 216, 1981.PubMedCrossRefGoogle Scholar
  30. 30.
    Lopes-Virella M. F., Wohltmann H. J., Mayfield R. K., Loadholt C. B., Colwell A.: Effect of metabolic control on lipid, lipoprotein and apolipoprotein levels in 55 insulin-dependent diabetic patients—Diabetes32, 20, 1983.PubMedGoogle Scholar
  31. 31.
    Madsbad S., Krarup T., McNair P., Christiansen C., Faber O. K., Transbøl I., Binder C.: Practical clinical value of the C-peptide response to glucagon stimulation in the choice of treatment in diabetes mellitus—Acta med. scand.210, 153, 1981.PubMedCrossRefGoogle Scholar
  32. 32.
    Misra D. P., Staddon G., Misra J., Cook D.: Lecithin cholesterol acyltranferase activity in diabetes mellitus and the effect of insulin in these cases—Clin. chim. Acta. (Amst.)56, 83, 1974.CrossRefGoogle Scholar
  33. 33.
    Nikkilä E. A.: High density lipoproteins in diabetes—Diabetes30 (Suppl. 2), 82, 1981.PubMedGoogle Scholar
  34. 34.
    Nikkilä E. A.: Are plasma lipoproteins responsible for the excess atherosclerosis in diabetes? —Acta endocrinol.110 (Suppl. 272), 27, 1985.Google Scholar
  35. 35.
    Nikkilä E. A., Taskinen M.-R., Sane T.: Plasma high density lipoprotein concentration and subfraction distribution in relation to triglyceride metabolism—Amer. Heart J.113, 543, 1987.PubMedCrossRefGoogle Scholar
  36. 36.
    Pietri A., Dun F. L., Raskin P.: The effect of improved diabetic control on plasma lipid and lipoprotein levels-A comparison of conventional therapy and continuous subcutaneous insulin infusion—Diabetes29, 1001, 1980.PubMedCrossRefGoogle Scholar
  37. 37.
    Radwan M., Massoud A. A. H., Botros M., Ali M. A.: Epidemiology of diabetes mellitus. In:Vannasaeng S., Nitiyanant W., Chandrrapraset S. (Eds): International Symposium on Epidemiology of Diabetes Mellitus, 1986, Bangkok, Thailand. Bangkok, 1987; p. 190.Google Scholar
  38. 38.
    Rendel M.: C-peptide as clinical assay—Ligand Quart.24, 30, 1979.Google Scholar
  39. 39.
    Schernthaner G., Kostner G. M., Dieplinger H., Prager R., Muhlhanser I.: Apolipoproteins (AI, AII, B) LP (a) lipoprotein and lecithin. Cholesterol acyltransferase activity in diabetes mellitus—Atherosclerosis49, 277, 1983.PubMedCrossRefGoogle Scholar
  40. 40.
    Schonfeld G.: Diabetes, lipoproteins and atherosclerosis—Metabolism.34 (Suppl), 45, 1985.PubMedGoogle Scholar
  41. 41.
    Schonfeld G., Jacobson D., White N., Santiago J., Gonen B.: Metabolic control and plasma apolipoproteins in diabetic patients—Diabetes31 (Suppl. 2), 14, 1982; Abstract no 328.Google Scholar
  42. 42.
    Sosenko J. M., Breslow J. L., Miettinen O. S., Gabbay K. H.: Hyperglycemia and plasma lipid levels. A prospective study of young insulin-dependent diabetic patients—New Engl. J. Med.302, 650, 1980.PubMedCrossRefGoogle Scholar
  43. 43.
    Takayama M., Itoh S., Nagasaki T., Tanimizu T.: A new enzymatic method for determination of serum choline containing phospholipids—Clin. Chim. Acta (Amst.)79, 93, 1977.Google Scholar
  44. 44.
    Taskinen M. R., Nikkilä E. A.: Lipoprotein lipase activity of adipose tissue and skeletal muscle in insulin-deficient human diabetes—Diabetologia17, 351, 1979.PubMedCrossRefGoogle Scholar
  45. 45.
    Tayler K. G., Wright A. D., Carter T. J. N., Valente A. J., Belts S. A., Matthews K. A.: High density lipoprotein cholesterol and apolipoprotein AI levels at diagnosis in patient with non-insulin-dependent diabetes—Diabetologia20, 535, 1981.Google Scholar
  46. 46.
    Trinder P.: Determination of glucose in blood using glucoseoxidase with an alternative oxygen acceptor—Ann. clin. Biochem.6, 24, 1969.Google Scholar
  47. 47.
    Walden C. E., Knopp R. H., Wahl P. W., Beach K. W., Strandness E.: Sex differences in the effect of diabetes mellitus on lipoprotein triglyceride and cholesterol concentrations—New Engl. J. Med.311, 953, 1984.PubMedCrossRefGoogle Scholar
  48. 48.
    Who Expert Committee on Diabetes Mellitus: Technical Report Series No. 646. World Health Organization, 2nd Rep. Geneva, 7, 1980.Google Scholar
  49. 49.
    Who Study Group: Diabetes Mellitus. Technical Report Series. No. 727. World Health Organization, Geneva, 1985.Google Scholar
  50. 50.
    Winocour P. H., Ishola M., Durrington P. N., Anderson D. C.: Lipoprotein abnormalities in insulin dependent diabetes mellitus—Lancetii, 1176, 1986.CrossRefGoogle Scholar

Copyright information

© Casa Editrice Il Ponte 1991

Authors and Affiliations

  • Najah Al-Muhtaseb
    • 1
  • Abdul Razzak Al-Yousuf
    • 1
  • Jasbir Singh Bajaj
    • 1
  1. 1.Department of Medicine, Faculty of MedicineKuwait UniversitySafatKuwait

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