Hyperinsulinemia and VLDL Kinetics

  • George Steiner
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 334)


The most frequent lipoprotein abnormality in diabetes mellitus is hypertriglyceridemia. The frequency of hypercholesterolemia is not very different from that found in the nondiabetic population.1,2 In those diabetic individuals who are grossly insulin deficient, the hypertriglyceridemia is due to an accumulation of chylomicrons, the primary transporters of dietary lipids. However, most diabetics, particularly those with NIDDM, do not have such severe insulin deficiency. In fact, as will be indicated below, many are hyperinsulinemic.3 In them the hypertriglyceridemia is due to an increased concentration of those triglyceride-rich lipoproteins that transport endogenous (i.e. nondietary) triglyceride. Such lipoproteins are generally called VLDL. However, they are in fact a population of lipoproteins that cover a wide spectrum of size and density. We have found, in nondiabetic individuals, that 75% of this population of lipoproteins is in the smaller, Sf 12–60 subpopulation of lipoproteins, a population also referred to as IDL.4 Based on kinetics considerations, this subpopulation in humans conforms to the characteristics of VLDL remnants.5 The remnant lipoproteins have been shown by many to be associated with an increased incidence of coronary artery disease.6–8


Lipoprotein Lipase Plasma Free Fatty Acid Triglyceride Fatty Acid VLDL Secretion Insulin Treated Group 
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Copyright information

© Springer Science+Business Media New York 1993

Authors and Affiliations

  • George Steiner
    • 1
  1. 1.Toronto General DivisionThe Toronto HospitalTorontoCanada

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