Background: Prebeta1-HDL is a minor HDL subfraction that is an initial acceptor of cellular free cholesterol. Prebeta1-HDL is elevated in hypertriglyceridemia, which is exaggerated with postprandial hyperglycemia. We investigated whether the prebeta1-HDL concentration changes postprandially in type 2 diabetic patients and blood glucose (BG) control reduces this change.
Methods: We examined 9 healthy controls and 20 diabetic patients with poor BG control. Seven blood samples (30 min before and 2 h after each meal, and at midnight) were obtained daily in the poor (poor-GC: n=20) and improved (imp-GC: n=11) glycemic control phases of diabetic patients after intensive insulin therapy and a low-calorie diet.
Results: The prebeta1-HDL concentration did not change postprandially in the controls. However, the fasting prebeta1-HDL concentration in the poor-GC phase was 28.3% higher than in the controls (25.4+/-6.8 vs 19.8+/-6.9 mg/l ApoAI, p<0.05) and decreased markedly after breakfast (20.9+/-7.7 mg/l ApoAI, p<0.01). In the imp-GC phase, the prebeta1-HDL concentration showed no morning surge, as in the controls.
Conclusions: Type 2 diabetic patients in the poor-GC phase have high prebeta1-HDL levels in the morning, followed by a gradual reduction until midnight. BG control diminishes this postprandial change. Glucose metabolism may be involved in modulating reverse cholesterol transport in type 2 diabetic patients.