Delayed β-cell response and glucose intolerance in young women with Turner syndrome

<p>Abstract</p> <p>Background</p> <p>To investigate glucose homeostasis in detail in Turner syndrome (TS), where impaired glucose tolerance (IGT) and type 2 diabetes are frequent.</p> <p>Methods</p> <p>Cross sectional study of women with Turner syndrome (TS)(n = 13) and age and body mass index matched controls (C) (n = 13), evaluated by glucose tolerance (oral and intravenous glucose tolerance test (OGTT and IVGTT)), insulin sensitivity (hyperinsulinemic, euglycemic clamp), beta-cell function (hyperglycaemic clamp, arginine and GLP-1 stimulation) and insulin pulsatility.</p> <p>Results</p> <p>Fasting glucose and insulin levels were similar. Higher glucose responses was seen in TS during OGTT and IVGTT, persisting after correction for body weight or muscle mass, while insulin responses were similar in TS and C, despite the higher glucose level in TS, leading to an insufficient increase in insulin response during dynamic testing. Insulin sensitivity was comparable in the two groups (TS vs. control: 8.6 ± 1.8 vs. 8.9 ± 1.8 mg/kg*30 min; p = 0.6), and the insulin responses to dynamic β-cell function tests were similar. Insulin secretion patterns examined by deconvolution analysis, approximate entropy, spectral analysis and autocorrelation analysis were similar. In addition we found low IGF-I, higher levels of cortisol and norepinephrine and an increased waist-hip ratio in TS.</p> <p>Conclusions</p> <p>Young normal weight TS women show significant glucose intolerance in spite of normal insulin secretion during hyperglycaemic clamping and normal insulin sensitivity. We recommend regularly testing for diabetes in TS.</p> <p>Trial Registration</p> <p>Registered with <url>http://clinicaltrials.com</url>, ID nr: <a href="http://www.clinicaltrials.gov/ct2/show/NCT00419107">NCT00419107</a></p

Factors affecting the impaired uptake of chylomicron remnants in the cholestatic rat

We have previously shown that bile duct ligation inhibits the hepatic uptake of chylomicron remnants in rats. In the present study we have investigated different possible causes of this inhibition. Intravenous infusion of bile or sodium taurocholate reduced the hepatic chylomicron remnant uptake. Perfused livers from bile duct-ligated rats metabolized chylomicron remnants at a reduced rate. Rat hepatocyte monolayer cultures metabolized remnants formed in cholestatic rats and those formed in hepatectomized animals equally well, but serum from cholestatic rats inhibited remnant uptake more strongly than control serum. Bile duct ligation did not influence the clearance from plasma of human low-density lipoprotein, and the inhibition of hepatic remnant uptake was not affected by treatment of cholestatic rats with ethinylestradiol. The clearance of 125I-labeled asialofetuin was only slightly impaired by cholestasis, indicating that no strong inhibition of all endocytic processes of the hepatocytes occurred. The reduced hepatic uptake of chylomicron remnants in the cholestatic rat is thus not due to formation of abnormal remnant particles. An increased plasma bile acid concentration rapidly reduced the hepatic remnant uptake without causing any significant hyperlipidemia. However, the pathological lipoproteins accumulating in the cholestatic rat aggravated the hepatic uptake defect even further

Hydrolysis och chylomicron arachidonate and linoleate ester bonds by lipoprotein lipase and heaptic lipase

Chylomicrons labeled with [3H]arachidonic and [14C]linoleic acid were incubated with bovine milk lipoprotein lipase or rat postheparin plasma, containing both lipoprotein lipase and hepatic lipase. During incubation with bovine lipoprotein lipase, [3H]arachidonic acid was released from chylomicron triacylglycerols at a slower rate than [14C]linoleic acid. Only small amounts of [14C]linoleic acid were found as 1,2(2,3)-diacylglycerols, whereas a transient accumulation as [14C]monoacylglycerols was observed. In contrast, significantly more [3H]arachidonic acid was found as 1,2(2,3)-diacylglycerols than as monoacylglycerols at all time intervals investigated. The initial pattern of triacylglycerol hydrolysis by postheparin plasma was similar to that of bovine lipoprotein lipase. However, in contrast to the results obtained with bovine lipoprotein lipase, little [3H]1,2(2,3)-diacylglycerol accumulated. The addition of antiserum to hepatic lipase increased the amount of 3H found in 1,2(2,3)-diacylglycerols and inhibited the formation of free [3H]arachidonic acid. The antiserum also caused a significant inhibition of the hydrolysis of [3H]-but not of [14C]triacylglycerol. With regard to chylomicron phospholipids, the rate of hydrolysis of [14C]linoleoyl phosphatidylcholine with milk lipoprotein lipase was twofold higher than that of the [3H]arachidonyl phosphatidylcholine. However, the hepatic lipase of postheparin plasma had similar activity towards the two phosphatidylcholine species. Postheparin plasma rapidly hydrolyzed chylomicron 3H-labeled and 14C-labeled phosphatidylethanolamine to the same degree, and lipoprotein lipase similarly hydrolyzed 3H-labeled and 14C-labeled phosphatidylethanolamine at approximately equal rates. Antiserum to hepatic lipase inhibited the postheparin plasma hydrolysis of phosphatidylethanolamine and 3H-labeled phosphatidylcholine by about 60%, but the 14C-labeled phosphatidylcholine by only 27%.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorption and lymphatic transport of exogenous and endogenous arachidonic and linoleic acid in the rat

[3H]Arachidonic (20:4) and [14C]linoleic acid (18:2) were fed to thoracic duct-cannulated rats in test meals of either tracers alone, cream, Intralipid, pure arachidonic acid, or pure linoleic acid. Less [3H]20:4 than [14C]18:2 was recovered in chyle during the first 5 h. After cream feeding, the proportion of radioactivity found in phospholipids was high and increased during the first 3 h. After the meal (3-5 h) 61 +/- 6% of the 3H and 57 +/- 10% of the 14C was in phosphatidylcholine, and 11 +/- 3% of the 3H and 3.0 +/- 4% of the 14C was in phosphatidylethanolamine. Changing the fat vehicle to Intralipid or pure 18:2 decreased the proportion of label in the phospholipids and increased the 3H and 14C radioactivity in the triacylglycerol fraction, the distribution of 14C being influenced more than that of 3H. After feeding the tracers in 200 microliters of pure 20:4, greater than 90% of both isotopes was in triacylglycerol. During fasting, triacylglycerol transported 56% (0.7 mumol/h), phosphatidylcholine transported 34% (0.4 mumol/h), and phosphatidylethanolamine transported 10% (0.1 mumol/h) of the 20:4 mass. After cream or Intralipid feeding, the output of 20:4-containing phosphatidylcholine and phosphatidylethanolamine increased 2.1- to 2.8-fold, whereas the transport of 20:4 with triacylglycerol remained constant. Phospholipids thus became the predominant transport form for 20:4. After feeding 200 microliters of 20:4, the intestine produced, however, 20:4-rich triacylglycerols that transported 89% of the chyle 20:

A role for hepatic lipase in chylomicron and high density lipoprotein phospholipid metabolism

The rate of removal of phosphatidylethanolamine and phosphatidylcholine from the plasma of rats treated with antiserum to hepatic lipase was measured. The hepatic lipase antiserum was injected intravenously into animals prior to injection of 32P-labeled chylomicrons or 32P-labeled high density lipoproteins. In experiments in which 32P-labeled chylomicrons were injected, antiserum treatment inhibited removal of [32P]phosphatidylethanolamine from chylomicrons, and the unlabeled serum phosphatidylethanolamine levels increased 2-2.5-fold in 30 min. In contrast, hepatic lipase antiserum had no significant effect on the clearance of chylomicron [32P]phosphatidylcholine or on unlabeled phosphatidylcholine concentrations in serum after injection of chylomicrons. In experiments in which 32P-labeled high density lipoproteins were injected, the inhibitory effect of the antiserum on the rapid removal of [32P]phosphatidylethanolamine from the circulation was even more marked than its effect on the removal from chylomicrons. The removal of high density lipoprotein phosphatidylcholine on the other hand was unaffected by the antiserum, although a moderate increase in serum phosphatidylcholine concentration was seen. In antiserum-treated rats injected with 32P-labeled chylomicrons or high density lipoproteins, hepatic [32P]phosphatidylethanolamine radioactivity was decreased. Significantly more [32P]phosphatidylethanolamine was recovered from blood plus liver in the antiserum-treated rats, indicating that the antiserum inhibited the overall degradation of injected [32P]phosphatidylethanolamine. The data suggest that phosphatidylethanolamine is a preferred substrate for hepatic lipase in the metabolism of chylomicron and high density lipoprotein phospholipid