on June 19, 2003
Published online before print June 19, 2003, doi: 10.1161/01.ATV.0000082461.77557.C7
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on May 13, 2003
Accepted on May 29, 2003
Effects of Insulin Resistance and Obesity on Lipoproteins and Sensitivity to Egg Feeding
Robert H. Knopp *;
From the University of Washington (R.H.K., B.R., B.F., C.W., S.W., M.A.), Northwest Lipid Research Clinic and VA Puget Sound Health Care System (S.E.K.), Division of Metabolism, Endocrinology and Nutrition, Seattle, Wash. C.W. is presently at College of Medicine Research Office, University of Arizona, Tucson, Ariz.
* To whom correspondence should be addressed. E-mail: rhknopp{at}u.washington.edu.
Objective--This study was undertaken to determine if insulin resistance without and with obesity influences LDL response to dietary cholesterol and saturated fat.
Methods and Results--We fed 0, 2, and 4 egg yolks per day to 197 healthy subjects in a 4-week, double-blind, randomized, crossover design. Subjects were dichotomized on body mass index (<27.5 and 
27.5 kg/m2) and insulin sensitivity (insulin-sensitivity index 4.2x1.0-4 and <4.2x1.0-4 min-1 µU/mL), yielding insulin-sensitive (IS, n=65), insulin-resistant (IR, n=75), and obese insulin-resistant (OIR, n=58) subjects. Mean fasting baseline LDL cholesterol (LDL-C) levels were higher in IR and OIR subjects (3.44±0.67 and 3.32±0.80 mol/L) than in IS subjects (2.84±0.75 mmol/L) (P<0.001). Progressive triglyceride elevations and HDL-C decreases were seen across the 3 groups. Ingesting 4 eggs daily yielded significant LDL-C increases of 7.8±13.7% (IS) and 3.3±13.2% (IR) (both P<0.05) compared with 2.4±12.6% for OIR (NS). HDL-C increases were 8.8±10.4%, 5.2±10.4%, and 3.6±9.4% in IS, IR, and OIR, respectively (all P<0.01).
Conclusions--Insulin resistance without and with obesity is associated with elevated LDL-C as well as elevated triglyceride and low HDL-C. The elevated LDL-C cannot be explained by dietary sensitivity, because the LDL-C rise with egg feeding is less in IR persons regardless of obesity status, probably attributable to diminished cholesterol absorption. The results suggest that dietary management of insulin resistance and obesity can focus more on restricting calories and less on restricting dietary fat.
Key words: insulin-resistant • obesity • LDL cholesterol • dietary cholesterol
This article has been cited by other articles:
 |
|
 |
|
  T. M. Wallace, K. M. Utzschneider, J. Tong, D. B. Carr, S. Zraika, D. D. Bankson, R. H. Knopp, and S. E. Kahn Relationship of Liver Enzymes to Insulin Sensitivity and Intra-Abdominal Fat Diabetes Care, October 1, 2007; 30(10): 2673 - 2678. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. M. Krudys, S. E. Kahn, and P. Vicini Population approaches to estimate minimal model indexes of insulin sensitivity and glucose effectiveness using full and reduced sampling schedules. Am J Physiol Endocrinol Metab, October 1, 2006; 291(4): E716 - E723. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Paramsothy and R. Knopp Management of dyslipidaemias. Heart, October 1, 2006; 92(10): 1529 - 1534. [Full Text] [PDF]
|
|
|
|
 |
|
 K. L. Herron, M. M. McGrane, D. Waters, I. E. Lofgren, R. M. Clark, J. M. Ordovas, and M. L. Fernandez The ABCG5 Polymorphism Contributes to Individual Responses to Dietary Cholesterol and Carotenoids in Eggs J. Nutr., May 1, 2006; 136(5): 1161 - 1165. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. M. Utzschneider, R. L. Prigeon, D. B. Carr, R. L. Hull, J. Tong, J. B. Shofer, B. M. Retzlaff, R. H. Knopp, and S. E. Kahn Impact of Differences in Fasting Glucose and Glucose Tolerance on the Hyperbolic Relationship Between Insulin Sensitivity and Insulin Responses Diabetes Care, February 1, 2006; 29(2): 356 - 362. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. H Knopp and P. Paramsothy Oxidized LDL and abdominal obesity: a key to understanding the metabolic syndrome Am. J. Clinical Nutrition, January 1, 2006; 83(1): 1 - 2. [Full Text] [PDF]
|
|
|
|
 |
|
 L. R. Tannock, K. D. O'Brien, R. H. Knopp, B. Retzlaff, B. Fish, M. H. Wener, S. E. Kahn, and A. Chait Cholesterol Feeding Increases C-Reactive Protein and Serum Amyloid A Levels in Lean Insulin-Sensitive Subjects Circulation, June 14, 2005; 111(23): 3058 - 3062. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. D. O'Brien, B. J. Brehm, R. J. Seeley, J. Bean, M. H. Wener, S. Daniels, and D. A. D'Alessio Diet-Induced Weight Loss Is Associated with Decreases in Plasma Serum Amyloid A and C-Reactive Protein Independent of Dietary Macronutrient Composition in Obese Subjects J. Clin. Endocrinol. Metab., April 1, 2005; 90(4): 2244 - 2249. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. H Knopp and B. M Retzlaff Saturated fat prevents coronary artery disease? An American paradox Am. J. Clinical Nutrition, November 1, 2004; 80(5): 1102 - 1103. [Full Text] [PDF]
|
|
|
|
 |
|
 K. M. Utzschneider, D. B. Carr, R. L. Hull, K. Kodama, J. B. Shofer, B. M. Retzlaff, R. H. Knopp, and S. E. Kahn Impact of Intra-Abdominal Fat and Age on Insulin Sensitivity and {beta}-Cell Function Diabetes, November 1, 2004; 53(11): 2867 - 2872. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. B. Carr, K. M. Utzschneider, R. L. Hull, K. Kodama, B. M. Retzlaff, J. D. Brunzell, J. B. Shofer, B. E. Fish, R. H. Knopp, and S. E. Kahn Intra-Abdominal Fat Is a Major Determinant of the National Cholesterol Education Program Adult Treatment Panel III Criteria for the Metabolic Syndrome Diabetes, August 1, 2004; 53(8): 2087 - 2094. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. L. Herron and M. L. Fernandez Are the Current Dietary Guidelines Regarding Egg Consumption Appropriate? J. Nutr., January 1, 2004; 134(1): 187 - 190. [Full Text] [PDF]
|
|
|
|
 |
|
 L. Berglund and D. Hyson Cholesterol Absorption and the Metabolic Syndrome: A New Look at an Old Area Arterioscler. Thromb. Vasc. Biol., August 1, 2003; 23(8): 1314 - 1316. [Full Text] [PDF]
|
|