The possible causes of the enhanced risk for coronary heart disease (CHD) were examined in morbidly obese women with normoglycemia, impaired glucose tolerance (IGT), and non-insulin-dependent diabetes mellitus (NIDDM) before and after gastric bypass surgery. Compared with age-matched lean women, plasma lipid and apolipoprotein concentrations of the obese women before surgery favored atherogenesis. The risk for CHD may further be exacerbated in the IGT and NIDDM groups by the prevalence of smaller and denser low-density-lipoprotein (LDL) particles. LDL size correlated negatively with plasma insulin levels independent of triglyceride levels, age, or body mass index (BMI). After surgery, BMI, plasma insulin, and triglyceride levels decreased, but LDL size increased, and LDL density decreased. Neither cholesterol nor LDL cholesterol levels were affected after surgery, but high-density-lipoprotein cholesterol was increased in all patients after surgery. Although the mechanisms underlying the changes in the properties of LDL could not be determined from this study, these changes appear to be of benefit in reducing CHD risk in these patients.
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Original Articles|
December 01 1990
Influence of Obesity, Impaired Glucose Tolerance, and NIDDM on LDL Structure and Composition: Possible Link Between Hyperinsulinemia and Atherosclerosis
Hisham A Barakat;
Hisham A Barakat
Departments of Biochemistry and Clinical Pathology, School of Medicine, East Carolina University
Greenville, North Carolina
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John W Carpenter;
John W Carpenter
Departments of Biochemistry and Clinical Pathology, School of Medicine, East Carolina University
Greenville, North Carolina
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Virginia D McLendon;
Virginia D McLendon
Departments of Biochemistry and Clinical Pathology, School of Medicine, East Carolina University
Greenville, North Carolina
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Prabhaker Khazanie;
Prabhaker Khazanie
Departments of Biochemistry and Clinical Pathology, School of Medicine, East Carolina University
Greenville, North Carolina
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Nancy Leggett;
Nancy Leggett
Departments of Biochemistry and Clinical Pathology, School of Medicine, East Carolina University
Greenville, North Carolina
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Judith Heath;
Judith Heath
Departments of Biochemistry and Clinical Pathology, School of Medicine, East Carolina University
Greenville, North Carolina
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Richard Marks
Richard Marks
Departments of Biochemistry and Clinical Pathology, School of Medicine, East Carolina University
Greenville, North Carolina
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Address correspondence and reprint requests to H.A. Barakat, PhD, Biochemistry Department, School of Medicine, East Carolina University, Greenville, NC 27858.
Diabetes 1990;39(12):1527–1533
Article history
Received:
July 24 1989
Revision Received:
July 27 1990
Accepted:
July 27 1990
PubMed:
2245877
Citation
Hisham A Barakat, John W Carpenter, Virginia D McLendon, Prabhaker Khazanie, Nancy Leggett, Judith Heath, Richard Marks; Influence of Obesity, Impaired Glucose Tolerance, and NIDDM on LDL Structure and Composition: Possible Link Between Hyperinsulinemia and Atherosclerosis. Diabetes 1 December 1990; 39 (12): 1527–1533. https://doi.org/10.2337/diab.39.12.1527
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