Patients with type 1 diabetes show signs of vascular dysfunction in response to multiple high-fat meals

• Published in: Nutrition & metabolism Vol. 11; no. 1; p. 28
• Main Authors: Lassenius, Mariann I, Mäkinen, Ville-Petteri, Fogarty, Christopher L, Peräneva, Lina, Jauhiainen, Matti, Pussinen, Pirkko J, Taskinen, Marja-Riitta, Kirveskari, Juha, Vaarala, Outi, Nieminen, Janne K, Hörkkö, Sohvi, Kangas, Antti J, Soininen, Pasi, Ala-Korpela, Mika, Gordin, Daniel, Ahola, Aila J, Forsblom, Carol, Groop, Per-Henrik, Lehto, Markku
• Format: Journal Article
• Language: English
• Published: London Springer-Verlag 13.06.2014; BioMed Central; BioMed Central Ltd; Springer Nature B.V
• Subjects: blood serum; Cardiovascular disease; Care and treatment; Cholesterol; Clinical Nutrition; Colleges & universities; Complications and side effects; Diabetes; endotoxemia; enzymes; fasting; high density lipoprotein; high fat diet; inflammation; Insulin; insulin-dependent diabetes mellitus; Kidney diseases; lipid metabolism; Lipids; Lipoproteins; Meals; Medicine; Medicine & Public Health; Metabolic Diseases; Metabolism; Metabolites; NMR; noninsulin-dependent diabetes mellitus; Nuclear magnetic resonance; obesity; Oils & fats; patients; Physiological aspects; Risk factors; Type 2 diabetes; Type 1 diabetes; High-fat diet; Vascular dysfunction
• ISSN: 1743-7075; 1743-7075
• DOI: 10.1186/1743-7075-11-28

BACKGROUND: A high-fat diet promotes postprandial systemic inflammation and metabolic endotoxemia. We investigated the effects of three consecutive high-fat meals on endotoxemia, inflammation, vascular function, and postprandial lipid metabolism in patients with type 1 diabetes. METHODS: Non-diabetic controls (n = 34) and patients with type 1 diabetes (n = 37) were given three high-caloric, fat-containing meals during one day. Blood samples were drawn at fasting (8:00) and every two hours thereafter until 18:00. Applanation tonometry was used to assess changes in the augmentation index during the investigation day. RESULTS: Three consecutive high-fat meals had only a modest effect on serum LPS-activity levels and inflammatory markers throughout the day in both groups. Of note, patients with type 1 diabetes were unable to decrease the augmentation index in response to the high-fat meals. The most profound effects of the consecutive fat loads were seen in chylomicron and HDL-metabolism. The triglyceride-rich lipoprotein remnant marker, apoB-48, was elevated in patients compared to controls both at fasting (p = 0.014) and postprandially (p = 0.035). The activities of the HDL-associated enzymes PLTP (p < 0.001), and CETP (p = 0.007) were higher and paraoxonase (PON-1) activity, an anti-oxidative enzyme bound to HDL, decreased in patients with type 1 diabetes (p = 0.027). CONCLUSIONS: In response to high-fat meals, early signs of vascular dysfunction alongside accumulation of chylomicron remnants, higher augmentation index, and decreased PON-1 activity were observed in patients with type 1 diabetes. The high-fat meals had no significant impact on postprandial LPS-activity in non-diabetic subjects or patients with type 1 diabetes suggesting that metabolic endotoxemia may be more central in patients with chronic metabolic disturbances such as obesity, type 2 diabetes, or diabetic kidney disease.