Postprandial chylomicron clearance rate in late teenagers with diabetes mellitus type 1

Abstract

A delayed chylomicron (CM) clearance rate, a known risk factor for atherosclerosis, has been described in adults with diabetes type 1 (DM1). We determined the CM clearance rate in late teenagers with DM1, and the relationship between CM clearance rate and elevated plasma lipid concentrations in DM1 teenagers in poor metabolic control (as characterized by HbA1c percentage). Plasma lipids and CM clearance were determined in nine patients with DM1 (mean age ± SD: 17.5 ± 0.6 y) and four healthy controls (mean age ± SD: 20.1 ± 0.8 y), by measuring breath 13CO2, plasma triglyceride, retinyl palmitate, and 13C-labeled oleic acid concentrations, after oral administration of a fat-rich meal together with vitamin A and 13C-oleic acid. In patients with DM1, fasting triglyceride and cholesterol concentrations were positively correlated with HbA1c percentage (p < 0.05). Neither in DM1 patients, nor in controls, was an elevated triglyceride concentration (above 1.7 mmol/L) found. Yet, in 22% of DM1 patients, cholesterol concentration was above 5.2 mmol/L, but not in any of the controls. CM clearance rate in DM1 patients was similar to that in controls and did not significantly correlate with HbA1c percentage. Fasting lipid concentrations in DM1 patients were not significantly correlated with CM clearance rate. Present data indicate that elevated lipid concentrations in late teenagers with DM1 are not attributable to a delay in CM clearance rate. A delayed CM clearance rate at late teenager age is not a risk factor contributing to the increased risk for atherosclerosis in DM1.