Metabolism of chylomicrons in patients with congenital lipoatrophic diabetes: a study with emulsion models of chylomicrons

Summary background Lipoatrophic diabetes is characterized by the near absence of adipose tissue and the presence of insulin‐resistant diabetes. Fasting hypertriglyceridaemia and increased postprandial lipidaemia are also present, but the metabolism of chylomicrons, the triglyceride‐rich lipoproteins in the circulation that carry the dietary fats absorbed by the intestine, was not specifically investigated. Because both the activity of insulin‐dependent lipoprotein lipase that catalyses the chylomicron lipolysis and the storage of the lipolysis products are affected in the disease, it is important to evaluate how those changes may ultimately affect the chylomicron lipolysis and removal of chylomicron remnants from the circulation. objective The aim of the study was to evaluate the chylomicron intravascular metabolism in patients with lipoatrophic diabetes. patients Six patients with lipoatrophic diabetes (four females, two males) aged 22·2 ± 4·4 years, with body mass index (BMI) 21·6 ± 3·6 kg/m2, were compared with 12 healthy control subjects (seven females, five males) aged 24·3 ± 2·1 years with BMI 22·5 ± 2·7 kg/m2. measurements The plasma kinetics of intravenously injected chylomicron‐like emulsions labelled with 3H‐triglycerides (3H‐TG) and with 14C‐cholesteryl esters (14C‐CE) were determined, the former tracing the chylomicron lipolysis by lipoprotein lipase and the latter the removal of chylomicron remnants from the plasma. results Triglyceride values (8·3 ± 9·2 mmol/l) in the patients were higher (P