The insulin resistance syndrome and postprandial lipid intolerance in smokers

• Published in: Atherosclerosis Vol. 129; no. 1; pp. 79 - 88
• Main Authors: Eliasson, Björn, Mero, Niina, Taskinen, Marja-Riitta, Smith, Ulf
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 28.02.1997; Elsevier
• Subjects: Adult; Apolipoprotein A-II - blood; Apolipoproteins B - blood; Biological and medical sciences; Blood Glucose - metabolism; Body Mass Index; C-Peptide - blood; Cigarette smoking; Fibrinogen - metabolism; Glucose Clamp Technique; HDL-cholesterol; Humans; Insulin Resistance - physiology; Insulin resistance syndrome; LDL-particle size; Lipids - blood; Lipoprotein A-I; Lipoprotein Lipase - blood; Lipoproteins; Male; MEDICAL AND HEALTH SCIENCES; Medical sciences; MEDICIN OCH HÄLSOVETENSKAP; Middle Aged; Plasminogen Activator Inhibitor 1 - blood; Postprandial lipemia; Postprandial Period - physiology; Radioimmunoassay; Risk Factors; Smoking - adverse effects; Smoking - blood; Smoking - physiopathology; Smoking/adverse effects/blood/physiopathology; Syndrome; Tobacco, tobacco smoking; Toxicology; Uric Acid - blood; Postprandial lipemia; Lipoproteins; LDL-particle size; HDL-cholesterol; Insulin resistance syndrome; Cigarette smoking; Lipoprotein A-I; Human; Target tissue resistance; Toxicology; Lipemia; Postprandial; Toxicity; Tobacco smoking; Lipoprotein; Insulin
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/S0021-9150(96)06028-5

Background: The effects of cigarette smoking on insulin resistance, postprandial lipemia following a mixed meal, lipoproteins and other aspects of the insulin resistance syndrome (IRS) were investigated in healthy middle-aged men. Methods: 36 smoking and 25 age- and body mass index (BMI)-matched non-smoking men participated. They were non-obese (BMI<27), healthy and without any medication. The smokers had been smoking more than 10 cigarettes per day for more than 20 years; the non-smokers had never been habitual smokers. Body composition and several metabolic and cardiovascular risk factors were studied, including the prevalence of small dense LDL-particles, lipoprotein and hepatic lipase activity and triglyceride levels after a mixed test meal. For determination of degree of insulin sensitivity the euglycemic hyperinsulinemic clamp technique was used. Results: The smokers had lower HDL-cholesterol and lipoprotein A-I levels but higher fasting triglycerides, as well as an increased proportion of small dense LDL-particles and higher postheparin hepatic lipase activity. They also had higher levels of fibrinogen, plasminogen activator inhibitor 1 (PAI-1) activity and fasting and steady-state C-peptide levels during the clamp. The smokers were insulin resistant and lipid intolerant with an impaired triglyceride clearance after a mixed test meal. This lipid intolerance was not mirrored by fasting hypertriglyceridemia. Conclusions: This study, using the euglycemic hyperinsulinemic clamp technique, shows that smokers are both insulin resistant and lipid intolerant. The postprandial lipid intolerance is also seen in individuals with normal fasting triglyceride levels and is related to an increased prevalence of atherogenic small dense LDL. IRS is likely to be an important reason for the increased cardiovascular morbidity in smokers.