HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Submit an electronic Letter to the Editor about this paper Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via ISI Web of Science (3) Citing Articles via Google Scholar Google Scholar Articles by Chu, J. W. Articles by Reaven, G. M. Search for Related Content PubMed PubMed Citation Articles by Chu, J. W. Articles by Reaven, G. M. Related Collections Lipids, Lipoproteins, and Cardiovascular Risk Factors Endocrinology and Metabolism

Multiple Lipoprotein Abnormalities Associated with Insulin Resistance in Healthy Volunteers Are Identified by the Vertical Auto Profile-II Methodology

¹ Stanford University School of Medicine, Department of Medicine, Stanford, CA 94305

² Atherotech, Birmingham, AL 35211

^aaddress correspondence to this author at: Falk Cardiovascular Research Center, Stanford University Medical Center, Stanford, CA 94305; fax 650-725-1599, e-mail greaven@cvmed.stanford.edu

The first 300 words of the full text of this article appear below.

The lipoprotein abnormalities first associated with insulin resistance (IR) and compensatory hyperinsulinemia were high plasma triglyceride (TG) and low HDL-cholesterol (HDL-C) concentrations (1)(2). It is now known that the characteristic IR-associated dyslipidemia also includes a shift to smaller, denser LDL particles (pattern B), enhanced postprandial lipemia, and decreased concentration of the more buoyant HDL particle, HDL₂ (3)(4)(5). Recently, the IR-associated lipoprotein abnormalities that increase risk of coronary heart disease (CHD) have continued to expand. In addition to high plasma TG and low HDL-C concentrations (6)(7), at least three classes of TG-rich lipoproteins are both atherogenic and associated with increased CHD risk, including intermediate density lipoprotein (IDL; a TG-rich remnant product derived from VLDL metabolism) (8)(9), VLDL₃ (the dense VLDL subclass) (10)(11), and TG-rich chylomicron remnants (8)(12)(13).

Despite awareness of the myriad IR-associated proatherogenic lipoprotein abnormalities (1)(2)(3)(4)(5)(14)(15)(16)(17), we are unaware of previous publications in which both IR and all relevant lipoproteins were quantified in the same cohort of individuals. This is likely partly attributable to the unavailability of analytical methods to measure multiple lipoprotein CHD risk factors in a clinically useful manner. However, the validated vertical auto profile-II (VAP-II) methodology (18) provides a means to comprehensively identify the IR-associated dyslipidemic profile, and we have used VAP-II to compare lipoprotein characteristics of nondiabetic individuals stratified into IR and insulin-sensitive (IS) groups.

The Stanford University Human Subjects Committee approved this study, and healthy volunteers from the San Francisco Bay Area gave informed consent. Participants underwent medical interview, anthropometric measurements, and a physical examination. Exclusion criteria . . . [Full Text of this Article]