OBJECTIVE: This study was undertaken to determine if insulin resistance without and with obesity influences LDL response to dietary cholesterol and saturated fat. METHODS AND RESULTS: We fed 0, 2, and 4 egg yolks per day to 197 healthy subjects in a 4-week, double-blind, randomized, crossover design. Subjects were dichotomized on body mass index (<27.5 and > or =27.5 kg/m2) and insulin sensitivity (insulin-sensitivity index > or =4.2x1.0(-4) and <4.2x1.0(-4) min(-1) microU/mL), yielding insulin-sensitive (IS, n=65), insulin-resistant (IR, n=75), and obese insulin-resistant (OIR, n=58) subjects. Mean fasting baseline LDL cholesterol (LDL-C) levels were higher in IR and OIR subjects (3.44+/-0.67 and 3.32+/-0.80 mol/L) than in IS subjects (2.84+/-0.75 mmol/L) (P<0.001). Progressive triglyceride elevations and HDL-C decreases were seen across the 3 groups. Ingesting 4 eggs daily yielded significant LDL-C increases of 7.8+/-13.7% (IS) and 3.3+/-13.2% (IR) (both P<0.05) compared with 2.4+/-12.6% for OIR (NS). HDL-C increases were 8.8+/-10.4%, 5.2+/-10.4%, and 3.6+/-9.4% in IS, IR, and OIR, respectively (all P<0.01). CONCLUSIONS: Insulin resistance without and with obesity is associated with elevated LDL-C as well as elevated triglyceride and low HDL-C. The elevated LDL-C cannot be explained by dietary sensitivity, because the LDL-C rise with egg feeding is less in IR persons regardless of obesity status, probably attributable to diminished cholesterol absorption. The results suggest that dietary management of insulin resistance and obesity can focus more on restricting calories and less on restricting dietary fat.
RCT Entities:
OBJECTIVE: This study was undertaken to determine if insulin resistance without and with obesity influences LDL response to dietary cholesterol and saturated fat. METHODS AND RESULTS: We fed 0, 2, and 4 egg yolks per day to 197 healthy subjects in a 4-week, double-blind, randomized, crossover design. Subjects were dichotomized on body mass index (<27.5 and > or =27.5 kg/m2) and insulin sensitivity (insulin-sensitivity index > or =4.2x1.0(-4) and <4.2x1.0(-4) min(-1) microU/mL), yielding insulin-sensitive (IS, n=65), insulin-resistant (IR, n=75), and obese insulin-resistant (OIR, n=58) subjects. Mean fasting baseline LDL cholesterol (LDL-C) levels were higher in IR and OIR subjects (3.44+/-0.67 and 3.32+/-0.80 mol/L) than in IS subjects (2.84+/-0.75 mmol/L) (P<0.001). Progressive triglyceride elevations and HDL-C decreases were seen across the 3 groups. Ingesting 4 eggs daily yielded significant LDL-C increases of 7.8+/-13.7% (IS) and 3.3+/-13.2% (IR) (both P<0.05) compared with 2.4+/-12.6% for OIR (NS). HDL-C increases were 8.8+/-10.4%, 5.2+/-10.4%, and 3.6+/-9.4% in IS, IR, and OIR, respectively (all P<0.01). CONCLUSIONS:Insulin resistance without and with obesity is associated with elevated LDL-C as well as elevated triglyceride and low HDL-C. The elevated LDL-C cannot be explained by dietary sensitivity, because the LDL-C rise with egg feeding is less in IR persons regardless of obesity status, probably attributable to diminished cholesterol absorption. The results suggest that dietary management of insulin resistance and obesity can focus more on restricting calories and less on restricting dietary fat.
Authors: Andrew N Hoofnagle; Jessica O Becker; Michael N Oda; Giorgio Cavigiolio; Philip Mayer; Tomas Vaisar Journal: Clin Chem Date: 2012-02-03 Impact factor: 8.327
Authors: Robert H Knopp; Pathmaja Paramsothy; Barbara M Retzlaff; Alice Dowdy; Brian Fish Journal: Curr Atheroscler Rep Date: 2005-11 Impact factor: 5.113
Authors: Robert H Knopp; Brian Fish; Alice Dowdy; Barbara Retzlaff; Carolyn Walden; Irina Rusanu; Pathmaja Paramsothy Journal: Curr Atheroscler Rep Date: 2006-11 Impact factor: 5.113
Authors: Mark M Smits; Pier Woudstra; Kristina M Utzschneider; Jenny Tong; Fernando Gerchman; Mirjam Faulenbach; Darcy B Carr; Kathryn Aston-Mourney; Alan Chait; Robert H Knopp; James B Meigs; Edward J Boyko; Steven E Kahn Journal: Ann Epidemiol Date: 2013-03-25 Impact factor: 3.797