Changes in high density lipoprotein cholesterol after initiation of insulin therapy in non-insulin dependent diabetes mellitus: relationship to changes in body weight.

To determine the interrelationships of serum lipoproteins and body weight changes with insulin therapy, 55 diabetics (mean age 52.0 +/- 2.2 years), had measurements of body weight, sum of skinfold thickness, fasting serum glucose, serum high density (HDL-C) and low density (LDL-C) lipoprotein cholesterol and serum triglycerides before and 6 weeks after beginning insulin. At entry HDL-C had a significant (p less than 0.05) negative correlation with indices of body weight-body mass index, relative weight and a significant positive correlation with serum triglycerides but no significant association with sum of skinfold thickness, fasting serum glucose or LDL-C. The relationships were seen mainly in patients who previously had not been receiving oral hypoglycemic medications. Insulin significantly increased HDL-C and body weight, and decreased glucose, triglycerides and LDL-C. Changes in HDL-C showed a significant inverse association with changes in triglycerides and direct correlation with changes in body weight, but no significant association with changes in fasting serum glucose or LDL-C. Thus, insulin therapy of diabetes mellitus favorably affects HDL-C concentration perhaps by altering triglyceride metabolism and represents a unique situation where increases in body weight are associated with increases in serum HDL-C concentration.