Preheparin lipoprotein lipase mass is a practical marker of insulin resistance in ambulatory type 2 diabetic patients treated with oral hypoglycemic agents

BackgroundLipoprotein lipase (LPL) is a key enzyme in the metabolism of triglyceride (TG)-rich lipoproteins. LPL in the preheparin serum (Pr-LPL) mass reflects the insulin sensitivity of diabetic patients (DM) receiving neither insulin nor hypoglycemic agents.MethodsTo determine whether Pr-LPL mass is a marker of insulin resistance in ambulatory type 2 DM receiving oral hypoglycemic agents, we measured Pr-LPL mass using an enzyme immunoassay in 107 ambulatory DM aged 64.9 ± 11.5 y.ResultsPr-LPL mass was inversely correlated with the homeostasis model assessment of insulin resistance (HOMA-IR) (− 0.363, p < 0.001), insulin (− 0.351, p < 0.001), and lnTG (− 0.402, p < 0.001), and was positively correlated with HDL-C (0.471, p < 0.001). The correlation between Pr-LPL mass and HOMA-IR was equally strong in men and women. Despite medications, hypertension, dyslipidemia, and metabolic syndrome were associated with low Pr-LPL mass. Multiple regression analysis revealed that HOMA-IR was the strongest predictor of Pr-LPL mass. Pr-LPL mass remained constant from 07:30 to 17:30 h.ConclusionsPr-LPL mass is a marker of insulin resistance in ambulatory type 2 DM receiving oral hypoglycemic agents, and Pr-LPL mass is stable during the daytime. Therefore, Pr-LPL mass may be more useful than HOMA-IR at diabetes clinics, especially for patients in the postprandial state.