High-density lipoprotein modulates glucose metabolism in patients with type 2 diabetes mellitus.

Description

This study tested the hypothesis that HDL metabolism modulates glucose metabolism by increasing plasma insulin and activating the key enzyme AMP-activated protein kinase in skeletal muscle. Patients with type 2 diabetes (n=13) received reconstituted HDL and placebo on separate days in a double-blind, placebo-controlled cross-over study. There was a larger decrease in plasma glucose from baseline to 4 hours after infusion of reconstituted HDL compared to placebo. At 4 hours, there was also an increase in plasma insulin concentrations and in the homeostasis model assessment of β-cell function index with reconstituted HDL that was significantly different from placebo. An activation of the AMP-activated protein kinase pathway was observed with reconstituted HDL. Therefore, this study demonstrated that HDL has the potential to modulate glucose metabolism in patients with type 2 diabetes, which likely occurs through increased glucose disposal via mechanisms including elevated plasma insulin and AMP-activated protein kinase pathway in skeletal muscle.