METABOLIC AND DIETARY DETERMINANTS OF SERUM-LIPIDS IN OBESE PATIENTS WITH RECENTLY DIAGNOSED NON-INSULIN-DEPENDENT DIABETES

The aim of the study was to ascertain the metabolic and dietary determ inants of changes in serum lipids during a 15-month diet therapy of ob ese patients (n = 71, 41 males, 30 females) with recently diagnosed Ty pe 2 (non-insulin-dependent) diabetes. The subjects lost weight and im provement in glycaemic control was observed, but due to variation in i ndividual responses the mean serum total cholesterol or non-HDL choles terol did not change significantly. The proportion of palmitic acid de creased and that of linoleic acid increased in serum lipids during the study, and serum triglycerides decreased and HDL-cholesterol increase d. In univariate analyses, decreased serum triglyceride level was asso ciated with serum triglycerides at baseline, decreases in body mass in dex, fasting blood glucose and palmitic acid proportion of serum trigl ycerides, and the intake of saturated fats and dietary fibre, but in m ultiple regression analyses the determinants for decreased serum trigl ycerides were high serum triglycerides at baseline and a decreased pro portion of palmitic acid in serum triglycerides. In univariate analysi s, increased HDL-cholesterol was associated with the baseline HDL-chol esterol, decrease in the triceps/subscapularis ratio and the intake of saturated and mono-unsaturated fatty acids, but none of these variabl es had an independent contribution to the increase in serum HDL-choles terol in multiple regression analysis. In conclusion, a reduction of p almitic acid in the serum lipids, which was probably due to reduction of dietary saturated fatty acids, had beneficial effects on serum lipi ds in obese patients with Type 2 diabetes, independently of weight los s and improvement in glycaemic control.