Postprandial hypertriglyceridemia and insulin resistance in normoglycemic first-degree relatives of patients with type 2 diabetes

Background: Impaired ability to eliminate lipids in the postprandial state is an atherogenic trait associated with insulin resistance. Objective: To assess insulin sensitivity and postprandial triglyceride meta bolism in prediabetic persons. Design: Cross-sectional study. Setting: Sahlgrenska University Hospital, Goteborg, Sweden. Participants: 13 healthy, normotriglyceridemic men with two first-degree re latives with type 2 diabetes and 13 carefully matched controls without know n diabetes heredity. Measurements: Oral glucose tolerance test, insulin sensitivity (euglycemic clamp technique), and fasting and postprandial triglyceride levels after a mixed meal. Results: Relatives of persons with type 2 diabetes were insulin resistant b ut had normal glucose tolerance. They exhibited postprandial hypertriglycer idemia; the 6-hour triglyceride incremental area under the curve was 50% hi gher than that of the control group (P = 0.037). Conclusions: These healthy male first-degree relatives of patients with typ e 2 diabetes are insulin resistant and exhibit postprandial lipid intoleran ce despite having normal fasting triglyceride levels. These characteristics , which occur in the absence of glucose intolerance, are associated with an increased risk for macroangiopathy.