Codon-54 polymorphism of the fatty acid-binding protein 2 gene is associated with elevation of fasting and postprandial triglyceride in type 2 diabetes

Patients with type 2 diabetes are frequently dyslipidemic or hypertriglycer idemic. To assess whether increased intestinal triglyceride input leads to elevated fasting and postprandial triglycerides in type 2 diabetes, we used the codon 54 polymorphism of the fatty acid-binding protein 2 gene, which results in the substitution of threonine (Thr) for alanine and is associate d with increased intestinal input of triglyceride. Of the 287 diabetic pati ents screened, 108 (37.6%) were heterozygous and 31 (10.8%) were homozygous for the Thr-54 allele. Mean (+/-SEM) fasting plasma triglyceride levels in patients with the wild-type (n = 80), those heterozygous for the Thr-54 al lele (n = 57), and those homozygous for it (n = 18) were 2.0 +/- 0.09, 2.7 +/- 0.20, and 3.8 +/- 0.43 mmol/L, respectively, A linear relationship of m ean fasting plasma triglyceride levels (r(2) = 0.97) between the 3 groups w as found. After fat ingestion, the postprandial area under the curve of pla sma triglyceride (P = 0.025) and chylomicrons (S-f > 400, P = 0.013) was hi gher in the Thr-54/Thr-54 (n = 6) than in the wild-type (n = 9). Our result s are consistent with the hypothesis that, in type 2 diabetes, increased in testinal input of triglyceride can lead to elevated fasting and postprandia l plasma triglycerides.