Remnant-like particle cholesterol, triglycerides, and insulin resistance in nonobese Japanese type 2 diabetic patients

OBJECTIVE - The aim of the study was to investigate the relationships betwe en remnant-like particle (RLP) cholesterol, triglycerides, and insulin resi stance in nonobese Japanese type 2 diabetic patients. RESEARCH DESIGN AND MEtHODS - A total of 86 nonobese Japanese type 2 diabet ic patients (72 men and 14 women, aged 40-83 gears, BMT 20.1-26.6 kg/m(2)) were studied. BMI, HbA(1c) levels, and fasting concentrations of plasma glu cose, serum lipids (RLP cholesterol, total cholesterol, HDL cholesterol, an d triglycerides), and serum insulin were measured. Insulin resistance was e stimated by the homeostasis model assessment (HOMA-IR). The subjects were d ivided into two groups according to the value of HOMA-IR. Values >2.5 were indicative of the insulin-resistant state, and values <2.5 were indicative of the insulin-sensitive state. RESULTS - The insulin-resistant group had significantly higher RLP choleste rol and triglyceride levels and lower HDL cholesterol levels compared with the insulin-sensitive group. Univariate regression analysis showed that ins ulin resistance was positively correlated with BMI (r = 0.254, P = 0.019), HbA(1c) levels (r = 0.278, P = 0.011), RLP cholesterol levels (r = 0.315, P = 0.004), and triglyceride levels (r = 0.332, P = 0.002) and was negativel y correlated with HDL cholesterol levels (r = -0.301, P = 0.006) in our dia betic patients. Multiple regression analysis showed that insulin resistance was independently associated with serum triglyceride levels, which explain ed 13.5% of the variability of insulin resistance in our nonobese Japanese type 2 diabetic patients. CONCLUSIONS - These results indicate that 1) nonobese Japanese type 2 diabe tic patients with insulin resistance are characterized by high RLP choleste rol and triglyceride levels, and low HDL cholesterol levels; and 2) the lev el of serum triglycerides is an independent predictor of insulin resistance in these patients.