Is pseudocholinesterase activity related to markers of triacylglycerol synthesis in Type II diabetes mellitus?

Hypertriglyceridaemia is a risk factor for cardiovascular disease in patien ts suffering from Type II diabetes mellitus, and is due to enhanced synthes is and/or impaired clearance of triacylglycerol-rich lipoproteins. In the p resent study we investigated whether pseudocholinesterase (PChE) activity c ould serve as a marker for the rate of triacylglycerol synthesis in these p atients. Patients were stratified according to their apolipoprotein E (apoE ) phenotype, i.e. E3E2, E3E3 or E3E4. In study I, the relationship between PChE activity and serum triacylglycerols was investigated in 224 insulin-tr eated patients with Type II diabetes. In study II, which had a cross-over d esign, PChE activity was measured in 45 dyslipidaemic, insulin-treated pati ents with Type II diabetes that were treated with bezafibrate or pravastati n. In study I. PChE activity was correlated positively with serum triacylgl ycerol concentrations, but did not differ significantly between apoE phenot ypes. The strongest relationship was found in the E3E4 group (r = 0.50; P = 0.001), the phenotype for which hypertriglyceridaemia is expected to be th e result of increased triacylglycerol synthesis. In a stepwise multiple reg ression analysis, serum triacylglycerol concentrations were found to be the strongest predictor of PChE activity in the E3E4 group. In study II, PChE activity decreased as a result of bezafibrate treatment in all three apoE g roups. The decrease in PChE activity with bezafibrate treatment paralleled the decrease in serum triacylglycerol concentrations in the apoE subgroups. Pravastatin treatment did not significantly affect PChE activity. Thus the present study suggests an association between PChE activity and the rate o f triacylglycerol synthesis. Measurement of PChE activity may therefore be a useful tool in the choice of drug for treatment of hypertriglyceridaemia in patients with Type II diabetes.