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The heterozygous N291S mutation in the lipoprotein lipase gene impairs whole-body insulin sensitivity and affects a distinct set of plasma metabolites in humans

Background Mutations in the lipoprotein lipase gene causing decreased lipoprotein lipase activity are associated with surrogate markers of insulin resistance and the metabolic syndrome in humans. Objective We investigated the hypothesis that a heterozygous lipoprotein lipase mutation (N291S) induces...

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Published in:Journal of clinical lipidology 2017-03, Vol.11 (2), p.515-523.e6
Main Authors: Berg, Sofia Mikkelsen, PhD, Havelund, Jesper, PhD, Hasler-Sheetal, Harald, PhD, Kruse, Vibeke, Thestrup Pedersen, Andreas James, MD, PhD, Bill Hansen, Aleksander, Nybo, Mads, MD, PhD, Beck-Nielsen, Henning, MD, PhD, Højlund, Kurt, MD, PhD, Færgeman, Nils Joakim, PhD
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container_title Journal of clinical lipidology
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creator Berg, Sofia Mikkelsen, PhD
Havelund, Jesper, PhD
Hasler-Sheetal, Harald, PhD
Kruse, Vibeke
Thestrup Pedersen, Andreas James, MD, PhD
Bill Hansen, Aleksander
Nybo, Mads, MD, PhD
Beck-Nielsen, Henning, MD, PhD
Højlund, Kurt, MD, PhD
Færgeman, Nils Joakim, PhD
description Background Mutations in the lipoprotein lipase gene causing decreased lipoprotein lipase activity are associated with surrogate markers of insulin resistance and the metabolic syndrome in humans. Objective We investigated the hypothesis that a heterozygous lipoprotein lipase mutation (N291S) induces whole-body insulin resistance and alterations in the plasma metabolome. Methods In 6 carriers of a heterozygous lipoprotein lipase mutation (N291S) and 11 age-matched and weight-matched healthy controls, we examined insulin sensitivity and substrate metabolism by euglycemic-hyperinsulinemic clamps combined with indirect calorimetry. Plasma samples were taken before and after the clamp (4 hours of physiological hyperinsulinemia), and metabolites were measured enzymatically or by gas chromatography-mass spectrometry. Results Compared with healthy controls, heterozygous carriers of a defective lipoprotein lipase allele had elevated fasting plasma levels triglycerides ( P  
doi_str_mv 10.1016/j.jacl.2017.02.009
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Objective We investigated the hypothesis that a heterozygous lipoprotein lipase mutation (N291S) induces whole-body insulin resistance and alterations in the plasma metabolome. Methods In 6 carriers of a heterozygous lipoprotein lipase mutation (N291S) and 11 age-matched and weight-matched healthy controls, we examined insulin sensitivity and substrate metabolism by euglycemic-hyperinsulinemic clamps combined with indirect calorimetry. Plasma samples were taken before and after the clamp (4 hours of physiological hyperinsulinemia), and metabolites were measured enzymatically or by gas chromatography-mass spectrometry. Results Compared with healthy controls, heterozygous carriers of a defective lipoprotein lipase allele had elevated fasting plasma levels triglycerides ( P  &lt; .006), and markedly impaired insulin-stimulated glucose disposal rates ( P  &lt; .024) and nonoxidative glucose metabolism ( P  &lt; .015). Plasma metabolite profiling demonstrated lower circulating levels of pyruvic acid and α-tocopherol in the N291S carriers than in controls both before and after stimulation with insulin (all &gt;1.5-fold change and P  &lt; .05). Conclusion Heterozygous carriers with a defective lipoprotein lipase allele are less insulin sensitive and have increased plasma levels of nonesterified fatty acids and triglycerides. The heterozygous N291S carriers also have a distinct plasma metabolomic signature, which may serve as a diagnostic tool for deficient lipoprotein lipase activity and as a marker of lipid-induced insulin resistance.</description><identifier>ISSN: 1933-2874</identifier><identifier>EISSN: 1876-4789</identifier><identifier>DOI: 10.1016/j.jacl.2017.02.009</identifier><identifier>PMID: 28502509</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Cardiovascular ; Female ; Gas chromatography-mass spectrometry ; Gene mutation ; Heterozygote ; Heterozygous N291S mutation ; Humans ; Insulin Resistance - genetics ; Insulin sensitivity ; Lipoprotein Lipase - genetics ; Lipoprotein lipase deficiency ; Male ; Middle Aged ; Mutation ; Plasma - metabolism ; α-tocopherol</subject><ispartof>Journal of clinical lipidology, 2017-03, Vol.11 (2), p.515-523.e6</ispartof><rights>National Lipid Association</rights><rights>2017 National Lipid Association</rights><rights>Copyright © 2017 National Lipid Association. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c362t-3c2ae3f4265e40682f1e6916b867facba3b6319099e809d87d745c02667f93143</cites><orcidid>0000-0002-7214-2783</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28502509$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Berg, Sofia Mikkelsen, PhD</creatorcontrib><creatorcontrib>Havelund, Jesper, PhD</creatorcontrib><creatorcontrib>Hasler-Sheetal, Harald, PhD</creatorcontrib><creatorcontrib>Kruse, Vibeke</creatorcontrib><creatorcontrib>Thestrup Pedersen, Andreas James, MD, PhD</creatorcontrib><creatorcontrib>Bill Hansen, Aleksander</creatorcontrib><creatorcontrib>Nybo, Mads, MD, PhD</creatorcontrib><creatorcontrib>Beck-Nielsen, Henning, MD, PhD</creatorcontrib><creatorcontrib>Højlund, Kurt, MD, PhD</creatorcontrib><creatorcontrib>Færgeman, Nils Joakim, PhD</creatorcontrib><title>The heterozygous N291S mutation in the lipoprotein lipase gene impairs whole-body insulin sensitivity and affects a distinct set of plasma metabolites in humans</title><title>Journal of clinical lipidology</title><addtitle>J Clin Lipidol</addtitle><description>Background Mutations in the lipoprotein lipase gene causing decreased lipoprotein lipase activity are associated with surrogate markers of insulin resistance and the metabolic syndrome in humans. Objective We investigated the hypothesis that a heterozygous lipoprotein lipase mutation (N291S) induces whole-body insulin resistance and alterations in the plasma metabolome. Methods In 6 carriers of a heterozygous lipoprotein lipase mutation (N291S) and 11 age-matched and weight-matched healthy controls, we examined insulin sensitivity and substrate metabolism by euglycemic-hyperinsulinemic clamps combined with indirect calorimetry. Plasma samples were taken before and after the clamp (4 hours of physiological hyperinsulinemia), and metabolites were measured enzymatically or by gas chromatography-mass spectrometry. Results Compared with healthy controls, heterozygous carriers of a defective lipoprotein lipase allele had elevated fasting plasma levels triglycerides ( P  &lt; .006), and markedly impaired insulin-stimulated glucose disposal rates ( P  &lt; .024) and nonoxidative glucose metabolism ( P  &lt; .015). Plasma metabolite profiling demonstrated lower circulating levels of pyruvic acid and α-tocopherol in the N291S carriers than in controls both before and after stimulation with insulin (all &gt;1.5-fold change and P  &lt; .05). Conclusion Heterozygous carriers with a defective lipoprotein lipase allele are less insulin sensitive and have increased plasma levels of nonesterified fatty acids and triglycerides. The heterozygous N291S carriers also have a distinct plasma metabolomic signature, which may serve as a diagnostic tool for deficient lipoprotein lipase activity and as a marker of lipid-induced insulin resistance.</description><subject>Cardiovascular</subject><subject>Female</subject><subject>Gas chromatography-mass spectrometry</subject><subject>Gene mutation</subject><subject>Heterozygote</subject><subject>Heterozygous N291S mutation</subject><subject>Humans</subject><subject>Insulin Resistance - genetics</subject><subject>Insulin sensitivity</subject><subject>Lipoprotein Lipase - genetics</subject><subject>Lipoprotein lipase deficiency</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mutation</subject><subject>Plasma - metabolism</subject><subject>α-tocopherol</subject><issn>1933-2874</issn><issn>1876-4789</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNp9ks1u1TAQhSMEoqXwAiyQl2wS_JPYsYSQUMWfVMGiZW05zqTXwYkvGacoPA2PiqNbWLBg5bH8nbHmnCmK54xWjDL5aqxG60LFKVMV5RWl-kFxzloly1q1-mGutRAlb1V9VjxBHCltGkWbx8UZbxvKG6rPi183ByAHSLDEn9ttXJF85ppdk2lNNvk4Ez-TlJHgj_G4xAT5nmuLQG5hBuKno_ULkh-HGKDsYr9lBa4hYwgz-uTvfNqInXtihwFcQmJJ7zH52aWMJBIHcgwWJ0smSLaLwSfA_dvDOtkZnxaPBhsQnt2fF8XX9-9uLj-WV18-fLp8e1U6IXkqheMWxFBz2UBNZcsHBlIz2bVSDdZ1VnRSME21hpbqvlW9qhtHuczPWrBaXBQvT33zlN9XwGQmjw5CsDNkWwxrtWaMScEzyk-oWyLiAoM5Ln6yy2YYNXsyZjR7MmZPxlBucjJZ9OK-_9pN0P-V_IkiA69PAOQp7zwsBp2H2UHvl-yb6aP_f_83_8hdDsE7G77BBjjGdZmzf4YZzAJzve_GvhpMCUqFasRvgNy2oA</recordid><startdate>20170301</startdate><enddate>20170301</enddate><creator>Berg, Sofia Mikkelsen, PhD</creator><creator>Havelund, Jesper, PhD</creator><creator>Hasler-Sheetal, Harald, PhD</creator><creator>Kruse, Vibeke</creator><creator>Thestrup Pedersen, Andreas James, MD, PhD</creator><creator>Bill Hansen, Aleksander</creator><creator>Nybo, Mads, MD, PhD</creator><creator>Beck-Nielsen, Henning, MD, PhD</creator><creator>Højlund, Kurt, MD, PhD</creator><creator>Færgeman, Nils Joakim, PhD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7214-2783</orcidid></search><sort><creationdate>20170301</creationdate><title>The heterozygous N291S mutation in the lipoprotein lipase gene impairs whole-body insulin sensitivity and affects a distinct set of plasma metabolites in humans</title><author>Berg, Sofia Mikkelsen, PhD ; Havelund, Jesper, PhD ; Hasler-Sheetal, Harald, PhD ; Kruse, Vibeke ; Thestrup Pedersen, Andreas James, MD, PhD ; Bill Hansen, Aleksander ; Nybo, Mads, MD, PhD ; Beck-Nielsen, Henning, MD, PhD ; Højlund, Kurt, MD, PhD ; Færgeman, Nils Joakim, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-3c2ae3f4265e40682f1e6916b867facba3b6319099e809d87d745c02667f93143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Cardiovascular</topic><topic>Female</topic><topic>Gas chromatography-mass spectrometry</topic><topic>Gene mutation</topic><topic>Heterozygote</topic><topic>Heterozygous N291S mutation</topic><topic>Humans</topic><topic>Insulin Resistance - genetics</topic><topic>Insulin sensitivity</topic><topic>Lipoprotein Lipase - genetics</topic><topic>Lipoprotein lipase deficiency</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mutation</topic><topic>Plasma - metabolism</topic><topic>α-tocopherol</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Berg, Sofia Mikkelsen, PhD</creatorcontrib><creatorcontrib>Havelund, Jesper, PhD</creatorcontrib><creatorcontrib>Hasler-Sheetal, Harald, PhD</creatorcontrib><creatorcontrib>Kruse, Vibeke</creatorcontrib><creatorcontrib>Thestrup Pedersen, Andreas James, MD, PhD</creatorcontrib><creatorcontrib>Bill Hansen, Aleksander</creatorcontrib><creatorcontrib>Nybo, Mads, MD, PhD</creatorcontrib><creatorcontrib>Beck-Nielsen, Henning, MD, PhD</creatorcontrib><creatorcontrib>Højlund, Kurt, MD, PhD</creatorcontrib><creatorcontrib>Færgeman, Nils Joakim, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical lipidology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Berg, Sofia Mikkelsen, PhD</au><au>Havelund, Jesper, PhD</au><au>Hasler-Sheetal, Harald, PhD</au><au>Kruse, Vibeke</au><au>Thestrup Pedersen, Andreas James, MD, PhD</au><au>Bill Hansen, Aleksander</au><au>Nybo, Mads, MD, PhD</au><au>Beck-Nielsen, Henning, MD, PhD</au><au>Højlund, Kurt, MD, PhD</au><au>Færgeman, Nils Joakim, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The heterozygous N291S mutation in the lipoprotein lipase gene impairs whole-body insulin sensitivity and affects a distinct set of plasma metabolites in humans</atitle><jtitle>Journal of clinical lipidology</jtitle><addtitle>J Clin Lipidol</addtitle><date>2017-03-01</date><risdate>2017</risdate><volume>11</volume><issue>2</issue><spage>515</spage><epage>523.e6</epage><pages>515-523.e6</pages><issn>1933-2874</issn><eissn>1876-4789</eissn><abstract>Background Mutations in the lipoprotein lipase gene causing decreased lipoprotein lipase activity are associated with surrogate markers of insulin resistance and the metabolic syndrome in humans. Objective We investigated the hypothesis that a heterozygous lipoprotein lipase mutation (N291S) induces whole-body insulin resistance and alterations in the plasma metabolome. Methods In 6 carriers of a heterozygous lipoprotein lipase mutation (N291S) and 11 age-matched and weight-matched healthy controls, we examined insulin sensitivity and substrate metabolism by euglycemic-hyperinsulinemic clamps combined with indirect calorimetry. Plasma samples were taken before and after the clamp (4 hours of physiological hyperinsulinemia), and metabolites were measured enzymatically or by gas chromatography-mass spectrometry. Results Compared with healthy controls, heterozygous carriers of a defective lipoprotein lipase allele had elevated fasting plasma levels triglycerides ( P  &lt; .006), and markedly impaired insulin-stimulated glucose disposal rates ( P  &lt; .024) and nonoxidative glucose metabolism ( P  &lt; .015). Plasma metabolite profiling demonstrated lower circulating levels of pyruvic acid and α-tocopherol in the N291S carriers than in controls both before and after stimulation with insulin (all &gt;1.5-fold change and P  &lt; .05). Conclusion Heterozygous carriers with a defective lipoprotein lipase allele are less insulin sensitive and have increased plasma levels of nonesterified fatty acids and triglycerides. The heterozygous N291S carriers also have a distinct plasma metabolomic signature, which may serve as a diagnostic tool for deficient lipoprotein lipase activity and as a marker of lipid-induced insulin resistance.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28502509</pmid><doi>10.1016/j.jacl.2017.02.009</doi><orcidid>https://orcid.org/0000-0002-7214-2783</orcidid></addata></record>
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identifier ISSN: 1933-2874
ispartof Journal of clinical lipidology, 2017-03, Vol.11 (2), p.515-523.e6
issn 1933-2874
1876-4789
language eng
recordid cdi_proquest_miscellaneous_1899111632
source Elsevier
subjects Cardiovascular
Female
Gas chromatography-mass spectrometry
Gene mutation
Heterozygote
Heterozygous N291S mutation
Humans
Insulin Resistance - genetics
Insulin sensitivity
Lipoprotein Lipase - genetics
Lipoprotein lipase deficiency
Male
Middle Aged
Mutation
Plasma - metabolism
α-tocopherol
title The heterozygous N291S mutation in the lipoprotein lipase gene impairs whole-body insulin sensitivity and affects a distinct set of plasma metabolites in humans
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