Whole-body insulin sensitivity, low-density lipoprotein (LDL) particle size, and oxidized LDL in overweight, nondiabetic men

Insulin resistance is often accompanied by elevated plasma triglycerides (TG) and a preponderance of small, dense low-density lipoprotein (LDL) particles. However, it remains unclear whether or not insulin resistance is related to LDL particle size, independent of plasma TG. We sought to determine the strength of the relationships among these variables in a group of overweight, nondiabetic men (N = 34; body mass index [BMI], 25 to 35 kg/m²; age, 50 to 75 years), as well as to examine the possible relation between insulin sensitivity and oxidized LDL (oxLDL). We also examined the strength of the relationships between these lipid variables and estimates of insulin sensitivity using calculated indices based on fasting insulin and glucose concentrations. Insulin sensitivity (Si) was significantly associated with total TG (r = [minus ]0.61, P [lt ] .001), very[ndash ]low-density lipoprotein (VLDL)-TG (r = [minus ]0.60, P [lt ] .001), and LDL size (r =.414, P [lt ] .05). LDL size was also significantly associated with TG (r = [minus ]0.73, P [lt ] .001), VLDL-TG (r = [minus ]0.73, P [lt ] .001), high-density lipoprotein-cholesterol (HDL-C) (r = 0.65, P [lt ] .001), the quantitative insulin sensitivity check index (QUICKI) (rho = 0.46, P [lt ] .01), and the homeostatic model for the assessment of insulin resistance (HOMA-IR) (rho = [minus ]0.45, P [lt ] .01). Si was a significant predictor of LDL size, with age and BMI also independent contributors to the variance in LDL size (R² = 0.172). However, when TG and HDL-C were added to the model, Si was no longer a significant predictor of LDL size. The correlation between Si and oxLDL was weak, but stastically significant (rho = [minus ]0.40, P = .02). These data suggest that the relation between Si and LDL size is largely mediated by plasma TG, and that Si is only weakly related to oxLDL in overweight, nondiabetic men.