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Abstract
The risk of coronary heart disease (CHD) is influenced by family history, insulin
sensitivity (IS), and diet. Adiposity affects CHD and IS. The cellular mechanism of
IS is thought to involve the adipocyte cytokine tumor necrosis factor-alpha (TNF-α).
Insulin-stimulated glucose uptake in isolated subcutaneous and omental adipocytes
obtained during elective surgery was measured in 61 premenopausal women, 24 with a
parental history (PH) of CHD. In vivo IS was measured using the short insulin tolerance
test (SITT) in 28 women, 16 with PH-CHD, before and 3 weeks after randomization to
a low glycemic index (LGI) or high glycemic index (HGI) diet. In vitro adipocyte IS
and TNF-α production was measured following dietary modification. On the habitual
diet, in vitro insulin-stimulated glucose uptake in adipocytes as a percentage increase
over basal was less in women with PH-CHD than in those without it (presented as the
median with 95% confidence limits: subcutaneous, 28% (17% to 39%) v 96% (70% to 120%),
P < .01); omental, 40% (28% to 52%) v 113% (83% to 143%), P < .01). In vivo IS in 16 PH-CHD subjects and 12 controls before dietary randomization
was similar, and increased in both groups consuming a LGI versus HGI diet (PH-CHD,
0.31 (0.26 to 0.37) v 0.14 (0.10 to 0.24) mmol/L/min, P < .01; controls, 0.31 (0.1 to 0.53) v 0.15 (0.06 to 0.23) mmol/L/min, P < .05). Adipocytes IS was greater in PH-CHD women on a LGI versus HGI diet (subcutaneous,
50% (20% to 98%) v 13% (1% to 29%); omental, 97% (47% to 184%) v 29% (4% to 84%),
P < .05). Adipocyte TNF-α production was higher in women with versus without PH-CHD
(subcutaneous, 0.3 (0.18 to 0.42) v 0.93 (0.39 to 1.30) ng/mL/min; visceral, 0.22
(0.15 to 1.30) v 0.64 (0.24 to 1.1) ng/mL/min, P < .04, respectively), but was uninfluenced by the dietary glycemic index. We conclude that
in vitro adipocyte IS is reduced and adipocyte TNF-α production is increased in premenopausal
women with PH-CHD. A LGI diet improves both adipocyte IS in women with PH-CHD and
in vivo IS in women with and without PH-CHD.
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Article info
Publication history
Accepted:
April 13,
1998
Received:
December 16,
1997
Footnotes
☆Supported by British Heart Foundation Project Grant No. 95/118 and Kellogg's UK.
Identification
Copyright
© 1998 Published by Elsevier Inc.
