Albumin and fibrinogen synthesis and insulin effect in type 2 diabetic patients with normoalbuminuria

Paolo Tessari, Edward Kiwanuka, Renato Millioni, Monica Vettore, Lucia Puricelli, Michela Zanetti, Antonella Gucciardi, Marina Tosolini, Paola Cogo, Virgilio Carnielli, Antonio Tiengo, Rocco Barazzoni

Research output: Contribution to journalArticle

Abstract

OBJECTIVE - Insulin stimulates albumin synthesis but inhibits that of fibrinogen in both type 1 diabetic and healthy subjects. In type 2 diabetes, fibrinogen production is increased both in the postabsorptive state and in response to hyperinsulinemia. No data exist on the rate of albumin synthesis and its response to insulin in type 2 diabetes. RESEARCH DESIGN AND METHODS - We measured fractional synthesis rates (FSRs) and absolute synthesis rates (ASRs) of both albumin and fibrinogen in postabsorptive normoalbuminuric type 2 diabetic patients at their spontaneous glucose levels (study A), as well as albumin FSR and ASR before and after a hyperinsulinemic-euglycemic euaminoacidemic clamp (study B), using leucine isotope methods. RESULTS - In postabsorptive type 2 diabetes (study A), albumin FSR (11.2 ± 0.9%/day) and albumin ASR (15.4 ± 1.2 g/day) were not different from control values (albumin FSR: 9.4 ± 0.7%/day; albumin ASR: 13.8 ± 1.2 g/day, P > 0.1 for both). In contrast, in the type 2 diabetic subjects, both fibrinogen FSR (24.9 ± 2.1%/day) and ASR (2.4 ± 0.2 g/day) were greater (P <0.025 and P <0.007, respectively) compared with the control subjects (FSR: 18.6 ± 1.51%/day; ASR: 1.6 ± 0.2 g/day). Worse metabolic control in the type 2 diabetic patients was associated with hyperfibrinogenemia and increased leucine rate of appearance, whereas neither the (increased) fibrinogen ASR nor the (normal) albumin production was affected. In study B, after hyperinsulinemia (raised to ∼860 nmol/l), albumin FSR and ASR increased by ∼25% versus basal (P <0.04) and to the same extent in both type 2 diabetic and control subjects. CONCLUSIONS - In normoalbuminuric type 2 diabetic patients, postabsorptive albumin synthesis and its response to insulin were normal, whereas fibrinogen synthesis was increased, irrespective of metabolic control. Furthermore, in normoalbuminuric type 2 diabetic patients, a normal insulin sensitivity with respect to albumin production but a selective hepatic dysregulation of fibrinogen metabolism were present.

Original languageEnglish
Pages (from-to)323-328
Number of pages6
JournalDiabetes Care
Volume29
Issue number2
Publication statusPublished - 2006

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Fibrinogen
Albumins
Insulin
Type 2 Diabetes Mellitus
Hyperinsulinism
Leucine
Glucose Clamp Technique
Isotopes
Insulin Resistance
Healthy Volunteers
Research Design
Glucose
Liver

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Tessari, P., Kiwanuka, E., Millioni, R., Vettore, M., Puricelli, L., Zanetti, M., ... Barazzoni, R. (2006). Albumin and fibrinogen synthesis and insulin effect in type 2 diabetic patients with normoalbuminuria. Diabetes Care, 29(2), 323-328.

Albumin and fibrinogen synthesis and insulin effect in type 2 diabetic patients with normoalbuminuria. / Tessari, Paolo; Kiwanuka, Edward; Millioni, Renato; Vettore, Monica; Puricelli, Lucia; Zanetti, Michela; Gucciardi, Antonella; Tosolini, Marina; Cogo, Paola; Carnielli, Virgilio; Tiengo, Antonio; Barazzoni, Rocco.

In: Diabetes Care, Vol. 29, No. 2, 2006, p. 323-328.

Research output: Contribution to journalArticle

Tessari, P, Kiwanuka, E, Millioni, R, Vettore, M, Puricelli, L, Zanetti, M, Gucciardi, A, Tosolini, M, Cogo, P, Carnielli, V, Tiengo, A & Barazzoni, R 2006, 'Albumin and fibrinogen synthesis and insulin effect in type 2 diabetic patients with normoalbuminuria', Diabetes Care, vol. 29, no. 2, pp. 323-328.
Tessari P, Kiwanuka E, Millioni R, Vettore M, Puricelli L, Zanetti M et al. Albumin and fibrinogen synthesis and insulin effect in type 2 diabetic patients with normoalbuminuria. Diabetes Care. 2006;29(2):323-328.
Tessari, Paolo ; Kiwanuka, Edward ; Millioni, Renato ; Vettore, Monica ; Puricelli, Lucia ; Zanetti, Michela ; Gucciardi, Antonella ; Tosolini, Marina ; Cogo, Paola ; Carnielli, Virgilio ; Tiengo, Antonio ; Barazzoni, Rocco. / Albumin and fibrinogen synthesis and insulin effect in type 2 diabetic patients with normoalbuminuria. In: Diabetes Care. 2006 ; Vol. 29, No. 2. pp. 323-328.
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abstract = "OBJECTIVE - Insulin stimulates albumin synthesis but inhibits that of fibrinogen in both type 1 diabetic and healthy subjects. In type 2 diabetes, fibrinogen production is increased both in the postabsorptive state and in response to hyperinsulinemia. No data exist on the rate of albumin synthesis and its response to insulin in type 2 diabetes. RESEARCH DESIGN AND METHODS - We measured fractional synthesis rates (FSRs) and absolute synthesis rates (ASRs) of both albumin and fibrinogen in postabsorptive normoalbuminuric type 2 diabetic patients at their spontaneous glucose levels (study A), as well as albumin FSR and ASR before and after a hyperinsulinemic-euglycemic euaminoacidemic clamp (study B), using leucine isotope methods. RESULTS - In postabsorptive type 2 diabetes (study A), albumin FSR (11.2 ± 0.9{\%}/day) and albumin ASR (15.4 ± 1.2 g/day) were not different from control values (albumin FSR: 9.4 ± 0.7{\%}/day; albumin ASR: 13.8 ± 1.2 g/day, P > 0.1 for both). In contrast, in the type 2 diabetic subjects, both fibrinogen FSR (24.9 ± 2.1{\%}/day) and ASR (2.4 ± 0.2 g/day) were greater (P <0.025 and P <0.007, respectively) compared with the control subjects (FSR: 18.6 ± 1.51{\%}/day; ASR: 1.6 ± 0.2 g/day). Worse metabolic control in the type 2 diabetic patients was associated with hyperfibrinogenemia and increased leucine rate of appearance, whereas neither the (increased) fibrinogen ASR nor the (normal) albumin production was affected. In study B, after hyperinsulinemia (raised to ∼860 nmol/l), albumin FSR and ASR increased by ∼25{\%} versus basal (P <0.04) and to the same extent in both type 2 diabetic and control subjects. CONCLUSIONS - In normoalbuminuric type 2 diabetic patients, postabsorptive albumin synthesis and its response to insulin were normal, whereas fibrinogen synthesis was increased, irrespective of metabolic control. Furthermore, in normoalbuminuric type 2 diabetic patients, a normal insulin sensitivity with respect to albumin production but a selective hepatic dysregulation of fibrinogen metabolism were present.",
author = "Paolo Tessari and Edward Kiwanuka and Renato Millioni and Monica Vettore and Lucia Puricelli and Michela Zanetti and Antonella Gucciardi and Marina Tosolini and Paola Cogo and Virgilio Carnielli and Antonio Tiengo and Rocco Barazzoni",
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T1 - Albumin and fibrinogen synthesis and insulin effect in type 2 diabetic patients with normoalbuminuria

AU - Tessari, Paolo

AU - Kiwanuka, Edward

AU - Millioni, Renato

AU - Vettore, Monica

AU - Puricelli, Lucia

AU - Zanetti, Michela

AU - Gucciardi, Antonella

AU - Tosolini, Marina

AU - Cogo, Paola

AU - Carnielli, Virgilio

AU - Tiengo, Antonio

AU - Barazzoni, Rocco

PY - 2006

Y1 - 2006

N2 - OBJECTIVE - Insulin stimulates albumin synthesis but inhibits that of fibrinogen in both type 1 diabetic and healthy subjects. In type 2 diabetes, fibrinogen production is increased both in the postabsorptive state and in response to hyperinsulinemia. No data exist on the rate of albumin synthesis and its response to insulin in type 2 diabetes. RESEARCH DESIGN AND METHODS - We measured fractional synthesis rates (FSRs) and absolute synthesis rates (ASRs) of both albumin and fibrinogen in postabsorptive normoalbuminuric type 2 diabetic patients at their spontaneous glucose levels (study A), as well as albumin FSR and ASR before and after a hyperinsulinemic-euglycemic euaminoacidemic clamp (study B), using leucine isotope methods. RESULTS - In postabsorptive type 2 diabetes (study A), albumin FSR (11.2 ± 0.9%/day) and albumin ASR (15.4 ± 1.2 g/day) were not different from control values (albumin FSR: 9.4 ± 0.7%/day; albumin ASR: 13.8 ± 1.2 g/day, P > 0.1 for both). In contrast, in the type 2 diabetic subjects, both fibrinogen FSR (24.9 ± 2.1%/day) and ASR (2.4 ± 0.2 g/day) were greater (P <0.025 and P <0.007, respectively) compared with the control subjects (FSR: 18.6 ± 1.51%/day; ASR: 1.6 ± 0.2 g/day). Worse metabolic control in the type 2 diabetic patients was associated with hyperfibrinogenemia and increased leucine rate of appearance, whereas neither the (increased) fibrinogen ASR nor the (normal) albumin production was affected. In study B, after hyperinsulinemia (raised to ∼860 nmol/l), albumin FSR and ASR increased by ∼25% versus basal (P <0.04) and to the same extent in both type 2 diabetic and control subjects. CONCLUSIONS - In normoalbuminuric type 2 diabetic patients, postabsorptive albumin synthesis and its response to insulin were normal, whereas fibrinogen synthesis was increased, irrespective of metabolic control. Furthermore, in normoalbuminuric type 2 diabetic patients, a normal insulin sensitivity with respect to albumin production but a selective hepatic dysregulation of fibrinogen metabolism were present.

AB - OBJECTIVE - Insulin stimulates albumin synthesis but inhibits that of fibrinogen in both type 1 diabetic and healthy subjects. In type 2 diabetes, fibrinogen production is increased both in the postabsorptive state and in response to hyperinsulinemia. No data exist on the rate of albumin synthesis and its response to insulin in type 2 diabetes. RESEARCH DESIGN AND METHODS - We measured fractional synthesis rates (FSRs) and absolute synthesis rates (ASRs) of both albumin and fibrinogen in postabsorptive normoalbuminuric type 2 diabetic patients at their spontaneous glucose levels (study A), as well as albumin FSR and ASR before and after a hyperinsulinemic-euglycemic euaminoacidemic clamp (study B), using leucine isotope methods. RESULTS - In postabsorptive type 2 diabetes (study A), albumin FSR (11.2 ± 0.9%/day) and albumin ASR (15.4 ± 1.2 g/day) were not different from control values (albumin FSR: 9.4 ± 0.7%/day; albumin ASR: 13.8 ± 1.2 g/day, P > 0.1 for both). In contrast, in the type 2 diabetic subjects, both fibrinogen FSR (24.9 ± 2.1%/day) and ASR (2.4 ± 0.2 g/day) were greater (P <0.025 and P <0.007, respectively) compared with the control subjects (FSR: 18.6 ± 1.51%/day; ASR: 1.6 ± 0.2 g/day). Worse metabolic control in the type 2 diabetic patients was associated with hyperfibrinogenemia and increased leucine rate of appearance, whereas neither the (increased) fibrinogen ASR nor the (normal) albumin production was affected. In study B, after hyperinsulinemia (raised to ∼860 nmol/l), albumin FSR and ASR increased by ∼25% versus basal (P <0.04) and to the same extent in both type 2 diabetic and control subjects. CONCLUSIONS - In normoalbuminuric type 2 diabetic patients, postabsorptive albumin synthesis and its response to insulin were normal, whereas fibrinogen synthesis was increased, irrespective of metabolic control. Furthermore, in normoalbuminuric type 2 diabetic patients, a normal insulin sensitivity with respect to albumin production but a selective hepatic dysregulation of fibrinogen metabolism were present.

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