Introduction: Subjects with insulin resistance (IR) and diabetes are at increased risk of cardiovascular disease (CVD) than those without diabetes, however the mechanistic basis remains elusive. Despite LDL-cholesterol lowering by statin therapy, two-thirds of all CVD events remain, constituting a significant 'residual risk' for CVD. This ‘residual risk’ has been found to be greater for patients with diabetes than those without diabetes. This suggests the role for alternative sources of lipoprotein-derived cholesterol in CVD during diabetes. Both type-1 diabetic as well as IR subjects have been found to have increased plasma concentrations of fasting intestinal derived apoB48 containing remnants (CM-r). However it is not known if the diabetic metabolic milieu indeed increases the susceptibility of the arteries to CM-r and if these indeed bind to arterial proteoglycans (PGs). Objectives: To determine arterial retention of CM-r in type-1 diabetes and IR using ex vivo perfusion methodology in a streptozotocin rat model of type 1 diabetes and JCR-LA-cp rat model of IR. To determine the direct binding affinity and capacity of CM-r to biglycan using an in vitro approach. Methods and Results: We observed increased arterial CM-R retention in type 1 diabetic vessels as well as in IR vessels when compared to control vessels. The retained CM-r colocalized with arterial biglycan in type 1 diabetic vessels and a direct correlation was observed between the CM-r and the presence of glycated proteins in type I diabetic arteries. The increased arterial CM-r retention in the IR rats was associated with increased arterial biglycan protein content. We have conclusively demonstrated for the first time that CM-r indeed bind to human biglycan. Conclusion: Tight glycemic control in patients with type 1 diabetes can alleviate CVD by reducing hyperglycemia and subsequent retention of CM-r. A significant increase in biglycan protein core content during IR is suggestive of early vascular remodeling and may help to explain how CM-r accumulate more readily during diabetes induced CVD. Based on the results from this study, individuals with IR may be at increased risk for atherogenesis due to increased atherogenicity of the post-prandial CM-r when compared to normal population. / Nutrition and Metabolism

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Intestinally derived chylomicron remnants (CM-r) may contribute to atherogenic dyslipidemia during the Metabolic Syndrome (Mets). However, the combined effects of ezetimibe (EZ) and simvastatin (SV) on post-prandial (PP) dyslipidemia during MetS remains unclear, nor is it known whether the combination has a synergistic anti-atherogenic effect on CM-r arterial retention. The first objective was to delineate the effects of EZ+SV therapy on intestinal cholesterol flux and CM PP metabolism in the JCR:LA-cp rat, a model of MetS. The second objective was to quantify the impact of EZ+SV therapy on arterial retention of CM-r and subsequent myocardial lesion development in the JCR:LA-cp rat. EZ+SV therapy decreased net intestinal cholesterol absorption in MetS rats. Furthermore, EZ+SV therapy reduced arterial retention of CM-r and frequency of myocardial lesions in MetS rats. In conclusion, EZ+SV therapy reduces arterial retention of CM-r and myocardial lesion development possibly through its beneficial effects on cholesterol transport and PP-metabolism. / Nutrition and Metabolism

Overproduction of intestinal chylomicrons (CM) has been proposed to contribute to fasting and post-prandial (PP) dyslipidemia and may accelerate the development of cardiovascular disease (CVD) during obesity, insulin resistance (IR) and diabetes. However, the impact of morphological changes in intestinal mucosa structure have not been investigated during IR and intestinal dyslipidemia. The first objective of this thesis was to characterize intestinal villi morphology and to determine whether a morphological relationship exists with enterocytic apoB48 (a marker of CM), and intestinal lymph secretion of apoB48 in the obese and IR JCR:LA-cp rat. The second objective was to assess the impact of n-3 PUFA supplementation on PP dyslipidemia in the JCR:LA-cp rat. Intestinal hypertrophy was observed in IR rats, corresponding to an increase in intestinal and lymphatic apoB48 expression. Further, a dietary intervention of n-3 PUFA showed lower PP plasma concentrations of apoB48 and PP plasma inflammatory markers. We conclude that intestinal hypertrophy may contribute to intestinal CM overproduction during obesity and IR. Additionally, dietary n-3 PUFA improves PP lipemia and the associated PP inflammatory response in the JCR:LA-cp rat model. / Nutrition and Metabolism

OBJECTIF: La mauvaise clairance des lipoprotéines riches en triglycérides par le tissu adipeux blanc (TAB) entraîne l’hypertriglycéridémie, la résistance à l’insuline et la sécrétion hépatique d’apolipoprotéine B (apoB). Ce mémoire tente de déterminer si le LDL entraîne une clairance réduite des lipoprotéines riches en triglycérides par le TAB. MÉTHODES/RÉSULTATS: Suivant l’ingestion d’un repas riche en gras marqué à la trioléine-13C, des femmes obèses postménopausées avec apoB plasmatique élevé (> médiane 0.93 g/L, N=22, 98% sous forme de IDL/LDL) avaient une clairance réduite de triglycérides-13C et acides gras non-estérifiés-13C (AGNE), comparées à celles avec un apoB plus bas. L'aire sous la courbe à 6 heures des triglycérides-13C et AGNE-13C plasmatiques corrélait avec l'apoB, suggérant une moindre captation dans les tissus périphériques chez les femmes avec apoB élevé. Ex vivo, suivant une incubation de 4 heures de biopsies de TAB avec de la trioléine-3H, l’apoB des patientes corrélait négativement avec les lipides-3H intracellulaires. Le traitement des biopsies de TAB des participantes avec leur propre LDL menait à une réduction de l’hydrolyse et de la captation de la trioléine-3H et à l’accumulation d’AGNE-3H dans le médium. In vitro, le LDL inhibait l’activité de la LPL. De plus, les adipocytes 3T3-L1 différenciés en présence de LDL avaient une hydrolyse et une captation réduite des lipoprotéines riches en trioléine-3H. CONCLUSION: Ce mémoire suggère que le LDL diminue la clairance des lipoprotéines riches en triglycérides par le TAB humain, ce qui pourrait expliquer la résistance à l’insuline observée chez des sujets avec apoB élevé. / OBJECTIVE: Delayed plasma clearance of postprandial triglyceride-rich lipoproteins (TRL) by white adipose tissue (WAT) promotes hypertriglyceridemia, insulin resistance and hepatic secretion of apoB-lipoproteins. The aim of this memoir was to examine whether low-density lipoproteins (LDL) induced delayed clearance of TRL by WAT. METHOD/RESULTS: Six hours following the ingestion of a high-fat meal, 22 postmenopausal obese women were separated based on plasma apoB levels (above/below median of 0.93 g/L). The high apoB group had delayed plasma clearance of postprandial triglyceride and non-esterified fatty acids (NEFA) compared to women with low apoB. There was no group difference in triolein oxidation rate, suggesting a lower NEFA uptake and storage in peripheral tissue in women with high apoB. Ex vivo, following a 4 hour incubation of participant’s WAT with synthetic 3H-triolein-TRL, plasma apoB correlated negatively with incorporated 3H-lipids. Incubation of women’s WAT with their own LDL (90% of apoB-lipoproteins in plasma) decreased 3H-TRL hydrolysis and increased medium 3H-NEFA accumulation. In vitro, LDL directly inhibited LPL activity. Finally, LDL-differentiated 3T3-L1 adipocytes had lower 3H-TRL hydrolysis and 3H-NEFA storage. CONCLUSION: This thesis suggests that LDL delay clearance and storage of TRL in human WAT, possibly explaining the increased insulin resistance observed in subjects with high apoB.

OBJECTIF: La mauvaise clairance des lipoprotéines riches en triglycérides par le tissu adipeux blanc (TAB) entraîne l’hypertriglycéridémie, la résistance à l’insuline et la sécrétion hépatique d’apolipoprotéine B (apoB). Ce mémoire tente de déterminer si le LDL entraîne une clairance réduite des lipoprotéines riches en triglycérides par le TAB. MÉTHODES/RÉSULTATS: Suivant l’ingestion d’un repas riche en gras marqué à la trioléine-13C, des femmes obèses postménopausées avec apoB plasmatique élevé (> médiane 0.93 g/L, N=22, 98% sous forme de IDL/LDL) avaient une clairance réduite de triglycérides-13C et acides gras non-estérifiés-13C (AGNE), comparées à celles avec un apoB plus bas. L'aire sous la courbe à 6 heures des triglycérides-13C et AGNE-13C plasmatiques corrélait avec l'apoB, suggérant une moindre captation dans les tissus périphériques chez les femmes avec apoB élevé. Ex vivo, suivant une incubation de 4 heures de biopsies de TAB avec de la trioléine-3H, l’apoB des patientes corrélait négativement avec les lipides-3H intracellulaires. Le traitement des biopsies de TAB des participantes avec leur propre LDL menait à une réduction de l’hydrolyse et de la captation de la trioléine-3H et à l’accumulation d’AGNE-3H dans le médium. In vitro, le LDL inhibait l’activité de la LPL. De plus, les adipocytes 3T3-L1 différenciés en présence de LDL avaient une hydrolyse et une captation réduite des lipoprotéines riches en trioléine-3H. CONCLUSION: Ce mémoire suggère que le LDL diminue la clairance des lipoprotéines riches en triglycérides par le TAB humain, ce qui pourrait expliquer la résistance à l’insuline observée chez des sujets avec apoB élevé. / OBJECTIVE: Delayed plasma clearance of postprandial triglyceride-rich lipoproteins (TRL) by white adipose tissue (WAT) promotes hypertriglyceridemia, insulin resistance and hepatic secretion of apoB-lipoproteins. The aim of this memoir was to examine whether low-density lipoproteins (LDL) induced delayed clearance of TRL by WAT. METHOD/RESULTS: Six hours following the ingestion of a high-fat meal, 22 postmenopausal obese women were separated based on plasma apoB levels (above/below median of 0.93 g/L). The high apoB group had delayed plasma clearance of postprandial triglyceride and non-esterified fatty acids (NEFA) compared to women with low apoB. There was no group difference in triolein oxidation rate, suggesting a lower NEFA uptake and storage in peripheral tissue in women with high apoB. Ex vivo, following a 4 hour incubation of participant’s WAT with synthetic 3H-triolein-TRL, plasma apoB correlated negatively with incorporated 3H-lipids. Incubation of women’s WAT with their own LDL (90% of apoB-lipoproteins in plasma) decreased 3H-TRL hydrolysis and increased medium 3H-NEFA accumulation. In vitro, LDL directly inhibited LPL activity. Finally, LDL-differentiated 3T3-L1 adipocytes had lower 3H-TRL hydrolysis and 3H-NEFA storage. CONCLUSION: This thesis suggests that LDL delay clearance and storage of TRL in human WAT, possibly explaining the increased insulin resistance observed in subjects with high apoB.