HDL and glucose metabolism: Current evidence and therapeutic potential

Andrew L. Siebel, Sarah Elizabeth Heywood, Bronwyn A. Kingwell

Research output: Contribution to journalReview ArticleResearchpeer-review

38 Citations (Scopus)

Abstract

High-density lipoprotein (HDL) and its principal apolipoprotein A-I (ApoA-I) have now been convincingly shown to influence glucose metabolism through multiple mechanisms. The key clinically relevant observations are that both acute HDL elevation via short-term reconstituted HDL (rHDL) infusion and chronically raising HDL via a cholesteryl ester transfer protein (CETP) inhibitor reduce blood glucose in individuals with type 2 diabetes mellitus (T2DM). HDL may mediate effects on glucose metabolism through actions in multiple organs (e.g., pancreas, skeletal muscle, heart, adipose, liver, brain) by three distinct mechanisms: (i) Insulin secretion from pancreatic beta cells, (ii) Insulin-independent glucose uptake, (iii) Insulin sensitivity. The molecular mechanisms appear to involve both direct HDL signaling actions as well as effects secondary to lipid removal from cells. The implications of glucoregulatory mechanisms linked to HDL extend from glycemic control to potential anti-ischemic actions via increased tissue glucose uptake and utilization. Such effects not only have implications for the prevention and management of diabetes, but also for ischemic vascular diseases including angina pectoris, intermittent claudication, cerebral ischemia and even some forms of dementia. This review will discuss the growing evidence for a role of HDL in glucose metabolism and outline related potential for HDL therapies.

Original languageEnglish
Article number258
Number of pages7
JournalFrontiers in Pharmacology
Volume6
DOIs
Publication statusPublished - 31 Oct 2015
Externally publishedYes

Keywords

  • Apolipoprotein A-I
  • Cholesterol efflux
  • Glucose metabolism
  • Glucose uptake
  • HDL
  • Insulin secretion
  • Insulin sensitivity

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