HDL biology
Intensive insulin therapy in newly diagnosed type 1 diabetes progressively suppresses serum CETP and PLTP over the first year (Nutr Metab Cardiovasc Dis 2021)
Original title: Suppression of serum lipid transfer proteins involved in high-density lipoprotein cholesterol metabolism by intensive insulin therapy in the first year of type 1 diabetes mellitus: Prospective InLipoDiab1 study
In the InLipoDiab1 study, 57 adults with newly diagnosed type 1 diabetes mellitus treated with intensive subcutaneous insulin therapy had serum phospholipid transfer protein (PLTP) and cholesteryl ester transfer protein (CETP) concentrations measured by ELISA at diagnosis and after three weeks, six months, and one year. Both PLTP and CETP concentrations significantly decreased over twelve months of insulin therapy, with the timing depending on whether patients achieved disease remission: in the non-remission group, PLTP and CETP fell significantly by six months, while in the remission group the decrease appeared only after one year. In the non-remission group, daily insulin dose correlated negatively with both PLTP and CETP levels. Exogenous insulin therefore acts as an inhibitor of these HDL-cholesterol-metabolism lipid transfer proteins during the first year of type 1 diabetes treatment.
Original abstract
Background And Aims: Cholesteryl ester transfer protein (CETP) and phospholipid transfer protein (PLTP) are crucial proteins in reverse cholesterol transport. There are insufficient data on regulating these proteins by insulin therapy in type 1 diabetes mellitus (T1DM). We aimed to assess prospectively the impact of insulin therapy initiation on transfer proteins serum levels in adults with newly diagnosed T1DM.
Methods And Results: 57 adults with newly diagnosed T1DM were enrolled in the InLipoDiab1 Study. All participants were treated with subcutaneous insulin in the model of intensive insulin therapy since the diagnosis of diabetes. Serum PLTP and CETP concentrations were measured at diagnosis, after three weeks, six months, and after one year of insulin treatment, using the immunoenzymatic method ELISA. A significant decrease in PLTP and CETP concentrations were demonstrated during twelve months of insulin therapy in newly diagnosed T1DM. The dynamics of changes in the level of these proteins varied depending on the occurrence of remission after a year of the disease. In the group without remission, a significant decrease in PLTP and CETP levels appeared after six months of follow-up. The remission group was characterized by a decrease in proteins concentration only after one year of treatment. In the non-remission group, significant negative correlations were found between the daily dose of insulin and levels of PLTP and CETP.
Conclusion: Exogenous insulin is an inhibitor of lipid transfer proteins involved in high-density lipoprotein cholesterol metabolism in the first year of treatment.
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 19 August 2026. Methods.