Diabetes
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Teran-Garcia, M.
Right arrow Articles by Bouchard, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Teran-Garcia, M.
Right arrow Articles by Bouchard, C.
Social Bookmarking
Add to CiteULike   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

Diabetes 54:2251-2255, 2005
© 2005 by the American Diabetes Association, Inc.

Brief Genetics Reports

Hepatic Lipase Gene Variant –514C>T Is Associated With Lipoprotein and Insulin Sensitivity Response to Regular Exercise

The HERITAGE Family Study

Margarita Teran-Garcia1, Nicola Santoro1,2, Tuomo Rankinen1, Jean Bergeron3, Treva Rice4, Arthur S. Leon5, D.C. Rao4,6, James S. Skinner7, Richard N. Bergman8, Jean-Pierre Després9, and Claude Bouchard1

1 Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana
2 Department of Pediatrics, "F. Fede" Second University of Naples, Napoli, Italy
3 Lipid Research Center, CHUL Medical Research Center, Québec, Canada
4 Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri
5 Laboratory of Physiological Hygiene and Exercise Science, School of Kinesiology, University of Minnesota, Minneapolis, Minnesota
6 Departments of Genetics and Psychiatry, Washington University School of Medicine, St. Louis, Missouri
7 Department of Kinesiology, Indiana University, Bloomington, Indiana
8 Keck School of Medicine, University of Southern California, Los Angeles, California
9 Quebec Heart Institute, Laval Hospital Research Center, Sainte-Foy, Québec, Canada


   ABSTRACT
TOP
 ABSTRACT
RESEARCH DESIGN AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
We investigated the associations between the hepatic lipase gene (LIPC) –514C>T polymorphism and lipases, lipoproteins, and insulin sensitivity (Si) responses to exercise training. Hepatic lipase and lipoprotein lipase activities, plasma lipoprotein levels, and Si were measured in the sedentary state and post–exercise training in the Health, Risk Factors, Exercise Training, and Genetics (HERITAGE) Family Study (n = 662). The LIPC –514C allele frequency was 0.516 (blacks) and 0.796 (whites). Baseline and post–exercise training hepatic lipase activities were 40% higher in CC homozygotes (P < 0.0001) in both races. Black CC homozygotes had lower baseline lipoprotein lipase activity, HDL cholesterol, HDL3, and apolipoprotein (apo)A-1 concentrations. White CC homozygotes had lower baseline HDL cholesterol, apoA-1, LDL cholesterol, and apoB levels that remained low post–exercise training. Baseline Si was not associated with the LIPC genotypes. However, training-induced improvements in Si both in blacks and whites were greater in CC homozygotes (+1.25 ± 0.2 and +0.22 ± 0.2 µU · min–1 · ml–1) than in the TT genotype (+0.27 ± 0.3 and –0.97 ± 0.3 µU · min–1 · ml–1) (P = 0.008 and P = 0.002, respectively). The LIPC –514C allele was associated with higher hepatic lipase activity in sedentary and physically active states and better Si responses to regular exercise both in black and white individuals. The benefits from an exercise program on Si are likely to be substantial in the general population given the high frequency of the LIPC –514C allele, particularly in whites.

Address correspondence and reprint requests to Claude Bouchard, Human Genomics Laboratory, Pennington Biomedical Research Center, 6400 Perkins Rd., Baton Rouge, LA 70808. E-mail: bouchac{at}pbrc.edu

Abbreviations: apo, apolipoprotein; CHD, coronary heart disease; HERITAGE, Health, Risk Factors, Exercise Training, and Genetics; LPL, lipoprotein lipase

Hepatic lipase hydrolyzes triglyceride and phospholipids from high-, intermediate-, and low-density lipoproteins, transforming them into smaller and denser particles, and promotes the cellular uptake of HDL cholesterol (1). The hepatic lipase gene (LIPC), located on chromosome 15q21-q23, is expressed in the liver. Hepatic lipase has been the subject of recent reviews for its molecular (1) and pathophysiologic significance in obesity, dyslipidemia, and atherogenesis (2). There is familial resemblance for plasma postheparin lipoprotein lipase (LPL) and postheparin hepatic lipase activities (3), and exercise training–induced improvement in insulin sensitivity (Si) correlates with decreased postheparin hepatic lipase activity.

Genetic polymorphisms in the LIPC gene are associated with postheparin hepatic lipase activity (4–6). Four frequently reported genetic variants in the LIPC promoter are in almost complete linkage disequilibrium, forming two haplotypes (2). The less common T allele in the –514C>T variant has been associated with a 30–40% decrease in postheparin hepatic lipase activity and higher HDL cholesterol levels (4). However, the relevance of this polymorphism for the transcriptional regulation of the LIPC gene remains controversial (7–10).

The benefits of regular physical activity in decreasing the risk of developing insulin resistance and coronary heart disease (CHD) are well documented, although individual responses vary considerably (11,12). Regular exercise affects lipid-lipoprotein profiles and peripheral glucose utilization (12,13). We investigated associations between the LIPC –514C>T variant and plasma lipoprotein levels, Si and postheparin hepatic lipase, and postheparin LPL activities in a biracial cohort under sedentary-state conditions and their responses to endurance exercise training.


   RESEARCH DESIGN AND METHODS
TOP
 ABSTRACT
 RESEARCH DESIGN AND METHODS
RESULTS
 DISCUSSION
 REFERENCES
 
The Health, Risk Factors, Exercise Training, and Genetics (HERITAGE) Family Study design and methods have been described previously (14). Briefly, the HERITAGE Family Study was designed to investigate the role of genetic factors in cardiovascular, metabolic, and hormonal responses to endurance training in white and black families. All subjects were required to be sedentary and in good health to participate in the HERITAGE Family Study, as well as to fulfill a series of inclusion criteria (14). For the present study we only excluded individuals without genotype or phenotype data. Data from 219 black adults (79 males and 140 females) and 443 white adults (218 males and 225 females) were available. Each institutional review board of the HERITAGE Family Study research consortium approved the study protocol. Written informed consent was obtained from each participant.

Exercise training program.
The exercise training program has been described in detail previously (14,15). Briefly, the exercise intensity of the 20-week program was customized for each participant based on the heart rate–oxygen uptake relationship measured at baseline. During the first 2 weeks, the subjects trained at a heart rate corresponding to 55% of VO2max for 30 min per session. Duration was gradually increased to 50 min per session and intensity to the heart rate associated with 75% of the baseline VO2max. These conditions were then sustained for the last 6 weeks. Training frequency was three times per week, and all training sessions were performed under supervision on cycle ergometers at the participating clinical centers. The subjects were instructed not to change their diet during the intervention.

Phenotype measurements.
All phenotypes were measured at baseline and after the 20-week exercise training program.

Measurement of Si.
A frequently sampled intravenous glucose tolerance test was performed as described (16) in the morning after a 12-h overnight fast and no less than 24 h after the last exercise session. From the frequently sampled intravenous glucose tolerance test data, Si was derived using the MINMOD Millennium computer program (17). Si measures the ability of plasma insulin to enhance the net disappearance of glucose from plasma. These analyses were described previously (16).

Postheparin lipase activities, lipids, and lipoproteins.
Postheparin LPL and postheparin hepatic lipase activities were measured by the modified Nilsson-Ehle and Ekman method, as previously reported (13). Activity is expressed as nanomoles of free fatty acid released divided by milliliters of plasma divided by minutes. Lipid, lipoprotein, and apolipoprotein (apo) assays have been reported previously in detail (3).

Genetic analyses.
Genomic DNA was extracted from lymphoblastoid cell lines using standard procedures. Genotyping for the LIPC –514C>T polymorphism (dbSNP rs#1800588) was performed using the TaqMan allelic discrimination method. Details for PCR conditions and primer/probe sequences are available upon request.

Statistical analyses.
All statistical analyses were performed with the SAS Statistical Software Package (release 8.2; SAS Institute, Cary, NC). A {chi}2 test was used to compare allele frequencies and to test whether the genotype distributions were in Hardy-Weinberg equilibrium. Associations between the LIPC –514C>T genotypes and phenotypes were analyzed using a MIXED procedure. Nonindependence among family members was adjusted using a "sandwich estimator" as described in previous HERITAGE publications. Because of the skewed distributions, baseline plasma triglyceride, VLDL cholesterol, and HDL cholesterol were normalized with log transformation. The Si data derived from the MINMOD Millennium model required a square root transformation to approximate a normal distribution. All analyses were done separately in blacks and whites. All baseline data were adjusted for age, sex, and BMI, whereas the training responses were also adjusted for the respective baseline values.


   RESULTS
TOP
 ABSTRACT
 RESEARCH DESIGN AND METHODS
 RESULTS
DISCUSSION
 REFERENCES
 
The LIPC –514C allele frequency was 0.516 (blacks) and 0.796 (whites). Genotype distributions were in Hardy-Weinberg equilibrium. The LIPC –514C>T polymorphism showed a strong association with postheparin hepatic lipase activity, which was ~40% higher in the CC homozygotes at baseline (P ≤ 0.0001) and posttraining (P ≤ 0.0001) in both ethnic groups (Fig. 1).


Figure 1
View larger version (22K):
[in this window]
[in a new window]

  		FIG. 1. Postheparin hepatic lipase (PH-HL) activity according to the LIPC –541C>T genotype in blacks (A) and whites (B). Pretraining ({square}) and post-training ({blacksquare}) columns represent the data adjusted for age, sex, and BMI. Error bars represent SE. P values are for the genotype differences.

 
The LIPC –514C>T polymorphism was also associated with postheparin LPL activity. The black CC homozygotes had 32 and 21% lower postheparin LPL activity before and after exercise training than the LIPC TT homozygotes (P = 0.0005 and 0.009, respectively). White CC homozygotes had 12 and 19% lower postheparin LPL activity before and after exercise training than TT homozygotes (P = 0.0004 and <0.0001, respectively) (Fig. 2).


Figure 2
View larger version (23K):
[in this window]
[in a new window]

  		FIG. 2. Postheparin lipoprotein lipase (PH-LPL) activity according to the LIPC –541C>T genotype in blacks (A) and whites (B). Pretraining ({square}) and post-training ({blacksquare}) columns represent the data adjusted for age, sex, and BMI. Error bars represent SE. P values are for the genotype differences.

 
Associations of LIPC –514C>T genotypes with lipids and lipoprotein concentrations in the sedentary state and their training responses in blacks and whites are shown in Table 1. In blacks, the TT homozygotes exhibited higher baseline HDL cholesterol, HDL3, and apoA-1 concentrations than the CC homozygotes. The LIPC –514 polymorphism was also associated with apoB (P = 0.04) training response, with the greatest reduction observed in the TT homozygotes. White TT homozygotes also had higher HDL cholesterol and apoA-1 concentrations in the sedentary state, as well as significantly higher plasma trigylceride, VLDL cholesterol, LDL cholesterol, and apoB concentrations.


View this table:
[in this window]
[in a new window]

  		TABLE 1 Associations between the LIPC –514C>T genotype and plasma lipids and lipoproteins

 
There were no differences in Si between the LIPC –514 genotypes in blacks and whites in the sedentary state (Table 2). However, training–induced improvements in Si in blacks and whites were greater in the CC homozygotes (+1.25 ± 0.2 and +0.22 ± 0.2 µU · min–1 · ml–1) than in the TT genotype (+0.27 ± 0.3 and –0.97 ± 0.32 µU · min–1 · ml–1), with heterozygotes showing intermediary values.


View this table:
[in this window]
[in a new window]

  		TABLE 2 Si (µU · min–1 · ml–1) in relation to the LIPC –514C>T genotype

 

   DISCUSSION
TOP
 ABSTRACT
 RESEARCH DESIGN AND METHODS
 RESULTS
 DISCUSSION
REFERENCES
 
Our data demonstrate significant associations between the LIPC –514C>T polymorphism and plasma postheparin hepatic lipase and postheparin LPL activities and lipoprotein levels in the sedentary state as well as with endurance training–induced changes in Si. Several studies have shown that DNA sequence variations at the LIPC locus contribute to postheparin hepatic lipase plasma levels and the lipoprotein profile (2,6). A recent meta-analysis concluded that the LICP –514C>T polymorphism is important in determining hepatic lipase activity and HDL concentration (18). However, associations between this polymorphism and changes in lipoprotein levels or Si in response to exercise training have not been addressed before.

The LIPC –514TT homozygotes had 30% lower postheparin hepatic lipase activity compared with the CC homozygotes, and the genotype accounted for 7–8% of the variation in postheparin hepatic lipase activity. This association remained after exercise training. Blacks had lower postheparin hepatic lipase activity, an ethnic difference found in both sexes and concordant with previous observations (19,20). Several in vitro studies have reported a 30–40% reduction in transcriptional activity in cells transfected with the T allele compared with the C allele (rev. in 2). Other studies found no functional effects of this allelic variant, perhaps because of differences in cell lines, transfection efficiencies, and reporter vectors used (7,8,10). Overall, our data strengthen reports that associate postheparin hepatic lipase activity with the LIPC –514C>T polymorphism (4,7,9). Recently, a prospective cohort study found that the TT genotype had increased susceptibility to CHD in sedentary or moderately physically active subjects but not among the vigorously active (21).

Individuals carrying the LIPC –514T allele had higher postheparin LPL activity at baseline and after exercise training. We have reported earlier higher postheparin LPL activity in blacks in the sedentary state (22) and that increased LPL activity was associated with an improved lipoprotein-lipid profile in response to an exercise training program (13). Here we report that the TT homozygotes had 25% higher LPL activity after exercise training than the CC homozygotes. The increase in LPL activity after endurance exercise training in combination with the higher HDL cholesterol observed in the TT homozygotes could impact CHD risk.

Hepatic lipase deficiency modifies the lipoprotein profile. It has been related to increased plasma cholesterol and trigylceride levels and mass redistribution within HDL particles (2). The most consistent finding in hepatic lipase deficiency is increased HDL2. The LIPC –250G>A variant, which is in complete linkage disequilibrium with the LIPC –514C>T, also leads to decreased hepatic lipase activity in the A allele carriers and to buoyant LDL particles and high HDL cholesterol (4). We found associations between the LIPC –514C>T polymorphism and the lipoprotein profile in the sedentary state, with higher HDL cholesterol and apoA-1 levels in the TT homozygotes. Although there were no significant associations with other lipoproteins, the association for HDL cholesterol levels remained significant in the trained state. Increased risk of atherosclerosis has been associated with the LIPC –514T allele, and CC homozygotes benefit the most from intensive lipid-lowering therapy (4,23).

This study is the first to examine the associations between the LIPC –514C>T genotypes and Si and the responses of postheparin lipase to an exercise training intervention. The LIPC –514C>T genotypes showed associations with Si and postheparin hepatic lipase activity after exercise training. The enhanced Si after exercise training, primarily in the CC homozygotes, was associated with higher postheparin hepatic lipases activity. Remarkably, these Si differences appeared only in response to exercise training. The second European Atherosclerosis Research Study reported that T allele carriers have the lowest glucose tolerance (24). Recently, the LIPC-205G>A polymorphism, which is in complete linkage disequilibrium with the LIPC –514C>T, has been reported to predict the conversion from impaired glucose tolerance to type 2 diabetes in a 3-year follow-up lifestyle intervention (25).

The mechanisms behind the association of the LIPC –514C>T polymorphism and Si are unclear. Changes in blood lipids in response to decreased postheparin hepatic lipase activity and increased postheparin LPL activity may accompany changes in intramyocellular lipid storage, affecting Si (26). Several regulatory elements have been identified in the rat LIPC promoter, and consensus analysis with the human sequence suggests that the LIPC –514C>T variant may be in a DNA motif containing the sequences necessary for insulin/glucose responses. Insulin regulation of the LIPC gene could be mediated by either upstream stimulatory factor or sterol regulatory element–binding protein-1c transcription factors, which bind to the E-box motif located in the LIPC promoter region at –514 bp, although this has not been demonstrated (9). One could speculate that human variation in Si response to exercise training associated with the LIPC genotype is the consequence of transcriptional effects on the LIPC gene by insulin and the binding (or lack of) of transcription factors to the E-box motif.

Finally, the present study suggests that regular exercise may not influence the lipoprotein profile or improve Si at the same rate for all individuals and that the efficacy of regular exercise could be related in part to the LIPC –514C>T genotype. C allele carriers may not only have more clinical benefit from intensive lipid-lowering therapy, as reported (4), but are more likely to benefit from an exercise training program. The improvement in Si with regular exercise in individuals with the LIPC –514C allele has significant clinical applications due to its high frequency in various populations (4,5,7). Arguably, screening for T allele carriers may allow the identification of subjects at elevated risk requiring individualized therapeutic strategies to decrease cardiovascular and metabolic disease risks.

In summary, results from the HERITAGE Family Study indicate that the C allele at –514 in the promoter region of the LIPC gene is associated with higher postheparin hepatic lipase activity and better Si response to regular exercise. The benefits on Si from an exercise program could be of considerable importance in the general population given the high frequency of the LIPC –514C allele.


   ACKNOWLEDGMENTS
 
The HERITAGE Family Study is supported by National Heart, Lung, and Blood Institute Grants HL-45670 (to C.B.), HL-47323 (to A.S.L.), HL-47317 (to D.C.R.), HL-47327 (to J.S.S.), and HL-47321 (to J.H.W.). A.S.L. is partially supported by the Henry L. Taylor endowed Professorship in Exercise Science and Health Enhancement, and C.B. is partially supported by the George A. Bray Chair in Nutrition.

Gratitude is expressed to Dr. Jack H. Wilmore for the critical reading of the manuscript and his comments. We thank Anik Boudreau for her expert contribution to the single nucleotide polymorphism genotyping. Thanks are expressed to Nina Laidlaw for her editorial support.

Received for publication July 26, 2004 and accepted in revised form April 1, 2005


   REFERENCES
TOP
 ABSTRACT
 RESEARCH DESIGN AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 

  1. Perret B, Mabile L, Martinez L, Terce F, Barbaras R, Collet X: Hepatic lipase: structure/function relationship, synthesis, and regulation. J Lipid Res 43:1163–1169, 2002[Abstract/Free Full Text]
  2. Deeb SS, Zambon A, Carr MC, Ayyobi AF, Brunzell JD: Hepatic lipase and dyslipidemia: interactions among genetic variants, obesity, gender, and diet. J Lipid Res 44:1279–1286, 2003[Abstract/Free Full Text]
  3. Perusse L, Rice T, Despres JP, Bergeron J, Province MA, Gagnon J, Leon AS, Rao DC, Skinner JS, Wilmore JH, Bouchard C: Familial resemblance of plasma lipids, lipoproteins and postheparin lipoprotein and hepatic lipases in the HERITAGE Family Study. Arterioscler Thromb Vasc Biol 17:3263–3269, 1997[Abstract/Free Full Text]
  4. Zambon A, Deeb SS, Pauletto P, Crepaldi G, Brunzell JD: Hepatic lipase: a marker for cardiovascular disease risk and response to therapy. Curr Opin Lipidol 14:179–189, 2003[Medline]
  5. Murtomaki S, Tahvanainen E, Antikainen M, Tiret L, Nicaud V, Jansen H, Ehnholm C: Hepatic lipase gene polymorphisms influence plasma HDL levels: results from Finnish EARS participants: European Atherosclerosis Research Study. Arterioscler Thromb Vasc Biol 17:1879–1884, 1997[Abstract/Free Full Text]
  6. Cohen JC, Vega GL, Grundy SM: Hepatic lipase: new insights from genetic and metabolic studies. Curr Opin Lipidol 10:259–267, 1999[Medline]
  7. Vega GL, Gao J, Bersot TP, Mahley RW, Verstraete R, Grundy SM, White A, Cohen JC: The -514 polymorphism in the hepatic lipase gene (LIPC) does not influence androgen-mediated stimulation of hepatic lipase activity. J Lipid Res 39:1520–1524, 1998[Abstract/Free Full Text]
  8. De Oliveira e Silva ER, Kong M, Han Z, Starr C, Kass EM, Juo SH, Foster D, Dansky HM, Merkel M, Cundey K, Brinton EA, Breslow JL, Smith JD: Metabolic and genetic determinants of HDL metabolism and hepatic lipase activity in normolipidemic females. J Lipid Res 40:1211–1221, 1999[Abstract/Free Full Text]
  9. Deeb SS, Peng R: The C-514T polymorphism in the human hepatic lipase gene promoter diminishes its activity. J Lipid Res 41:155–158, 2000[Abstract/Free Full Text]
  10. van ’t Hooft FM, Lundahl B, Ragogna F, Karpe F, Olivecrona G, Hamsten A: Functional characterization of 4 polymorphisms in promoter region of hepatic lipase gene. Arterioscler Thromb Vasc Biol 20:1335–1339, 2000[Abstract/Free Full Text]
  11. Bouchard C, Rankinen T: Individual differences in response to regular physical activity. Med Sci Sports Exerc 33:S446–S451, 2001[Medline]
  12. Duncan GE, Perri MG, Theriaque DW, Hutson AD, Eckel RH, Stacpoole PW: Exercise training, without weight loss, increases insulin sensitivity and postheparin plasma lipase activity in previously sedentary adults. Diabetes Care 26:557–562, 2003[Abstract/Free Full Text]
  13. Bergeron J, Couillard C, Despres JP, Gagnon J, Leon AS, Rao DC, Skinner JS, Wilmore JH, Bouchard C: Race differences in the response of postheparin plasma lipoprotein lipase and hepatic lipase activities to endurance exercise training in men: results from the HERITAGE Family Study. Atherosclerosis 159:399–406, 2001[Medline]
  14. Bouchard C, Leon AS, Rao DC, Skinner JS, Wilmore JH, Gagnon J: The HERITAGE family study: aims, design, and measurement protocol. Med Sci Sports Exerc 27:721–729, 1995[Medline]
  15. Skinner JS, Wilmore KM, Krasnoff JB, Jaskolski A, Jaskolska A, Gagnon J, Province MA, Leon AS, Rao DC, Wilmore JH, Bouchard C: Adaptation to a standardized training program and changes in fitness in a large, heterogeneous population: the HERITAGE Family Study. Med Sci Sports Exerc 32:157–161, 2000[Medline]
  16. Hong Y, Weisnagel SJ, Rice T, Sun G, Mandel SA, Gu C, Rankinen T, Gagnon J, Leon AS, Skinner JS, Wilmore JH, Bergman RN, Bouchard C, Rao DC: Familial resemblance for glucose and insulin metabolism indices derived from an intravenous glucose tolerance test in blacks and whites of the HERITAGE Family Study. Clin Genet 60:22–30, 2001[Medline]
  17. Boston RC, Stefanovski D, Moate PJ, Sumner AE, Watanabe RM, Bergman RN: MINMOD Millennium: a computer program to calculate glucose effectiveness and insulin sensitivity from the frequently sampled intravenous glucose tolerance test. Diabetes Technol Ther 5:1003–1015, 2003[Medline]
  18. Isaacs A, Sayed-Tabatabaei FA, Njajou OT, Witteman JCM, van Duijn CM: The -514 C>T hepatic lipase promoter region polymorphism and plasma lipids: a meta-analysis. J Clin Endocrinol Metab 89:3858–3863, 2004[Abstract/Free Full Text]
  19. Vega GL, Clark LT, Tang A, Marcovina S, Grundy SM, Cohen JC: Hepatic lipase activity is lower in African American men than in white American men: effects of 5' flanking polymorphism in the hepatic lipase gene (LIPC). J Lipid Res 39:228–232, 1998[Abstract/Free Full Text]
  20. Carr MC, Brunzell JD, Deeb SS: Ethnic differences in hepatic lipase and HDL in Japanese, black, and white Americans: role of central obesity and LIPC polymorphisms. J Lipid Res 45:466–473, 2004[Abstract/Free Full Text]
  21. Hokanson JE, Kamboh MI, Scarboro S, Eckel RH, Hamman RF: Effects of the hepatic lipase gene and physical activity on coronary heart disease risk. Am J Epidemiol 158:836–843, 2003[Abstract/Free Full Text]
  22. Despres JP, Couillard C, Gagnon J, Bergeron J, Leon AS, Rao DC, Skinner JS, Wilmore JH, Bouchard C: Race, visceral adipose tissue, plasma lipids, and lipoprotein lipase activity in men and women: the Health, Risk Factors, Exercise Training, and Genetics (HERITAGE) family study. Arterioscler Thromb Vasc Biol 20:1932–1938, 2000[Abstract/Free Full Text]
  23. Maitland-van der Zee AH, Klungel OH, Stricker BH, Monique Verschuren WM, Kastelein JJ, Leufkens HG, de Boer A: Genetic polymorphisms: importance for response to HMG-CoA reductase inhibitors (Review). Atherosclerosis 163:213–222, 2002[Medline]
  24. Jansen H, Waterworth DM, Nicaud V, Ehnholm C, Talmud PJ: Interaction of the common apolipoprotein C-III (APOC3–482C > T) and hepatic lipase (LIPC –514C > T) promoter variants affects glucose tolerance in young adults: European Atherosclerosis Research Study II (EARS-II). Ann Intern Med 65:237–243, 2001
  25. Todorova B, Kubaszek A, Pihlajamaki J, Lindstrom J, Eriksson J, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Tuomilehto J, Uusitupa M, Laakso M: The G-250A promoter polymorphism of the hepatic lipase gene predicts the conversion from impaired glucose tolerance to type 2 diabetes mellitus: the Finnish Diabetes Prevention Study. J Clin Endocrinol Metab 89:2019–2023, 2004[Abstract/Free Full Text]
  26. McGarry JD: Dysregulation of fatty acid metabolism in the etiology of type 2 diabetes. Diabetes 51:7–18, 2002[Free Full Text]

Add to CiteULike CiteULike   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?



This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Teran-Garcia, M.
Right arrow Articles by Bouchard, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Teran-Garcia, M.
Right arrow Articles by Bouchard, C.
Social Bookmarking
Add to CiteULike   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Diabetes Diabetes Care Clinical Diabetes Diabetes Spectrum