From the Guidelines
Insulin decreases triglycerides by inhibiting the breakdown of fat in adipose tissue and promoting the storage of triglycerides, as well as reducing the liver's production of VLDL, a major carrier of triglycerides in the blood, as supported by the most recent study 1.
Mechanism of Action
When insulin is released after a meal, it activates lipoprotein lipase, an enzyme that helps clear triglycerides from the bloodstream by breaking them down so they can be taken up by fat cells for storage. Simultaneously, insulin suppresses hormone-sensitive lipase, which normally breaks down stored triglycerides in fat cells, thus preventing the release of fatty acids into circulation.
Clinical Implications
In people with insulin resistance or diabetes, these mechanisms become impaired, often resulting in elevated triglyceride levels. This is why proper insulin therapy in diabetic patients typically leads to improved triglyceride profiles alongside better glucose control, as noted in 1 and 1.
Lifestyle Interventions
Additionally, lifestyle changes such as reducing saturated fat intake, increasing physical activity, and modest weight loss can also help decrease plasma triglycerides and improve insulin sensitivity, as recommended in 1 and 1.
Key Points
- Insulin therapy can improve triglyceride profiles in diabetic patients
- Lifestyle interventions, such as dietary changes and increased physical activity, can also help decrease plasma triglycerides
- Proper management of triglyceride levels is important to reduce the risk of cardiovascular disease and other complications in diabetic patients, as emphasized in 1.
From the Research
Insulin's Effect on Triglycerides
- Insulin plays a crucial role in regulating triglyceride levels in the body, although the exact mechanisms are complex and involve multiple pathways 2, 3, 4, 5, 6.
- According to the study by 3, insulin action is associated with decreased triglyceride and VLDL production, which can lead to lower triglyceride levels.
- The study by 4 suggests that insulin resistance, which is often characterized by elevated free fatty acid levels, can lead to increased triglyceride production and accumulation in tissues such as skeletal muscle and liver.
- Another study by 5 found that excess muscle triglyceride accumulation is associated with insulin resistance, and that reducing muscle lipid accumulation can improve insulin sensitivity.
- Additionally, the study by 6 found that elevated plasma free fatty acid levels can inhibit insulin-stimulated glucose uptake into muscle, leading to peripheral insulin resistance.
Mechanisms of Insulin's Effect on Triglycerides
- Insulin stimulates the translocation of fatty acid transport protein 1 (FATP1) to the plasma membrane, increasing free fatty acid uptake in adipocytes 2.
- Insulin also inhibits the production of triglycerides and VLDL in the liver, which can lead to decreased triglyceride levels in the blood 3.
- The activation of peroxisome proliferator-activated receptors (PPARs) by insulin can also modulate transcription and contribute to improved glucose metabolism 4.
- Furthermore, insulin can reduce the accumulation of fat metabolites such as ceramides, diacylglycerol, and acyl-CoA in skeletal muscle and liver, which can improve insulin signaling and glucose transport 4, 5.