Diabetes and Cholesterol Metabolism
The succinate hypothesis
- Piia P. Simonen, MD1,
- Helena Gylling, MD2 and
- Tatu A. Miettinen, MD1
- 1Department of Medicine, University of Helsinki, Helsinki, Finland
- 2Department of Clinical Nutrition, University of Kuopio and Kuopio University Hospital, Kuopio, Finland
Markedly increased cholesterol synthesis and low absorption of cholesterol in our obese patients with type 2 diabetes (1) prompted Dr. Ertel (2) to question whether the “succinate hypothesis” could explain the changes in cholesterol metabolism.
According to the succinate mechanism, summarized by Fahien and MacDonald (3), a basic requirement for insulin release would be the generation of mevalonic acid. This would be regulated by insulinotropic action of succinate and other nutrient secretagogues through several intracellular metabolic …
