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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #131825

Title: ELEVATED REMNANT-LIKE PARTICLE (RLP) CHOLESTEROL AND TRIGLYCERIDE LEVELS INDIABETIC MEN AND WOMENT IN THE FRAMINGHAM OFFSPRING STUDY

Author
item SCHAEFER, ERNST - HNRCA-TUFTS
item MCNAMARA, JUDITH - HNRCA-TUFTS
item SHAH, PAULESH - NEMC
item NAKAJIMA, KATSUYUKI - OTSUKA AMERICA PHARMA INC
item CUPPLES, ADRIENNE - BOSTON UNIVERSITY
item ORDOVAS, JOSE - HNRCA-TUFTS
item WILSON, PETER - BOSTON UNIVERSITY

Submitted to: Diabetes Care
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/12/2001
Publication Date: 6/1/2002
Citation: SCHAEFER, E., MCNAMARA, J.R., SHAH, P.K., NAKAJIMA, K., CUPPLES, A., ORDOVAS, J.M., WILSON, P.W. ELEVATED REMNANT-LIKE PARTICLE (RLP) CHOLESTEROL AND TRIGLYCERIDE LEVELS INDIABETIC MEN AND WOMENT IN THE FRAMINGHAM OFFSPRING STUDY. DIABETES CARE. 2002;25:989-994.

Interpretive Summary: In analysis based on the Framingham Heart Study, we carefully examined blood fat levels, namely triglyceride and cholesterol levels in various particles including special particles in the blood called remnants, in participants in the Framingham Heart Study. In this study there were 68 women with diabetes and 1499 women without diabetes, and 121 men with diabetes and 1357 men without diabetes. Among diabetic women blood triglyceride levels were 146% higher, while the bad remnant particles were 106% higher than controls, and remnant:triglyceride levels were marked 385% or almost fourfold increased. Levels of the good particle, or HDL cholesterol, were 26% lower. Similar differences were seen in men, but they weren't as striking, where the triglyceride levels were 41% higher in diabetics versus controls, remnant cholesterol levels were 28% higher, and remnant triglyceride levels were 70% higher, while levels of the good cholesterol particle were 11% higher. In both men and women with diabetes, the mean level of the bad cholesterol particle, known as LDL cholesterol, was only modestly affected. Therefore, the major particle in diabetics causing clogging of arteries are a subset of triglyceride-rich particles known as remnants, and these patients also have low levels of HDL. In order to reduce the risk of heart disease in these patients one must reduce remnant particles in the blood stream, using weight reduction, dietary modification, and medications.

Technical Abstract: Remnants of triglyceride-rich lipoproteins are thought to be atherogenic. A new antibody-based assay allows isolation of remnant-like particles (RLP) from plasma or serum, and subsequent measurement of RLP cholesterol and triglyceride (RLPC and RLPTG). We hypothesized that diabetics (DM) would have higher remnant levels than non-diabetics. We compared RLPC and RLPTG levels in DM subjects participating in the Framingham Heart Study with non-DM (68 women, 121 men with DM; 1499 women, 1357 men without DM). Mean RLPC values in DM women were 0.367 +/- 0.546 mmol/L (14.2 +/- 21.1 mg/dL), or 106% higher than in non-DM women at 0.179 +/- 0.109 mmol/L(6.9 +/-4.2 mg/dL; p <0.0001). RLPTG values for DM women were 1.089 +/-2.775 mmol/L (93.1 +/-245.6 mg/dL); 385% higher than in non-DM women, at 0.217 +/-0.235 mmol/L (19.2 +/-20.8 mg/dL; p <0.0001). Similar but less striking differences were observed in DM men; mean RLPC: 0.285 +/-0.261 mmol/L (11.0 +/-10.1 mg/dL); 28% higher than in non-DM men, at 0.223 +/-0.163 mmol/L (8.6 +/-6.3 mg/dL; p <0.001), and mean RLPTG: 0.606 +/-1.019 mmol/L (53.6 +/-90.2 mg/dL); 70% higher than non-DM, at 0.357 +/-0.546 mmol/L (31.6 +/-48.3 mg/dL; p <0.001). Moreover, DM men and women had significantly higher total triglycerides and lower HDL cholesterol levels than non-DM. The data indicate that RLP particles are elevated in DM subjects, and that for optimal cardiovascular risk reduction, treatment of elevated RLP values, along with LDL cholesterol control, should be considered.