|Siegel, Richard - NEMC|
|Cupples, Adrienne - BOSTON UNIV|
|Schaefer, Ernst - HNRCA-TUFTS|
|Wilson, Peter - FRAMINGHAM HEART STUDY|
Submitted to: Metabolism
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: May 7, 1996
Publication Date: N/A
Interpretive Summary: Diabetes is a disorder in which blood sugar levels are elevated because of a disturbance in blood sugar metabolism and regulation. It is also known that diabetics have higher levels of fat-rich particles (known as lipoproteins) in their blood. These lipoproteins carry cholesterol and triglyceride, the two major blood fats. Our purpose was to carefully examine levels of such fats both in the whole blood and on various particles in the blood of participants in the Framingham Offspring Study (3757 control and 174 diabetic subjects). Both male and female diabetics had higher triglyceride levels as well as lower levels of high density lipoprotein (or HDL) cholesterol. Also, diabetics had smaller low density lipoprotein (or LDL) particles than nondiabetics. These data indicate that subjects with diabetes have lower HDL cholesterol and higher triglyceride levels and are more likely to have smaller dense LDL particles than controls, conditions that would lead to an increased risk of heart disease. Thus, the increased risk for heart disease in diabetics is related not only to the condition itself, but also to associated abnormalities in blood fats. Treatment with diet and medication would be predicted to reduce this risk.
Technical Abstract: Diabetes mellitus has been shown to be associated with lipid abnormalities. Prior studies have indicated that women with diabetes have a risk of coronary heart disease similar to that of men. We compared lipid parameters in diabetic and nondiabetic participants in cycle 3 of the Framingham Offspring Study. Male and female diabetics showed lower high density lipoprotein (HDL) cholesterol, higher triglycerides, higher very low density lipoprotein cholesterol, lower apo A1, and higher LDL particle scores than nondiabetics. Female diabetics also showed significantly higher total cholesterol and apo B values than nondiabetics. The presence of small dense LDL particles (pattern B) was highly associated with diabetes and hypertriglyceridemia in both sexes, and the relative odds for pattern B remained significant in women but not in men after adjustment for age and hypertriglyceri- demia. In conclusion, diabetics have lower HDL cholesterol and higher triglyceride levels and are more likely to have small dense LDL particles. Diabetes is not a secondary cause of elevated LDL cholesterol values. Lipid screening of diabetics should include full quantification of lipids for proper assessment of potential atherosclerotic risk.