LDL, trigs, HDL and all that

We've wandered so I've changed the subject. Was "NYT
article"

On Tue, 21 Aug 2007 12:09:35 -0400, Susan
<nevermind@xxxxxxxxxx> wrote:

It's the HDL and TGLs, not the LDL that'll getcha.


Susan



• Diabetes Care. 2005 May;28(5):1264; author reply 1264-5.

Is atherosclerosis in diabetes and impaired fasting glucose driven by
elevated LDL cholesterol or by decreased HDL cholesterol?

Drexel H, Aczel S, Marte T, Benzer W, Langer P, Moll W, Saely CH.

Vorarlberg Institute for Vascular Investigation and Treatment,
Feldkirch, Austria. vivit@xxxxxxx

OBJECTIVE: To evaluate the atherogenicity of lipids in coronary patients
with normal fasting glucose (NFG), impaired fasting glucose (IFG), and
type 2 diabetes. RESEARCH DESIGN AND METHODS: Serum lipid values, the
presence of angiographic coronary artery disease (CAD) at baseline, and
the incidence of vascular events over 2.3 years were recorded in 750
consecutive patients undergoing coronary angiography. RESULTS:
Triglycerides significantly (P < 0.001) increased and HDL cholesterol (P
< 0.001) as well as LDL particle diameter (P < 0.001) significantly
decreased from subjects with NFG <5.6 mmol/l (n = 272) over patients
with IFG > or =5.6 mmol/l (n = 314) to patients with type 2 diabetes (n
= 164). Factor analysis revealed two factors in the lipid profiles of
our patients: triglycerides, HDL cholesterol, apolipoprotein A1, and LDL
particle diameter loaded high on an HDL-related factor, and total
cholesterol, LDL cholesterol, and apolipoprotein B loaded high on an
LDL-related factor. In patients with type 2 diabetes, the HDL-related
factor (odds ratio 0.648 [95% CI 0.464-0.904]; P = 0.011), but not the
LDL-related factor (0.921 [0.677-1.251]; P = 0.597), was associated with
significant coronary stenoses > or =50%. Consistently, in the
prospective study, the HDL-related factor (0.708 [0.506-0.990]; P =
0.044), but not the LDL-related factor (1.362 [0.985-1.883]; P = 0.061),
proved significantly predictive for vascular events in patients with
type 2 diabetes. CONCLUSIONS: The low HDL cholesterol/high triglyceride
pattern is associated with the degree of hyperglycemia. In coronary
patients with type 2 diabetes, this pattern correlates with the
prevalence of CAD and significantly predicts the incidence of vascular
events.

PMID: 15616241 [PubMed - indexed for MEDLINE]

Hi Susan

I went looking for the link to the original article, which
is
http://care.diabetesjournals.org/cgi/content/full/28/1/101
but while searching I came across the responses and comments
page:
http://care.diabetesjournals.org/cgi/reprint/28/5/1264-a

You may be interested in this closing statement from the
authors in response to one of the comments:

"Even though cardiovascular risk is significantly reduced in
diabetic patients by statins, it remains at a very high
level in these patients (5). The consistent association
of the HDL-related factor with glycemia, with significant
stenoses and with the future incidence of vascular events,
provides compelling and conclusive evidence that the main
lipid risk factor in our patients with diabetes is the triad
of low HDL cholesterol, small LDL particles, and high
triglycerides."

There were also some other interesting related articles and
comments on that link:

Simvastatin, Fenofibrate, and Rhabdomyolysis

Two-Year Statin Therapy Does Not Alter the Progression
of Intima-Media Thickness in Patients With Type 2
Diabetes Without Manifest Cardiovascular Disease

On a totally different subject in another thread, someone
was asking questions about this, which also appears on that
link:
Performance of Glucose Dehydrogenase– and Glucose
Oxidase–Based Blood Glucose Meters at High Altitude and Low
Temperature


Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraltraveloz.blogspot.com/
latest: Mossman Gorge in the Daintree Rainforest
http://loraldiabetes.blogspot.com/
latest: Self-Testing and Type 2 Management
.

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