Abstract
Background: Dyslipidemia has been associated with vascular complications of type 1 diabetes mellitus (T1DM). We examined the proton nuclear magnetic resonance (NMR)-assessed lipoprotein subclass profiles in subjects with T1DM compared with those of healthy subjects and assessed the potential relationship of these profiles with arterial stiffness. Methods: Eighty-four participants with T1DM of at least 10 years duration and no clinical cardiovascular disease (age: 35–65 years; 50% men) and 42 healthy participants were evaluated for: (1) clinical and anthropometric data (including classical cardiovascular risk factors), (2) insulin sensitivity by estimated glucose disposal rate, (3) microvascular complications, (4) NMR-assessed lipoprotein subclass profile, and (5) arterial stiffness (aortic pulse wave velocity). Results: Participants with T1DM had an apparently better conventional lipid profile than healthy participants, but with significant differences in NMR-assessed lipoprotein profiles such as higher triglyceride content of low-density lipoprotein (LDL) and high-density lipoprotein (HDL). In healthy participants, arterial stiffness was associated with NMR-based LDL subclasses. By contrast, in T1DM participants, arterial stiffness was independently associated mainly with NMR-based very-low-density lipoprotein (VLDL) subclasses: positively with total VLDL particles (and subclasses) and VLDL triglyceride content, and negatively with LDL and HDL particle sizes. These results were maintained after adjustments for classical cardiovascular risk factors. Conclusions: Subjects with T1DM, while having an apparently better conventional lipid profile than healthy controls, presented significant alterations in their NMR-assessed lipoprotein profile. The association between arterial stiffness and NMR-assessed lipoprotein profiles also differed in both groups. These results support a potential role of the identified differences in the residual cardiovascular risk in T1DM.
Highlights
Cardiovascular disease (CVD) is the leading cause of mortality in type 1 diabetes mellitus (T1DM), with an incidence rate 2–8 times higher compared to the non-diabetic population [1,2,3], especially in women [4] and in patients with early-onset T1DM [5]
The association between arterial stiffness and nuclear magnetic resonance (NMR)-assessed lipoprotein profiles differed in both groups
While in healthy participants the increase in arterial stiffness was associated with NMR-based low-density lipoprotein (LDL) subclasses, in those with T1DM it was mostly linked with NMR-based very-low-density lipoprotein (VLDL) subclasses
Summary
Cardiovascular disease (CVD) is the leading cause of mortality in type 1 diabetes mellitus (T1DM), with an incidence rate 2–8 times higher compared to the non-diabetic population [1,2,3], especially in women [4] and in patients with early-onset T1DM [5]. Results: Participants with T1DM had an apparently better conventional lipid profile than healthy participants, but with significant differences in NMR-assessed lipoprotein profiles such as higher triglyceride content of low-density lipoprotein (LDL) and high-density lipoprotein (HDL). In T1DM participants, arterial stiffness was independently associated mainly with NMR-based very-low-density lipoprotein (VLDL) subclasses: positively with total VLDL particles (and subclasses) and VLDL triglyceride content, and negatively with LDL and HDL particle sizes. These results were maintained after adjustments for classical cardiovascular risk factors. These results support a potential role of the identified differences in the residual cardiovascular risk in T1DM
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