Diabetes Mellitus Dyslipidemia Research Articles

Status of glycemic control and lipid profile in type 2 diabetes mellitus: A descriptive cross-sectional study

Introduction: Dyslipidemia in diabetes mellitus is commonly seen in the form of high total cholesterol (TC), high lowdensity lipoprotein (LDL), high triglyceride (TG) and low high-density lipoprotein (HDL) levels. This study was done to study the association of glycemic control with lipid profile in Type 2 Diabetes Mellitus (T2DM) patients. Methods:This was a cross sectional, observational study conducted from December 2018 to June 2020 at Universal College of Medical Sciences and Teaching Hospital, Bhairahawa. It involved 125 patients of type 2 diabetes mellitus (68 males and 57 females), who visited in outpatient department of Internal Medicine. Laboratory tests [(Fasting Blood Sugar(FBS), Post Prandial Blood Sugar (PPBS), Glycosylated Hemoglobin (HbA1c), Renal Function Test (RFT) and Fasting Lipid Profile] were noted. The data was analyzed with SPSS Version 25. Descriptive statistics like frequency, percentage,mean and standard deviation (SD) were calculated. Independent t-test was used to measure the association between glycated hemoglobin with blood glucose level and glycated hemoglobin with lipid profile. Results: The study patients were categorized into two groups on the basis of HbA1C level [(good glycemic control ≤7 (n=33) and poor glycemic control >7 (n=92)]. In good glycemic control the mean TC was 143.30, LDL 71.88, HDL 43.70, VLDL 29.55, TG 134.39 mg/dl while in poor glycemic control the mean TC was 182.47, LDL 114.85, HDL 32.03. VLDL 36.61, TG 179.33 mg/dl with p-value <0.05. Conclusions: There was significant positive association of HbA1c with TC, LDL, VLDL, TG and significant negative association with HDL.

Prevalence, knowledge, and lifestyle-associated risk factors of dyslipidemia among Ghanaian type-2 diabetes mellitus patients in rural and urban areas: A multicentercross-sectional study.

Dyslipidemia in diabetes mellitus has been linked to unhealthy lifestyle and bad eating habits. However, this association has not been well studied among rural and urban Ghanaian populations. In this study, we determined the prevalence, knowledge, and lifestyle-associated risk factors of dyslipidemia among Ghanaian type-2 diabetes mellitus (T2DM) patients in rural and urban areas. This comparative multicentre-cross-sectional study recruited 228 T2DM outpatients attending the St. Michael Hospital, Pramso (rural) and Kumasi South Regional Hospital (urban), Ghana for routine check-ups. Self-structured questionnaire was used to collect sociodemographic, knowledge, and lifestyle characteristics. Fasting blood samples were taken to measure lipid profiles. Dyslipidemia was defined per the American Diabetes Association criteria. All p < 0.05 were considered statistically significant. The overall prevalence of dyslipidemia was 79/228 (34.7%). Dyslipidemia was more prevalent among urban participants 43 (18.9%) than rural participants 36 (15.8%). Twenty-seven (11.7%) had adequate knowledge about the risk factors, complications, and management of diabetes. Eating supper after 7 p.m. [adjusted odds ratio = 3.77, 95% confidence interval (1.70-8.37), p = 0.001] significantly increased one's risk of having dyslipidemia by 3.8-fold compared to eating supper earlier (before 5 p.m.). Dyslipidemia is increasing among T2DM patients in both urban and rural areas and it's independently influenced by eating supper after 7 p.m. Most participants were ignorant of the risk factors, complications, and management of diabetes. Adjusting eating habits and increasing diabetes awareness programs to sensitize the general public can mitigate the increasing prevalence of dyslipidemia in both urban and rural areas.

A Comparison of Lipid Profile in Ischemic Stroke Patiens with Diabetes Mellitus and Non-Diabetes Mellitus at Rumah Sakit Umum Daerah Ciamis 2020

Diabetes mellitus causes lipid profile abnormalities, resulting in dyslipidemia in diabetic patients leading to ischemic stroke. This research aims to contrast lipid profiles in ischemic stroke patients with type 2 diabetes mellitus (T2DM) and non-type 2 diabetes mellitus (non-T2DM) to prevent stroke recurrence, treat dyslipidemia in diabetes mellitus, and evaluate for treatment of T2DM and non-T2DM ischemic stroke patients. A cross-sectional design was conducted at RSUD Ciamis using secondary medical record data in 2020. The data was collected using a nonprobability sampling approach, with the sampling extent determined by inclusion and exclusion criteria. Univariate analysis was used to determine the quantity and calculation. Besides, an independent t-test and chi-square test was utilized to test two hypotheses in bivariate analysis. Multifaceted analysis in age, gender, hypertension, and coronary heart disease was incorporated to observe its influence on T2DM and non-T2DM ischemic stroke patients. By using four lipid profile indicators, the differences were only in the triglyceride. While the total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were insignificant. Meanwhile, hypertension and coronary heart disease (CHD) significantly affect the incidence of ischemic stroke.

Clinical and Pharmacological Parameters Determine Relapse During Clopidogrel Treatment of Acute Coronary Syndrome.

The therapeutic efficacy of clopidogrel as an antiplatelet drug varies among individuals, being the mainstream hypothesis that its bioavailability depends on the individual genetic background and/or interactions with other drugs. A total of 477 patients receiving double antiaggregation therapy with aspirin and clopidogrel, after suffering a first event, were followed for 1 year to record relapse, as a surrogate end point to measure their therapeutic response, as defined by presenting with an acute coronary event (unstable angina, ST-segment-elevation myocardial infarction, or non-ST-segment-elevation myocardial infarction), stent thrombosis/restenosis, or cardiac mortality. Anthropometric, clinical, and pharmacological variables along with CYP2C19 genotypes were analyzed for their association with the disease relapse phenotype. Only 75 patients (15%) suffered a relapse, which occurred during the first 6months of therapy, with a peak at 4.5 months. An initial univariate analysis identified that patients in the relapse group were significantly older (67.4 ± 11.0 vs 61.6 ± 12.3 years old) and presented with diffuse coronary disease, insulin-dependent type 2 diabetes mellitus dyslipidemia, and arterial hypertension. A poor clinical response to the platelet antiaggregation regime also occurred more frequently among patients taking acenocoumarol and calcium channel blockers, along with aspirin and clopidogrel, while no association was found according to CYP2C19 genotypes. A retrospective multivariate analysis indicated that patients belonging to the nonresponder phenotype to treatment with aspirin and clopidogrel were older, presented with diffuse coronary disease, a group largely overlapping with type 2 insulin-dependent diabetes mellitus, and were taking dihidropyrimidinic calcium channel blockers.

Comparison of Efficacy and Safety of Statin-Ezetimibe Combination Therapy with Statin Monotherapy in Patients with Diabetes: A Meta-Analysis of Randomized Controlled Studies.

Dyslipidemia in diabetes mellitus is characterized by hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C), and elevated low-density lipoprotein cholesterol (LDL-C). Additionally, the potentially increased risk of morbidity and mortality following atherosclerotic cardiovascular diseases should be considered in the treatment of dyslipidemia in patients with diabetes. We performed a meta-analysis of the published data to compare the effects of HMG-CoA reductase inhibitor (statin)-ezetimibe combination therapy and statin monotherapy on lipid and glucose parameters in patients with diabetes. We also compared safety based on the adverse events reported for the two groups. In total, 17 articles were included in this meta-analysis. In the efficacy assessment, the combination treatment afforded a significantly greater reduction in LDL-C than did statin monotherapy (standard difference in means 0.691; 95% confidence interval 0.534-0.847). A significantly greater improvement effect was observed in the levels of HDL-C, total cholesterol, triglyceride, and apolipoprotein B, but not apolipoprotein A1, with combination therapy than with statin monotherapy. Additionally, combination therapy reduced fasting blood glucose levels more significantly than did statin monotherapy. In terms of safety, there were no significant differences in treatment-related adverse events between the two treatments. Statin-ezetimibe combination therapy enhances levels of LDL-C and other lipids without increasing the risk of adverse events compared with statin monotherapy. The present meta-analysis presents valid evidence for appropriate drug regimens to treat dyslipidemia in patients with diabetes. PROSPERO Identifier Number CRD42021244578.

Who is the target population for shortening prehospital delay in acute stroke?

Prehospital delay is the main barrier of early administration of thrombolytic therapy in patients with acute ischemic stroke. Many studies suggested that stroke awareness had a great impact on early arrival at hospital. Our purpose is to identify the target population to emphasize the importance of recognizing stroke symptoms and early arrival at hospital. A prospective study was conducted during 4 months in Habib Bourguiba Hospital of Sfax (Tunisia). Patients with ischemic stroke or transient ischemic attack were enrolled. Exact time of symptoms onset, initial symptoms and signs, initial GCS, NIHSS, and stroke risk factors were registered by doctors. We defined prehospital delay less than 2 h as “early arrival group”. One hundred ninety seven patients with definite time of prehospital delay were included (66 patients among early arrival group). Younger patients and those using emergency medical service (EMS) consult earlier (p = 0,029 and 0,004 respectively). Within all stroke risk factors, hypertension, diabetes mellitus dyslipidemia and prior stroke were not associated with early arrival, whereas, heart disease (atrial fibrillation and coronary artery disease) was associated with early arrival (p = 0.007 and 0.012 respectively). Among all initial symptoms and signs, consciousness disturbance is the only symptom associated with early arrival (p = 0.05). A lower GCS and intracerebral hemorrhage were correlated with reduced prehospital delay (p = 0.013 and 0,05 respectively). Our analysis suggested that to shorten prehospital delay, elderly and people with prior stroke, hypertension, diabetes mellitus and dyslipidemia are the priority populations, and stroke symptoms other than consciousness should be emphasized as well.

STUDY OF LIPID PROFILE IN DIABETIC MELLITUS IN TERTIARY CARE HOSPITAL

INTRODUCTION: Diabetes mellitus (DM) is a group of metabolic disorder which is characterized by increase blood glucose level resulting from defects in insulin secretion, insulin action or both and disturbances of carbohydrate, lipid and protein metabolism. Worldwide With an increasing incidence of DM may be a likely leading cause of morbidity and mortality in the future[i]. It is well known that dyslipidemia is a major risk factor for macrovascular complications with type-2 diabetes mellitus (T2DM) which affects 10%-73% of this population. It is well known that dyslipidemia is a major risk factor for macrovascular complications with type-2 diabetes mellitus (T2DM) which affects 10%-73% of this population. Dyslipidemia, hyperglycemia and hyperlipidemia are results of Insulin resistance and obesity combine cause and have additive cardiovascular risk. Therefore identification, critical evaluation and follow-up of serum lipid profile is important in DM continuously. One of the study showed that prevalence of dyslipidemia in diabetes mellitus is 95%. Major risk factor for Coronary Heart Disease is dyslipidemia. In DM patients cardiovascular disease is a cause of morbidity and mortality because of disturbance in lipoproteins i.e. serum triglycerides (TC) 69%, serum cholesterol 56.6%, Low Density Lipoprotein cholesterol (LDL) 77% and High Density Lipoprotein cholesterol (HDL) 71%.&#x0D; AIM: The main aim of this study is to know the lipid profile in Diabetics mellitus (DM). MATERIAL AND METHODS: Total 100 patients with DM were included in this study during the period of 1 year. During the study period 100 normal healthy people without DM were also included as control study. From all the patients detail histories were taken as well as relevant clinical examination with routine investigations were also done. All the patients were for at least 12-14 hours overnight fasting and 5ml venous blood was collected in a disposable syringe on next morning (before breakfast) for the serum lipid profile and fasting blood sugar.&#x0D; RESULT: In this study out of 100 diabetic patients 48 (48%) were males and 52 (52%) were females. 70% of DM patients showed high serum cholesterol level and all persons had normal serum cholesterol level in control group. 75% of DM patients showed high serum triglyceride level (&gt;150mg/dl). 39% of DM patients showed Serum LDL level was high (&gt;160 mg/dl). 85% of DM patients showed low (&lt;40 mg/dl) serum HDL value.&#x0D; CONCLUSION: In DM patients lipid abnormalities in diabetes are raised serum cholesterol, raised triglycerides, and raised serum LDL and low serum HDL. Therefore there is important impact of dyslipidemia on cardio vascular complications required complete attention throughout the course of disease. Hence early screening of diabetic patients for dyslipidemia and intervention is necessary to minimize the risk of cardiovascular diseases.&#x0D; KEYWORDS: Diabetes mellitus (DM), dyslipidemia, cholesterol, triglyceride&#x0D; &#x0D; &#x0D; Diabetes: facts and figures [Internet]. International Diabetes Federation. [cited 2016Jul14].&#x0D;

Dyslipidemia in diabetes mellitus and cardiovascular disease.

Patients with diabetes have a high residual risk for cardiovascular disease (CVD) and adverse outcomes despite statin therapy and lifestyle modifications. Particular to individuals with diabetes is the pattern of elevated triglycerides, small dense low density lipoprotein cholesterol, and reduced levels of high density lipoprotein cholesterol, described as dyslipidemia of diabetes. The role of combination therapy with an additional agent such as niacin, ezetimibe, fenofibrate, and n-3 fatty acids has been studied; however, at the same time, these agents have come under criticism for their limitations. We performed a review of key trials assessing the benefit of combination therapy to reduce CVD risk from dyslipidemia. Of the currently available agents that can be used in combination with statins, ezetimibe has the most favorable risk profile, with a recent trial demonstrating modest incremental benefit when given in addition to statins. PCSK9 inhibitors are a promising category, although clinical outcome data in individuals with diabetes are pending.

A Prospective Study on Incidence of Dyslipidemia in Diabetes Mellitus

Background: Diabetes Mellitus is a metabolic syndrome characterized by increased blood sugar levels in the body. Dyslipidemia in diabetes is one of the most important reasons for silent heart attacks. The main aim and Objectives of this study are to evaluate the incidence of dyslipidemia after the diagnosis of Diabetes mellitus Methodology: A prospective non interventional single centred study was carried out in a tertiary care hospital. A specially designed proforma was used to collect the data from the case sheets such as patient demographics. Lipid profile values were obtained from the patient after obtaining written consent from each patient and correlated with American Dyslipidemic Associations standard values. The incidence rate was calculated. Results: We have included 500 patients in this study. We also observed that there were isolated, combined and mixed patterns of dyslipidemia in Diabetes Mellitus. The incidence rate was found to be 45.60%. Although there was no significant difference between the incidence rate of men and women. Conclusion: Dyslipidemia in Diabetes Mellitus possess a major threat of myocardial risk and heart attacks. As HbA1C is monitored every 3 months we recommend the monitoring of lipid profile test also every 3 months. Regular monitoring of Lipid Profile is an important way to prevent silent heart attacks.

Abstract 407: Atherogenic Dyslipidemia in Patients with Diabetes Mellitus May Have Distinct High Density Lipoprotein Function

There is growing evidence suggesting that high-density lipoprotein (HDL) function is more important than the HDL cholesterol (HDL-C) levels. HDL particles are highly heterogeneous and their function may also differ among different patient populations. There are two populations that are recognized tohave significant residual cardiovascular risk despite intensive statin therapy: atherogenic dyslipidaemia and diabetes mellitus. Atherogenic dyslipidemia and diabetes have significant homology with regards to lipid profiles. However, systemic epidemiological studies that describes the overlapping profiles between atherogenic dyslipidemia and diabetes is lacking. The function and types of HDL in these two populations needs to be carefully elucidated. HDL has many functions includingreverse cholesterol transport, anti-oxidant activity and anti-inflammatory activity. HDL may also exert “antiplatelet effects”but the mechanism is unclear.We assessed the prevalence of atherogenic dyslipidemia in diabetes mellitus using data from the National Health and Nutrition Examination Survery (NHANES) and data from Yale New Haven Health (YNHH). We found that atherogenic dyslipidemia and diabetes mellitushave overlapping lipid profiles but are clearly two distinct conditions. In our preliminary studies, we found that HDL inhibits platelet aggregation and activation. Very interestingly, we found HDL can induce mitochondria dependent platelet apoptosis. The antiplatelet effect of HDL, as observed by others in the past, may arise fromapoptotic platelets that do not aggregate, and thus the inhibition of platelet aggregation. Whether HDL subtypes from atherogenic dyslipidemia and diabetes patient have differential effects on platelet apoptosis are currently being investigated.

Prevalence and pattern of dyslipidemia in hyperglycemic patients and its associated factors among Pakistani population.

In diabetes mellitus dyslipidemia is one of the major risk factors for cardiovascular disease. In type 2 diabetes mellitus early detection and treatment of dyslipidemia can avoid risk for cardiovascular disorder. The present study was carried to determine the prevalence and pattern of hyperlipidemia in patients with hyperglycemia. The cross sectional study was done in different laboratories of Pakistan, the laboratories served patients referred from different government and private hospitals between July 2014 and June 2015. All known cases of diabetes mellitus were evaluated for their lipid profile. Totally 200 diabetic patients were included in the study in which 120 (60%) were males and 80 (40%) were females. Prevalence of dyslipidemia among diabetic males was 97.18% while for females 87.15%. Among dyslipidemic male the proportion with mixed dyslipidemic patients was 17.5%, combined two parameters dyslipidemia was 47.5% and isolated single parameter dyslipidemia was 35%. In females these proportions in mixed, combined two parameters and isolated single parameter were 16.25%, 51.25% and 32.5%, respectively. Majority of hyperglycemic patients were dyslipidemic. The most prevalent pattern among male was combined dyslipidemia with high triglycerides (TG) and low High Density Lipoprotein (HDL) and in female it was high Low Density Lipoprotein (LDL) and low HDL. The most prevalent lipid abnormality in our study was low HDL followed by high TG.

Ethanol extract of Butea monosperma bark modulates dyslipidemia in streptozotocin-induced diabetic rats

Context: Dyslipidemia is one of the major risk factors for cardiovascular disease in diabetes mellitus (DM). The availability of multiple lipid-lowering drugs and supplements provides new opportunities for patients to regulate lipid levels.Objective: The present study was designed to evaluate the effect of Butea monosperma Lam. (Fabaceae) bark extract in diabetes-induced dyslipidemia.Materials and methods: A daily dose of B. monosperma bark extract (BMBE, 500 mg/kg body weight) was given orally to streptozotocin (STZ)-induced diabetic rats for 60 d. Several indices such as blood glucose, insulin, glycosylated hemoglobin, TC, TG, high-density lipoprotein-cholesterol (HDL-C), apo A1, apo B, activities of lipogenic enzymes in tissues, liver function tests, and histopathology of liver were analyzed to assess the modulation of STZ-induced diabetic dyslipidemia by B. monosperma bark.Results: BMBE significantly reduced blood glucose (40.79%) and increased plasma insulin (37.5%) levels in diabetic rats. Altered levels of serum lipids, lipoproteins, and activities of lipogenic enzymes in tissues were partially restored upon the administration of BMBE in diabetic rats. Liver function tests and histopathological examination revealed that consumption of BMBE at a dose of 500 mg/kg body weight had no toxic effects in experimental rats.Conclusion: The findings suggest that BMBE supplementation could ameliorate dyslipidemia in DM.

Antihyperlipidemic Activity of the Ethyl-acetate Fraction of Stereospermum Suaveolens in Streptozotocin-induced Diabetic Rats.

Objectives:Dyslipidemia in diabetes mellitus is a significant risk factor for the development of cardiovascular complications. The aim of this study was to evaluate the effect of the ethyl-acetate fraction of an ethanolic extract from Streospermum suaveolens on lipid metabolism in streptozotocin (STZ)-induced diabetic rats.Methods:Diabetes was induced by intraperitonial injection of STZ (50 mg/kg). Diabetic rats were treated with an ethyl-acetate fraction orally at doses of 200 and 400 mg/kg daily for 14 days. On the 15th day, serum lipid profiles, such as total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL), were estimated in experimental rats. The atherogenic (AI) and the coronary risk (CRI) indices were also evaluated.Results:The ethyl-acetate fraction at doses of 200 and 400 mg/kg significantly (P< 0.001) and dose-dependently reduced serum cholesterol, triglycerides and LDL, but increased HDL towards near normal levels as compared to diabetic control rats. The fraction also significantly (P< 0.001) lowered the atherogenic index (AI) and coronary risk index (CAI) in a dose-dependent manner.Conclusion:The present study demonstrated that the ethyl-acetate fraction of Stereospermum suaveolens exhibits a potent antihyperlipidemic activity in hyperglycemic rats and suggests that the plant may have therapeutic value in treating the diabetic complication of hyperlipidemia.

Plasma MDA and antioxidant vitamins in diabetic retinopathy.

Hyperglycemia and dyslipidemia in diabetes mellitus induce increased lipid peroxidation and peroxyl radical formation, an important mechanism in genesis of microangiopathy. We took up a study on oxidative stress, measured by plasma MDA and antioxidant vitamin status in type - 2 DM patients with and without retinopathy and compared them with a control non-diabetic group. Lipid peroxidation marker MDA was significantly elevated (p < 0.001) in both the diabetic groups whereas, serum vitamin E and vitamin C registered a significant fall (p<0.001) as compared to controls. Our correlation study revealed a significant positive association between plasma MDA with both fasting and 2hr post prandial plasma glucose (r=0.81, p < 0.001, r=0.92, p <0.001) suggesting the role of hyperglycemia in free radical production. Plasma MDA also depicted significant positive relation (p< 0.001) with all lipid parameters except serum HDLc pointing the role of dyslipidemia towards lipid peroxidation. Plasma MDA level was also found to be negatively correlated with both the vitamins (p<0.001, p<0.001) in the study group explaining their protective consumption in the oxidative process prevailing in diabetic retinopathy.

Sugars and starch in the nutritional management of diabetes mellitus

Nutritional recommendations, long recognized as an important aspect of diabetes mellitus treatment, have also been an area of persistent controversy, particularly regarding the proportions and types of carbohydrate and fat. This review addresses the role of sugars within medical nutrition therapy for diabetes mellitus. Nutritional recommendations for diabetes mellitus treatment were revised recently. The new guidelines do not specifically restrict intake of sugars, although general recommendations are made for including fiber, whole grains, vegetables, and fruits within dietary selections containing starches. For carbohydrates, the principle focus is on overall caloric amounts. In type 1 diabetes the most effective approach to the control of postprandial hyperglycemia continues to be adjustment of premeal doses of insulin on the basis of carbohydrate counting. In type 2 diabetes, in addition to a focus on caloric content of carbohydrate, consideration continues to be given to the role of the glycemic index as a determinant of postprandial hyperglycemia and overall metabolic control. Nevertheless, consensus recommendations do not support widespread use of the glycemic index. An area of some change is a more clear endorsement of including monounsaturated fatty acids. Current recommendations are that monounsaturated fatty acids and carbohydrates combined should provide 60-70% of daily energy intake, with individual flexibility in the respective proportions, whereas intake of saturated fats is limited to < 10% of energy intake. This new emphasis reflects greater awareness of the importance of responding to individual and cultural dietary preferences and the need to address treatment of both hyperglycemia and dyslipidemia in diabetes mellitus.

Therapeutic approaches to dyslipidemia in diabetes mellitus and metabolic syndrome.

Type 2 diabetes mellitus and the closely related metabolic syndrome are associated with significant risk for cardiovascular disease. Recent evidence suggests that both conditions are increasing in epidemic proportions. Dyslipidemia is characterized by increased triglyceride-rich lipoproteins; low high-density lipoprotein cholesterol; small, dense low-density lipoprotein particles; increased postprandial lipemia; and abnormal apolipoprotein A1 and B metabolism. All these lipoprotein disturbances accelerate atherosclerosis in these patients. It is likely that many patients will need combinations of lipid-modifying therapy to achieve American Diabetes Association (ADA), Adult Treatment Panel III, and American Heart Association (AHA)/American College of Cardiology (ACC) guidelines to help prevent cardiovascular disease and death.

Cardiovascular disease in the diabetic woman.

The incidence of cardiovascular disease (CVD) with age is increasing in the United States, and elderly women constitute a disproportional component of the aging population. Elderly women also have a relatively high incidence of diabetes, which contributes to this relatively high CVD risk. Although CVD is less common in premenopausal women than in men, this difference begins to disappear after the onset of menopause, presumably related to decreased levels of female sex hormones (estrogen and/or progesterone). Diabetes mellitus removes the normal premenopausal gender-related differences in the prevalence of CVD by mechanisms that are not clearly defined, including metabolic and hemodynamic factors associated with diabetes. Dyslipidemia in diabetes mellitus consists of low high density lipoprotein cholesterol, elevated triglyceride levels, and a small, dense, more atherogenic low density lipoprotein particle (i.e. oxidized). Dyslipidemia interacts with associated hemodynamic (i.e. hypertension) and metabolic abnormalities (i.e. increased platelet aggregation and plasminogen activator inhibitor-1 levels) to promote CVD risks in diabetic women. Recent controlled trials underscore the critical importance of aggressively treating CVD risk factors, especially dyslipidemia, in women with diabetes.

Hyperlipidemia: a factor contributing to diabetic nephropathy development and progress

Twenty-nine patients with insulin-dependent diabetes mellitus with similarly manifest renal involvement were examined to elucidate the role of dyslipidemia in diabetic nephropathy progress. Clinicolaboratory parameters (urinary albumin excretion, blood serum levels of total cholesterol, triglycerides, low, very low, and high density lipoprotein cholesterol) and morphologic changes in renal tissue biopsy specimens were analyzed. An increment of the number of large lipid incorporations was observed in various cells of renal glomeruli and interstitium, as well as a high prevalence of low density lipoprotein deposition in glomerular basal membranes and canaliculi as the renal process augmented in severity. Since lipids accumulating in glomerular structures may stimulate mesangial cell proliferation and mesangial matrix hyperproduction, the authors believe that dyslipidemia in diabetes mellitus may be conducive to a more rapid progress of renal disease.