Lipid Abnormalities In Type Research Articles

A study on fasting and post-prandial lipid abnormalities in type 2 diabetes mellitus in rural areas of central Telangana, India

ABSTRACT Background: Post-prandial triglyceridemia has been considered an independent cardiovascular risk factor, even more important than altered fasting triglycerides, which are influenced primarily by diet. The study aimed to investigate the fasting and post-prandial lipid profile among type 2 diabetes mellitus (T2DM) patients in rural communities considering their different dietary patterns. Patients and Methods: Fasting and post-prandial lipid profile were done among 100 T2DM patients from a rural area in central Telangana. Fasting and post-prandial total cholesterol, triglycerides, HDL, LDL, and LDL were compared. Correlations between HbA1c and post-prandial lipid parameters and also between fasting and post-prandial lipid parameters were studied. Results: The mean age of the subjects was 48.17 ± 9.6 years, whereas the mean HBA1c was 9% ± 2.12%. The mean post-prandial triglycerides were significantly elevated in comparison with fasting (202 ± 101.72 vs. 161.6 ± 83.91; P < 0.0001). The mean post-prandial total cholesterol was also elevated modestly (181.8 ± 43.79 vs. 174.5 ± 36.51; P = 0.0004). There was a non-significant very weak positive correlation between HBA1c and post-prandial TGL and TC; ((r = 0.17) and (r = 0.05); P = 0.10 and P = 0.60, respectively). There was a significant positive correlation between fasting and post-prandial TC, LDL, TGL, and HDL ((r = 0.88), (r = 0.81), (r = 0.79) and (r = 0.73); (P < 0.001)). Conclusions: The current study found that post-prandial triglycerides were significantly elevated in comparison with fasting triglycerides. There was a very strong positive correlation between fasting and post-prandial total cholesterol, triglyceride, HDL, LDL, and VLDL.

Assessment of Lipid Profile and Clinical Manifestation of Obese Patients with Type 2 Diabetes

This case-control study involved 356 diabetic patients and 384 apparently healthy individuals, matched for age and sex, who attended the outpatient department at Al-Zahrawi Private Hospital in Mosul from January to December 2004. The study aimed to evaluate changes in serum lipid profile among type 2 diabetics in relation to body mass index (BMI) and determine the extent and pattern of dyslipidemia in obese diabetics. Fasting plasma glucose and serum lipid profile were compared between type 2 diabetics and control subjects based on BMI. Data analysis utilized chi-square, Z, ANOVA, and Duncan tests. Fasting plasma glucose levels were highest in obese diabetics, and the frequency of poorly controlled diabetics increased with higher BMI. There was a significant positive association between BMI and serum triglyceride (TG) (p < 0.01), total cholesterol (TC) (p < 0.001), LDL-C (p < 0.001), and VLDL-C (p < 0.01). Serum HDL-C levels significantly decreased (p < 0.01) with increasing BMI. The prevalence of dyslipidemia increased with higher BMI levels in both genders. In conclusion, several lipid abnormalities in type 2 diabetics underscore the importance of diabetic control, regular lipid profile monitoring, and obesity management.

Prevalence of Dyslipidemia among Type 2 Diabetes Mellitus Patient in Combined Military Hospital, Sylhet

Introduction: Diabetes mellitus is a group of metabolic disorders that are caused by deficiency of insulin secretion or decreased ability of insulin to act effectively on target tissues, particularly muscle, liver and fat. Diabetes is associated with high risk of cardiovascular diseases and underlying lipid abnormalities. Its early identification can make aggressive cardiovascular preventive management possible. Objectives: To determine the prevalence and pattern of lipid abnormalities in type 2 diabetes mellitus. Methods: A Retrospective, descriptive cross-sectional study was conducted in Combined Military Hospital, Sylhet, Bangladesh over a period of 2 years from January 2018 to December 2019. Diagnosed patients of type 2 diabetes mellitus of different age group and both sex were selected for this study according to inclusion and exclusion criteria. The lipid profiles and fasting blood sugar values of 85 known diabetics were studied. Their serum samples were assessed for fasting blood glucose (FBG), total cholesterol (TC), triacylglycerol (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) by using standard biochemical methods. Results: Present study comprised of 85 diagnosed patients of type 2 diabetes mellitus. Out of those 78.8% were male and 21.2% were female. The age range was from 26 to 85 years with an average of 50.4±13.9 years. The average fasting blood glucose was noted as 10.787±4.2053mmol/l. The average total cholesterol, triglycerides, LDL and HDL were 194.35±177.07mg/dl, 226.18±115.19mg/dl, 91.08±26.79mg/dl and 39.75±9.51 mg/dl respectively. The prevalence of dyslipidemia in the present study was found as 81.2%, 14.1% were having hypercholesterolemia, 65.88% patients were having hypertriglyceridemia, 25.88% patients were having increased LDL levels and 43.52% patients were having reduced HDL levels. In respect of pattern of dyslipidemia, we found isolated and combined dyslipidemia. Conclusion: In the diabetics higher frequencies of high TC, high TG and high LDL-C levels were noted indicating diabetic patients were more prone for dyslipidemia which may lead to cardiovascular disorders. JAFMC Bangladesh. Vol 18, No 2 (December) 2022: 3-6

To study fasting and post prandial lipid profile in type 2 diabetes mellitus in comparison to non diabetics

Background: Postprandial diabetic dyslipidemia creates proatherogenic conditions which are associated with microvascular and macrovascular complications. Its timely identification might help prevent complications. Aims and Objectives: The aims of this study were to assess the fasting and postprandial lipid abnormalities in type 2 diabetes mellitus (DM) in comparison to non-diabetic patients attending SGMH, Rewa, M.P. Materials and Methods: This was a cross-sectional case–control study done from April 2021 to March 2022 in SSMC and SGMH Rewa (M.P). 200 cases and 200 controls taken as per inclusion and exclusion criteria, age, and sex matched. Relevant examination and investigations including fasting and postprandial lipid profile were done. All data compiled and compared with the previous studies. Results: The comparative findings of fasting and postprandial lipid profile in type 2 DM compared to controls (non-diabetics) revealed the following observations. In fasting state, 56% cases and 30% controls had triglyceride levels of >150 mg/dL, while, in postprandial state, it was 82% cases and 32% controls. In fasting state, 28% cases and 8% controls had very low-density lipoproteins-cholesterol (VLDL-C) levels of >40 mg/dL, while, in postprandial state, it showed 46% cases and 14% of controls. In fasting state, 70% cases and 60% controls had high-density lipoproteins-cholesterol (HDL-C) levels of <35 mg/dL, while, in postprandial state, it was found in 80% cases and 58% controls. Conclusion: In the postprandial state, there was significant hyper-triglyceridemia, increased VLDL-C, and decreased HDL-C levels in cases than controls. In the fasting state, there was significant hyper-triglyceridemia and increased VLDL-C levels in cases than controls.

A comparative study on the fasting and postprandial lipid abnormalities in type 2 diabetes mellitus in tertiary care teaching hospital of southern Rajasthan, India

Background: The worldwide prevalence of diabetes mellitus has risen dramatically. Based on current trends, the International Diabetes Federation projects that 438 million individuals will have diabetes by the year 2030.Type 2 diabetes is characterized by insulin resistance which is associated with hypertension, dyslipidemia, micro and macro vascular disease.Methods: This study was institutional based Case Control comparative study carried out on 200 type 2 diabetes patients and on 200 healthy controls at tertiary care teaching hospital in Jhalawar, Rajasthan. Non-probability purposive sampling technique was used followed by interview of 400 participants.Results: In final analysis, Diabetes subjects were middle aged (mean age 43.2±7.48 years) with a mean BMI of 26.9±5.46 kg/m2, matched with controls. Among diabetes patients 152 has positive family history for diabetes. The fasting and postprandial lipid profile were increased in the type 2 DM subjects as compared to controls and among the type 2 DM patients, the postprandial lipid parameters were increased as compared to the fasting level.Conclusions: Both fasting and post prandial lipid abnormalities seen in type 2 diabetes but the post- prandial lipid profile was altered when compare to fasting lipid levels. Lifestyle modifications along with diet and proper lipid lowering drugs are helpful in diabetic individuals with lipid abnormalities.

Study of fasting and post prandial lipid abnormalities in type 2 diabetes mellitus in comparison to controls

In the modern world, the growing incidence of type 2 diabetes mellitus (T2DM) is a critical problem. In type 2 DM, abnormal lipid profile in the postprandial state has more significance than abnormal lipid profile in fasting state in causing atherosclerotic complications. The high cardiovascular morbidity and mortality in type2 DM are due to prolonged postprandial hyperglycemia and triglyceridemia. Postprandial hypertriglyceridemia results in a proatherogenic environment which leads to atherosclerosis and macrovascular complications in type 2 diabetes mellitus. It is believed that atherosclerosis is a postprandial phenomenon with respect to lipids, as we are in the postprandial state for most of the day.It is not clearly known whether diabetic patients with macrovascular disease have greater abnormalities of postprandial TG metabolism than those without.Hence this study is being carried out to find out the characteristics of post prandial lipid levels in patients with type 2 diabetes mellitus and itsimpact on macrovascular complications.: To study fasting & postprandial lipid abnormality in type 2 DM patients in comparison to controls.: This is a cross-sectional study, wherein written informed consent was taken after giving detailed information to the participants regarding the study. Patients who were in the age group of 35-65 years, admitted in the Department of Medicine, RRMCH from November 2017 for next 18 months with Diabetes Mellitus who met a predefined inclusion and exclusion criteria were studied. The study was initiated after obtaining clearance from the institution's ethical committee.: There was a significant elevation of mean values of total serum cholesterol, LDL and TG of cases and controls in the postprandial state compared to their fasting state, statistical significance was found (P<0.05). Peripheral vascular disease in our study was found in 25 patients i.e.25% of the study group. In cases, it was found in 20 patients and in controls, it was found in 5 patients i.e. 40% and 10% respectively. The occurrence of PVD was more in cases compared to controls with statistical significance(p<0.05). Stroke in our study is found in 7 patients i.e. 7% of the study group. In cases, it was found in 6 patients and in controls, it was found in 1 patient i.e. 12% and 2% respectively. The occurrence of CVA was more in cases compared to controls with statistical significance(p<0.05). Ischemic strokes were more common than haemorrhagic strokes.: Patients on irregular treatment (63%) were more in the study group(cases) compared to controls. So it could be said that patient not on regular treatment are more prone to have dyslipidemia. (fasting as well as postprandial). There was a significant increase in total serum cholesterol, LDL and TG in postprandial states of cases compared to that in controls, so it could be said that diabetic patients with fasting dyslipidemia are more prone to have dyslipidemia in the postprandial state. This study concluded that all macrovascular complications (IHD, CVA, PVD) were found more in the case compared to controls with statistical significance. So it could be said that there is an increase in the occurrence of macrovascular complications with an increase in postprandial dyslipidemia.

Applying Logistic Regression to Predict Diabetic Nephropathy Based on Some Clinical and Paraclinical Characteristics of Type 2 Diabetic Patients

Applying Logistic Regression to Predict Diabetic Nephropathy Based on Some Clinical and Paraclinical Characteristics of Type 2 Diabetic Patients

The Association of Glycated Hemoglobin With Lipid Profile Indices in Type 2 Diabetic Patients

The high risk of lipid abnormalities in type 2 diabetic (T2D) patients with uncontrolled hyperglycemia may be associated with an increased risk of cardiovascular complications. The aim of the current study was to investigate the association between glycated hemoglobin )HbA1c( and lipid profile levels in T2D patients. This cross-sectional study was conducted on 802 T2D patients, aged≥ 40 years, visiting the Abu Reyhan Clinic of Shahid Mohammadi Hospital in Bandar Abbas, Iran. Serum lipid profiles were measured by the enzymatic method. Diabetes was defined based on the criteria of the American Diabetes Association. The association of HbA1c and estimated glomeruli filtration rate (eGFR) with lipid profile indices was assessed using the Spearman correlation coefficient test and linear regression model. The mean±SD age of participants (27.7% of men) was 53.55±5.56 years. The mean±SD of HbA1c and eGFR for all subjects were 8.97±2.14 and 86.30±17.48, respectively. In this study,a positive association was observed between HbA1c and fasting blood glucose (r=0.619, β=0.635), total cholesterol (r=0.165, β=0.188), triglycerides (r=0.103, β=0.095), and low-density lipoprotein cholesterol (r=0.162, β=0.173), (P<0.01). Also, an inverse association has been observed between eGFR level and TGs (r=-0.08, β=-0.096) and FBS (r=- 0.123, β=-0.172), (P<0.05). Our findings suggested that HbA1c is not only an applicable predictor of longterm glycaemic control but also can be considered as a potential biomarker for predicting lipid abnormalities in T2D patients.

Effect of zinc supplement on glycemic control and lipid abnormalities in Type 2 diabetic patients.

To evaluate the effects of zinc on glycemic control and lipid profile in type 2 diabetic patients. Objectives: The zinc deficiency is reported in with diabetes, which increases oxidative stresses leading to complications of diabetes. Previous studies demonstrated that zinc supplementation improved glucose control in patients with diabetes, but limited data is available and single blind trials. Study Design: Randomized Controlled study. Setting: Combined Military Hospital (CMH) Malir Cantt, Karachi. Period: 1st December 2018 to 30th June, 2019. Material & Methods: Patients (n=350) were randomly divided into two groups. The first group (n=175) was supplemented with oral zinc sulfate 30 mg/day and second group (n=175) received placebo for a period of 3 months. Blood samples were taken at baseline and after 3 months to assess fasting blood glucose (FBS), glycosylated hemoglobin (HbA1C %) and serum lipid levels and BMI which were compared by t test for paired samples. Results: The mean age of all subjects was 51.80+10.281 years and male to female ratio was 1.08:1. The mean BMI was 31.74+5.806. There was no statistical difference in age and gender between two groups but more obese patient received placebo. The zinc supplemented group had a significant reduction in FBS (p= 0.032) compared to placebo (p= 0.158). The HbA1C% level reduced significantly in zinc supplemented group (p<0.001).compared to the placebo group (p=0.273). Serum lipid levels reduced significantly in the zinc supplemented group (p<0.001) but no significant changes observed in the placebo group (p=0.395). Conclusions: Zinc supplementation improved glycemic control and decreased levels of serum cholesterol, LDL and triglyceride.

Study of Lipid Abnormalities in Type 2 Diabetes Mellitus Patients with Nephropathy in Eastern India

Background: Diabetic nephropathy is one of the major complications of diabetes. Nephropathy patients must be evaluated for dyslipidemia as it is an established risk factor for cardiovascular events. We compared the degree of dyslipidemia among type 2 diabetes mellitus (T2DM) subjects with or without nephropathy and analyzed the factors associated with nephropathy among them. Methods: In this retrospective study, T2DM patients with overt nephropathy were enrolled in the study group (n = 50); without nephropathy were enrolled in the control group (n = 50). Both groups were matched for age duration of diabetes. After taking informed consent anthropometrical clinical examinations were done. Biochemical investigations (Total cholesterol, TG, HDL, LDL, VLDL, sdLDL-C, S. urea, S. creatinine were done in SCB MCH, Biochemistry department. Urine microalbumin per gm of creatinine was done. TG/HDL-C ratio, a surrogate marker for small, dense, LDL particles (sdLDL), and estimated glomerular filtration rate (eGFR) were calculated using equations. Results were analyzed statistically using SPSS version 20. Results: Mean Total cholesterol, TG, LDL, sdLDL are significantly high in nephropathy patients with p values 0.026, 0.012, 0.014, 0.04 respectively. Estimated GFR has a significant positive correlation with TCHOL (r = −0.850, p = 0.01), TG (r = −0.14, p = 0.008), LDL (r = −0.62 p = 0.037). Estimated GFR has a significant negative correlation with S. urea (r = −0.587, p ≤ 0.01), S. creatinine (r = −0.59, p ≤ 0.01), UACR (r = −0.47, p ≤ 0.01). Dyslipidema sdLDL is significantly more in nephropathy group in comparison to diabetic group with p values 0.033, 0.045 respectively. Conclusion: Our study shows that dyslipidemia was highly prevalent among subjects with nephropathy. So cardiovascular risks can be averted by regular screening for dyslipidemia in diabetic nephropathy patients.

Characterization of Lipid Abnormalities in Type 2 Diabetes Mellitus

Characterization of Lipid Abnormalities in Type 2 Diabetes Mellitus

Lipid Abnormalities in Type 2 Diabetes Mellitus Patients with Overt Nephropathy.

BackgroundDiabetic nephropathy is a major complication of diabetes and an established risk factor for cardiovascular events. Lipid abnormalities occur in patients with diabetic nephropathy, which further increase their risk for cardiovascular events. We compared the degree of dyslipidemia among type 2 diabetes mellitus (T2DM) subjects with and without nephropathy and analyzed the factors associated with nephropathy among them.MethodsIn this retrospective study, T2DM patients with overt nephropathy were enrolled in the study group (n=89) and without nephropathy were enrolled in the control group (n=92). Both groups were matched for age and duration of diabetes. Data on total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), urea and creatinine were collected from the case sheets. TG/HDL-C ratio, a surrogate marker for small, dense, LDL particles (sdLDL) and estimated glomerular filtration rate (eGFR) were calculated using equations. Multivariate analysis was done to determine the factors associated with eGFR.ResultsDyslipidemia was present among 56.52% of control subjects and 75.28% of nephropathy subjects (P=0.012). The percentage of subjects with atherogenic dyslipidemia (high TG+low HDL-C+sdLDL) was 14.13 among controls and 14.61 among nephropathy subjects. Though serum creatinine was not significantly different, mean eGFR value was significantly lower among nephropathy patients (P=0.002). Upon multivariate analysis, it was found that TC (P=0.007) and HDL-C (P=0.06) were associated with eGFR among our study subjects.ConclusionOur results show that dyslipidemia was highly prevalent among subjects with nephropathy. Regular screening for dyslipidemia may be beneficial in controlling the risk for adverse events among diabetic nephropathy patients.

Dyslipidemia in Type II Diabetes Mellitus - An assessment of the main lipoprotein abnormalities

Background: Diabetes is associated with a high risk of cardiovascular diseases and underlying lipid abnormalities. Dyslipidemia, a modifiable risk factor is often underdiagnosed and undertreated in our patients. Its early identification can make aggressive cardiovascular preventive management possible. This report seeks to determine the prevalence and pattern of lipid abnormalities in type II diabetes mellitus.Methods: The lipid profiles and fasting blood sugar values of 100 known diabetics were studied. Their serum samples were assessed for fasting blood glucose [FBG], total cholesterol [TC], triacylglycerol [TG], low density lipoprotein cholesterol [LDL-C] and high density lipoprotein cholesterol [HDL-C] by using standard biochemical methods.Results: 83% of study subjects had lipid abnormalities. The mean TC, TG, LDL-C, and FBG levels were highly significant in the diabetics as compared to those in controls. It was found that 28% had hypercholesterolemia and 44% had hypertriglyceridemia. The mean HDL-C concentration was significantly high in female diabetics as compared to that in male diabetics. The correlation studies showed a non-significant negative correlation of FBG with TC, TG and LDL-C.Conclusion: In the diabetics, higher frequencies of high TC, high TG and high LDL-C levels are noted indicating diabetic patients were more prone for dyslipidemia which could cause cardiovascular disorders.Bangladesh Journal of Medical Science Vol.15(1) 2016 p.99-102

The relation between overweight, obesity and plasma lipids in Saudi adults with type 2 diabetes

Background: Worldwide, epidemic exists with respect to diabetes mellitus, primarily because of increased rates of obesity. Lipoprotein abnormalities are common in overweight and obese patients with diabetes and contribute significantly to its complications. Methods: A cross-sectional study was conducted at the Primary Health Care Clinics at King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia. A total of 2519 Saudi diabetic and non-diabetic patients were randomly selected to assess the association of dyslipidaemia and overweight and obesity in type 2 diabetic patients and non-diabetic controls. Patients were subjected to investigations of glycosylated haemoglobin (HbA1c) and fasting serum lipids. Results: A total of 2519 patients attending the Primary Health Care Clinics were included in this study (45.9% men, 54.1% women). The diabetic group comprised 50.8% (1280) and non-diabetic group comprised 49.2% (1239) of the sample. The mean ± standard deviation age of diabetic and non-diabetic patients was 37.1 ± 7.7 and 32.1 ± 8.1, respectively. The diabetic patients were older, had higher body mass index, serum triglyceride and HbA1c values were significantly higher when compared to non-diabetic subjects. Whereas, total cholesterol, low density lipoprotein (LDL) and high density lipoprotein (HDL) were significantly lower in diabetics. Nineteen percentage of men and 27% of women with diabetes mellitus had increased total plasma cholesterol levels that did not differ significantly (P = 0.2) from the rates in non-diabetic men and women (21% of men and 34% of women). The prevalence of high LDL cholesterol levels in men and women with diabetes mellitus (23% and 31%, respectively) did not differ significantly (P = 0.4) from the rates in non-diabetic men and women (18% and 28%, respectively). The prevalence of high HDL cholesterol levels in men and women with diabetes mellitus (25% and 27%, respectively) did not differ significantly (P = 0.7) from the rates in non-diabetic men and women (23% and 25%, respectively). In contrast, the prevalence of high plasma triglyceride levels in individuals with diabetes mellitus (30% in men and 32% in women) was significantly higher than in those without diabetes mellitus (21% of men and 16% of women), P = 0.02. Conclusion: The study has documented several lipid abnormalities in type 2 diabetic patients and has pointed the significance of diabetic management in the control of lipid abnormalities where the control over overweight and obesity conditions is of importance. The study revealed that obesity and dyslipidaemia were high among diabetic patients and required special attention. This can be done through health education at the primary care level and at the diabetic clinics.

Lipid abnormalities in type 2 diabetes mellitus patients in Sri Lanka

The Galle Medical Journal is published by the Galle Medical Association. The journal is published quarterly in March, June, September and December each year. The submissions are accepted throughout the year. The aims of the Journal are to foster co-operation among the medical fraternity and to be a forum to make literary contributions, share experiences encountered in medical practice, update their knowledge and have debates on topics related to all aspects of medicine.

Physiopathologie de la dyslipidémie du syndrome métabolique et du diabète de type 2

Lipid abnormalities in people with Metabolic Syndrome and Type 2 diabetes are likely to play an important role in the development of atherogenesis. These lipid disorders include not only quantitative but also qualitative abnormalities of lipoproteins which are potentially atherogenic. The main quantitative abnormalities are increased triglyceride levels, related to an augmented hepatic production of VLDL and a reduction of both VLDL and IDL catabolism (in Type 2 diabetes), and decreased HDL-Cholesterol levels due to an accelerated HDL catabolism. The main qualitative abnormalities include large VLDL particles (VLDL 1), relatively rich in triglycerides, small dense LDL particles, increase in triglyceride content of LDL and HDL. Moreover, glycation of apolipoproteins and increased susceptibility of LDL to oxidation are observed in Type 2 diabetes. Although plasma LDL-cholesterol level is usually normal in Type 2 diabetic patients, LDL particles show significant kinetic abnormalities, such as reduced turn over, which is potentially harmful. The pathophysiology of lipid abnormalities in Type 2 diabetes is not yet totally explained. However, insulinresistance and the "relative" insulin deficiency, observed in patients with Type 2 diabetes, are likely to play a crucial role since insulin has an important function in the regulation of lipid metabolism. In addition, it is not excluded that adipocytokines, such as adiponectin, could play a role in the pathophysiology of lipid abnormalities in Type 2 diabetes.

Does statin monotherapy address the multiple lipid abnormalities in type 2 diabetes?

Lipid abnormalities, which are common in type 2 diabetes, predispose to a greatly increased risk of coronary heart disease. This characteristic dyslipidaemia includes decreased concentrations of high-density lipoprotein cholesterol (HDL-C), elevated triglycerides, and a small, dense, atherogenic form of low-density lipoprotein cholesterol (LDL-C). Insulin resistance and obesity, which is commonly present in type 2 diabetes, act in concert to disrupt normal lipoprotein metabolism; reverse cholesterol transport in particular. The proatherogenic changes, which result from this process include enrichment of very-low-density lipoprotein with cholesteryl esters and enrichment of LDL with triglycerides. Results from both the Pravastatin Pooling Project and the Heart Protection Study demonstrate that, although people with diabetes obtain the same relative risk reduction with statin therapy, the absolute benefit derived is much lower than for comparable individuals without diabetes. In order to achieve improved outcomes in diabetes patients, it will be important to address other abnormalities in their lipid profiles, including elevated triglycerides and low HDL-C.

Exogenous and endogenous postprandial lipid abnormalities in type 2 diabetic patients with optimal blood glucose control and optimal fasting triglyceride levels.

The aim of this study was to evaluate exogenous and endogenous lipoprotein responses to a standard fat-rich meal in type 2 diabetic patients with optimal fasting triglyceridemia and optimal blood glucose control. Seven type 2 diabetic patients and five nondiabetic controls (age, 49 +/- 7 and 48 +/- 4 yr; body mass index, 28.3 +/- 3.6 and 25.1 +/- 3.6 kg/m(2); mean +/- SD) were given, after at least 12 h of fasting, a standard fat-rich meal. Before and over the 6 h after the meal, serial blood samples were taken for determination of glucose, insulin, lipids, lipoproteins, apolipoprotein B-48 (apo B-48), apo B-100, free fatty acids, and lipoprotein lipase activity. The main abnormality in the postprandial lipid response of diabetic patients involved large very low density lipoproteins. In these particles, apo B-48, apo B-100, cholesterol, and triglyceride incremental areas were, in fact, significantly higher in diabetics compared with controls [7.08 +/- 2.65 vs. 1.17 +/- 0.88 mg/liter.h, 65.5 +/- 11.5 vs. 12.4 +/- 1.77 mg/liter.h, 29.7 +/- 3.9 vs. 13.1 +/- 3.1 mg/dl.h (0.77 +/- 0.10 vs. 0.34 +/- 0.08 mmol/liter.h), 170 +/- 31 vs. 94 +/- 22 mg/dl.h (1.93 +/- 0.35 vs. 1.06 +/- 0.25 mmol/liter.h)] (all P < 0.05; mean +/- SEM). Postprandial preheparin lipoprotein lipase plasma activity was, if anything, higher in diabetic patients. In conclusion, even with fasting normotriglyceridemia and optimal blood glucose control, type 2 diabetic patients are characterized, in the postprandial period, by a significant increase in large very low density lipoproteins of both endogenous and exogenous origins.

Dyslipidaemia in type 2 diabetes: epidemiology and biochemistry

Lipid abnormalities in type 2 diabetes are characterised by high triglyceride concentrations, low high density lipoprotein-cholesterol concentrations, and normal total and low density lipoprotein-cholesterol (LDL-c) concentrations. LDL particles, however, are small and dense. Epidemiological evidence for these lipid abnormalities, and for the associations between lipid abnormalities and the increased risk of cardiovascular disease in type 2 diabetes, are presented. Most, of the lipid abnormalities in type 2 diabetes can be explained by reduced action of insulin at the tissue level. The biochemical and metabolic mechanisms underlying the lipid abnormalities are discussed.

Dyslipidaemia in type 2 diabetes: a panel discussion

Dyslipidaemia in type 2 diabetes: a panel discussion