Lipid Profile In Diabetic Patients Research Articles

Interleukin-18 can predict pre-clinical atherosclerosis and poor glycemic control in type 2 diabetes mellitus

Background:Contradictory reports about the role of cytokines, particularly interleukins (IL) in atherosclerosis are found in the literature.Objectives:This study was aimed to investigate the association between the levels of cytokines notably IL-4, IL-12, IL-18 and, the atherogenicity and glycemic control in patients with type 2 diabetes mellitus.Materials and Methods:Seventy five patients with type 2 diabetes mellitus (25 males and 50 females) attending diabetic clinic during 1st August 2008 to 30th December 2009 as well as seventy healthy subjects (38 males and 32 female) were enrolled in the study. Fasting serum lipid profile and IL-4, IL-12 and IL-18 levels were determined.Results:The serum lipid profile of diabetic patients was significantly different from healthy subjects, favoring atherogenicity. IL 4, 12, and 18 were significantly higher in diabetic patients compared with healthy subjects. Significant association of high serum IL-18 with poor glycemic control (P < 0.001) assessed by HbA1c, long duration of diabetes and atherogenic index were observed.Conclusions:IL-18 can serve as a predictor for pre-clinical atherosclerosis and poor glycemic control in type 2 diabetes mellitus.

Update on the Safety of Thiazolidinediones

Diabetic patients are at increased risk for developing cardiovascular disease, and they constitute a large proportion of the global cardiovascular disease burden. Although multiple drugs exist for treating the hyperglycemia associated with diabetes, few have been shown to reduce cardiovascular risk. Great hope surrounded the arrival of the thiazolidinediones-drugs that favorably affect insulin sensitivity, inflammation, and some aspects of lipid profiles in diabetic patients. However, the cardiovascular effects of these agents are varied, and studies have suggested that they may be associated with increases in ischemic heart disease and heart failure, as well as with an increased risk for bone fracture. The following article provides a summary of important studies that have been published regarding the safety profiles of these agents. Findings from two recently published trials, RECORD and BARI 2D, are emphasized in this paper.

Fenofibrate ameliorates diabetic and dyslipidemic profiles in KKAy mice partly via down-regulation of 11β-HSD1, PEPCK and DGAT2. : Comparison of PPARα, PPARγ, and liver x receptor agonists

Fenofibrate and rosiglitazone are prescribed to treat hypertriglyceridemia and diabetes, respectively. Since fenofibrate improves lipid profile in diabetic patients and improves insulin resistance in animal models, we examined the mechanism of antidiabetic effects of fenofibrate in KKAy mouse, an animal model of diabetes and dyslipidemia. KKAy mice were treated with fenofibrate, rosiglitazone, liver x receptor agonist, N-(2,2,2-trifluoroethyl)-N-[4-[2,2,2-trifluoro-1-hydroxy-1-(trifluoromethyl)ethyl]phenyl]-benzenesulfonamide (T0901317), and a combination of fenofibrate and T090317 for 2 weeks. Fenofibrate lowered serum triglycerides by 90% and free fatty acid (FFA) by 50% via inhibition of hepatic fatty acid synthesis. Fenofibrate also prevented T0901317-induced increases of triglycerides by dampening T090317-mediated sterol response element binding protein 1c (SREBP1c) up-regulation. Glucose lowering was comparable (~ 40%) in fenofibrate and rosiglitazone treated mice. T090317 also showed mild reduction in serum glucose, in part, via down-regulation of phosphoenol pyruvate carboxykinase (PEPCK). Combining fenofibrate with T0901317 caused greater reduction in serum glucose, suggesting an additive effect. The mechanism of lipid and glucose lowering in KKAy mice was examined. Liver PEPCK showed down-regulation in all treatment groups with fenofibrate showing greater effects. Combination of fenofibrate with T090317 showed additive effects on PEPCK down-regulation. Fenofibrate decreased hepatic diacyl glycerol acyl transferase 2 (DGAT2) mRNA leading to reduction in triglyceride synthesis. Most importantly, fenofibrate down regulated expression of hepatic and adipose 11beta hydroxysteroid dehydrogenase ( 11β-HSD1) gene, which contributed in attenuating diabetic state. Thus, amelioration of antidiabetic and hyperlipidemic state by fenofibrate in KKAy mice occurred via down-regulation of DGAT2, PEPCK and 11β-HSD1. It is also shown that the undesirable lipogenic effects of T090317 could be dampened by fenofibrate.

Effects of Icodextrin on Glycemic and Lipid Profiles in Diabetic Patients Undergoing Peritoneal Dialysis

Aim: Icodextrin reduces glucose absorption from the peritoneal dialysate. We conducted this prospective, open-labeled, multicenter study to determine the effects of icodextrin on glycemic and lipid parameters in diabetic patients undergoing continuous ambulatory peritoneal dialysis (PD) or automated PD. Methods: Patients were recruited from 15 institutions in Japan, and a total of 51 patients (15 women and 36 men, mean age: 59 ± 10 years, median duration of PD: 13 months) were enrolled. The patients were administered an overnight or daytime dwell of 1.5 or 2.0 l of 7.5% icodextrin-containing solution. At baseline and 3, 6, 9 and 12 months after the start of icodextrin, nonfasting blood was drawn for measurement of glycated hemoglobin (HbA1C) and serum lipids. Results: During icodextrin treatment, there was no change in overall HbA1C levels compared to baseline values; however, for those with baseline HbA1C ≧6.5% (n = 22), significant decreases in HbA1C were observed. Mean total/LDL cholesterol and triglycerides were decreased significantly during icodextrin treatment, with greater decreases for patients with baseline total cholesterol ≧220 mg/dl, LDL cholesterol ≧120 mg/dl or triglycerides ≧150 mg/dl. HDL cholesterol did not differ at any time point; however, values for patients with baseline HDL cholesterol <40 mg/dl tended to increase with marginal significance. Conclusions: In the current study, switching from glucose-containing dialysis solution to icodextrin resulted in improved lipid profiles and possibly a favorable metabolic profile, particularly in patients with poor glycemic control. These hypotheses remain to be proven in controlled clinical trials.

Association between glycaemic control and serum lipids profile in type 2 diabetic patients: HbA1c predicts dyslipidaemia

Impaired lipid metabolism resulting from uncontrolled hyperglycaemia has been implicated in cardiovascular complications in diabetes patients. The aim of this study was to examine the impact of glycaemic control on the lipid profile of diabetic patients. We also determined the ability of glycated haemoglobin (HbA(1c)) as an indirect marker of dyslipidaemia. A total of 1011 type 2 diabetic patients (males, 574; females, 437; mean age, 59.76 years) were included in this study. Venous blood samples were collected from all the subjects after at least 8 h fasting. The sera were analysed for HbA(1c), fasting blood glucose (FBG), total cholesterol, triglycerides (TG), high-density lipoprotein cholesterol (HDL) and low-density lipoprotein cholesterol (LDL). The levels of HbA(1c), FBG and LDL did not differ significantly between males and females. Female patients showed significantly higher serum cholesterol and HDL but significantly lower TG levels as compared to males. There was a highly significant correlation between HbA(1c) and FBG. Both HbA(1c) and FBG exhibited direct correlations with cholesterol, TG and LDL and inverse correlation with HDL; the magnitude of significance for all these lipid parameters being greater with HbA(1c) than FBG. There was a linear relationship between HbA(1c) and dyslipidaemia. The levels of serum cholesterol and TG were significantly higher and of HDL significantly lower in patients with worse glycaemic control as compared to patients with good glycaemic control. The findings of this study clearly indicate that HbA(1c) is not only a useful biomarker of long-term glycaemic control but also a good predictor of lipid profile. Thus, monitoring of glycaemic control using HbA(1c) could have additional benefits of identifying diabetic patients who are at a greater risk of cardiovascular complications.

Relationship between adiponectin, glycemic control and blood lipids in diabetic type 2 postmenopausal women with and without complication of ischemic heart disease

Background Recently major adipocytokine, adiponectin, are thought to play important roles in the regulation of cardiovascular and metabolic homeostasis. We compared serum adiponectin concentrations and lipid profile in diabetic patients with and without complication of cardiovascular disease in postmenopausal women. Methods We included 120 female subjects between the age of 45 and 60 years. The subjects were divided into 3 groups and each group comprised of 40 subjects. First group comprised of normal healthy controls, second group diabetic type 2 patients with no history of ischemic heart disease (IHD) and the third group diabetic patients with IHD. Serum adiponectin concentrations, serum triglycerides, cholesterol, LDL cholesterol and HDL cholesterol concentrations were determined. Results Values of fasting and random blood glucose, serum triglycerides, cholesterol, LDL cholesterol were significantly increased ( P < 0.001) in diabetic patients with IHD as compared with normal control subjects except for serum adiponectin and HDL cholesterol concentrations, which were significantly decreased ( P < 0.001) in diabetic patients and diabetic patients with IHD group. When values of cholesterol, triglycerides, LDL cholesterol, HDL cholesterol, fasting and random blood glucose and adiponectin were compared among diabetic and diabetic patients with IHD, it was observed that they were significantly increased ( P < 0.001) except for adiponectin, which was decreased significantly ( P < 0.001) and random blood glucose, LDL and HDL cholesterol in which no change was observed between the 2 groups. Conclusions Serum adiponectin concentrations may be a predictor for development of cardiovascular disease in postmenopausal diabetic patients.

LDL-cholesterol predicts negative coronary artery remodelling in diabetic patients: an intravascular ultrasound study

Aims To investigate the relationship between coronary artery remodelling and glycaemic and lipid profiles in diabetic patients. Methods and results Intravascular ultrasound analyses of 131 angiographically non-significant coronary stenoses in 80 diabetic patients were performed. The remodelling index (RI) was calculated as the ratio between total vessel area at target site and total vessel area at proximal reference, and was assessed in two ways: as a continuous variable, and as a binary categorical variable: RI<1 namely, negative remodelling (group I), or RI≥1 (group II). Percentage cross-sectional narrowing was 57±13%. On average, RI was 0.93±0.13. Coronary shrinkage was found in 94 (71.7%) lesions. Significant inverse correlations were demonstrated between RI and total cholesterol ( r =–0.26, P =0.003), apolipoprotein-B ( r =–0.23, P =0.01) and LDL-cholesterol ( r =–0.3, P =0.001) levels. Multivariable lineal regression analysis identified LDL-cholesterol as the only independent predictor of RI ( P =0.001). Conclusion Negative remodelling is a frequent finding in diabetics and it is associated with LDL-cholesterol levels. This may contribute to the diffuse coronary artery disease observed in diabetic patients.

Effect of AT1 receptor blockers on plasma lipid profiles in type 1 diabetic patients with incipient diabetic nephropathy

Inhibitors of the renin-angiotensin system are considered as the first line antihypertensive drugs in therapy of incipient diabetic nephropathy (DN). The aim od this study was to investigate the effect of angiotensin II receptor blockers-valsartan, on plasma lipid profiles in diabetic patients with persistent microalbuminuria (McA). Among the group of 67 type 1 diabetic patients, we choose 20 normotensive patients with incipient DN, who were divided into two groups (10 patients each): valsartan group, treated with 80 mg valsartan daily during 6 months, and the group treated with placebo during the same period. After 6 months therapy, the reduced values of total cholesterol (5.35 ? 1.19 vs 5.20 ? 1.94 mmol/L), triglyceride (1.42 ? 0.79 vs 1.21 ? 0.69 mmol/L) and LDL-cholesterol fraction (3.41 ? 1.21 vs 3.31 ? 0.84 mmol/L) were registrated in valsartan group. While compared with placebo gruop, reduction in serum triglyceride values reached statistical singificancy (-15.5%; p&lt;0.05). Patients with persistent McA have a higher risk of cardiovascular morbidity and mortality than diabetics without this complication. These results, therefore, suggests beneficial effect of valsartan on lipid metabolism, additionally to secondary prevention of chronic diabetic complications.

Concentrated Pomegranate Juice Improves Lipid Profiles in Diabetic Patients with Hyperlipidemia

Concentrated Pomegranate Juice Improves Lipid Profiles in Diabetic Patients with Hyperlipidemia