© 1997 American Heart Association, Inc.
Articles |
The Severity of Coronary Atherosclerosis in Type 2 Diabetes Mellitus Is Related to the Number of Circulating Triglyceride-Rich Lipoprotein Particles
From Department of Medicine, WHO Collaborating Center for Study of Atherosclerosis in Diabetes (I.T., K.U., G.S.); Department of Medicine, Division of Cardiology (B..P.K.); Department of Medicine, Division of Endocrinology (G.L.); The Toronto Hospital, University of Toronto.
Correspondence to Dr. George Steiner, Department of Medicine, WHO Collaborating Center for Study of Atherosclerosis in Diabetes, Room NUW 9–112, The Toronto Hospital - General Division, 200 Elizabeth Street, Toronto, Ontario, M5G 2C4 Canada.
Abstract The presence or absence of coronary artery disease (CAD) in diabetic patients has been related to the level of circulating plasma lipoproteins. This study examines whether there is a relationship between the actual severity of CAD and the plasma concentration of major classes of plasma lipoproteins (HDL, LDL, triglyceride-rich lipoproteins (TRL), and their Sf 12 to 60 and Sf 60 to 400 subfractions), particularly the numbers of lipoprotein particles, in men and women with type 2 diabetes. 174 diabetic patients (136 men, 38 women) who underwent angiography were studied. Nine specific coronary segments were scored. The population was divided into tertiles according to the angiographic severity of their coronary disease: mild CAD: coronary score 1 to 10; moderate CAD: coronary score 11 to 13; or severe CAD: coronary score 14 to 22. The main findings were that the numbers of particles (as reflected by the apoB levels) of the TRL were greater in those with moderate and severe disease than in those with mild disease (P=.001). There was a significant correlation between the coronary score and the apoB in TRL (P=.006). There were parallel but nonsignificant changes in triglyceride levels. ApoA-I was lower in patients with moderate and severe disease (P=.01). These differences were more striking in women than they were in men. There were no differences in plasma, LDL, or HDL cholesterol or in LDL apoB or Lp(a). Multiple linear regression analysis, when adjusted for sex, age, and BMI, showed that three lipid variables (TRL apoB, LDL cholesterol, and plasma apoA-I) significantly and independently predicted the coronary score. This study demonstrates that in type 2 diabetes, the severity of angiographically evaluated CAD is positively related to the numbers of TRL particles in the plasma. This relationship is stronger in women than in men, and it is independent of HDL and LDL.
Key Words: triglycerides • diabetes • coronary artery disease
This article has been cited by other articles:
 |
|
 |
|
  L. Pilote, K. Dasgupta, V. Guru, K. H. Humphries, J. McGrath, C. Norris, D. Rabi, J. Tremblay, A. Alamian, T. Barnett, et al. A comprehensive view of sex-specific issues related to cardiovascular disease Can. Med. Assoc. J., March 13, 2007; 176(6): S1 - S44. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Srinivasan, D. T. Bolick, M. E. Hatley, R. Natarajan, K. B. Reilly, M. Yeh, C. Chrestensen, T. W. Sturgill, and C. C. Hedrick Glucose Regulates Interleukin-8 Production in Aortic Endothelial Cells through Activation of the p38 Mitogen-activated Protein Kinase Pathway in Diabetes J. Biol. Chem., July 23, 2004; 279(30): 31930 - 31936. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K P Morgan, A Kapur, and K J Beatt Anatomy of coronary disease in diabetic patients: an explanation for poorer outcomes after percutaneous coronary intervention and potential target for intervention Heart, July 1, 2004; 90(7): 732 - 738. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Carmena, P. Duriez, and J.-C. Fruchart Atherogenic Lipoprotein Particles in Atherosclerosis Circulation, June 15, 2004; 109(23_suppl_1): III-2 - III-7. [Abstract] [Full Text]
|
|
|
|
 |
|
 J. Frohlich and M. Dobiasova Fractional Esterification Rate of Cholesterol and Ratio of Triglycerides to HDL-Cholesterol Are Powerful Predictors of Positive Findings on Coronary Angiography Clin. Chem., November 1, 2003; 49(11): 1873 - 1880. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. E. Hatley, S. Srinivasan, K. B. Reilly, D. T. Bolick, and C. C. Hedrick Increased Production of 12/15 Lipoxygenase Eicosanoids Accelerates Monocyte/Endothelial Interactions in Diabetic db/db Mice J. Biol. Chem., July 3, 2003; 278(28): 25369 - 25375. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Srinivasan, M. Yeh, E. C. Danziger, M. E. Hatley, A. E. Riggan, N. Leitinger, J. A. Berliner, and C. C. Hedrick Glucose Regulates Monocyte Adhesion Through Endothelial Production of Interleukin-8 Circ. Res., March 7, 2003; 92(4): 371 - 377. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Thomsen, H. Storm, J. J Holst, and K. Hermansen Differential effects of saturated and monounsaturated fats on postprandial lipemia and glucagon-like peptide 1 responses in patients with type 2 diabetes Am. J. Clinical Nutrition, March 1, 2003; 77(3): 605 - 611. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Guerin, W. Le Goff, T. S. Lassel, A. Van Tol, G. Steiner, and M. J. Chapman Proatherogenic Role of Elevated CE Transfer From HDL to VLDL1 and Dense LDL in Type 2 Diabetes : Impact of the Degree of Triglyceridemia Arterioscler. Thromb. Vasc. Biol., February 1, 2001; 21(2): 282 - 288. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Hirany, D. O'Byrne, S. Devaraj, and I. Jialal Remnant-like Particle-Cholesterol Concentrations in Patients with Type 2 Diabetes Mellitus and End-Stage Renal Disease Clin. Chem., May 1, 2000; 46(5): 667 - 672. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Ryan, D. McInerney, D. Owens, P. Collins, A. Johnson, and G.H. Tomkin Diabetes and the Mediterranean diet: a beneficial effect of oleic acid on insulin sensitivity, adipocyte glucose transport and endothelium-dependent vasoreactivity QJM, February 1, 2000; 93(2): 85 - 91. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. K. Patricia, J. A. Kim, C. M. Harper, P. T. Shih, J. A. Berliner, R. Natarajan, J. L. Nadler, and C. C. Hedrick Lipoxygenase Products Increase Monocyte Adhesion to Human Aortic Endothelial Cells Arterioscler. Thromb. Vasc. Biol., November 1, 1999; 19(11): 2615 - 2622. [Abstract] [Full Text] [PDF]
|
|