(1) Background: Diabetes mellitus (DM) is a significant health problem and is associated with dyslipidemia; however, the association between glycative stress, in terms of glycated hemoglobin (HbA1c), and atherogenic dyslipidemia in hyperlipidemic patients with and without DM has rarely been reported. (2) Methods: We prospectively recruited 949 hyperlipidemic patients from the Lipid Clinic of the National Taiwan University Hospital. HbA1c and fasting serum lipids, including total cholesterol (TC), high- and low-density lipoprotein cholesterol (HDL-C and LDL-C), small dense LDL-C (sdLDL-C), very low-density lipoprotein cholesterol (VLDL-C), triglycerides, and advanced glycation end-products (AGEs), were measured. After fasting for 10–14 h, all subjects except those with DM underwent a standard oral glucose tolerance test (OGTT) with 75 g of glucose loading. All subjects were asked to discontinue the use of lipid-lowering agents for 8 weeks before recruitment. (3) Results: Patients with DM had a higher prevalence of hypertension and higher levels of triglyceride, TC/HDL-C ratio, AGEs, VLDL-C, and sdLDL-C. Among patients with higher HbA1c, the serum VLDL-C, AGEs, and TC/HDL-C ratio were significantly higher than those with lower HbA1c. After adjustment for covariates, multiple logistic regression analyses revealed different groups of dysglycemia with higher HbA1c had a higher odds ratio for TC/HDL-C ≥ 5, sdLDL-C ≥ 75th percentile, VLDL-C ≥ 75th percentile and AGEs ≥ 75th percentile. (4) Conclusions: A higher HbA1c was associated with a significant increase in the risk of atherogenic dyslipidemia and AGEs levels in patients with hyperlipidemia. The findings can be very promising in clinical application.
BACKGROUND: Diabetes mellitus (DM) is a significant health problem and is associated with dyslipidemia; however, the association between glycated hemoglobin (HbA1C) and atherogenic lipids in patients with diabetes and nondiabetes has rarely been reported.METHODS: We prospectively recruited 939 subjects from the Lipid Clinic of the National Taiwan University Hospital. HbA1C and fasting serum lipids, including total cholesterol (TC), high- and low-density lipoprotein cholesterol (HDL-C and LDL-C), small dense LDL-C (sdLDL-C), very low density lipoprotein cholesterol (VLDL-C), triglycerides, and advanced glycation end-products (AGEs), were measured. All subjects except those with diabetes with a fasting period of 10–14 h underwent an oral glucose tolerance test with 75 g of glucose loading. All subjects were asked to discontinue the use of lipid-lowering agents for 4 weeks before study. RESULTS: Patients with DM had a higher prevalence of hypertension, triglyceride, TC/HDL-C ratio, AGEs, VLDL-C and sdLDL-C. Among patients with higher HbA1C levels, the serum levels of triglyceride, VLDL-C, AGEs, and TC/HDL-C ratio were significantly higher than in those groups with lower HbA1C levels. After adjustment for covariates, multiple logistic regression analysis revealed different groups of dysglycemia, such as DM, impaired glucose tolerance (IGT), and normal glucose tolerance (NGT) those with higher HbA1C levels had a higher odds ratio for TC/HDL-C ≥ 5, sdLDL-C ≥75th percentile, VLDL-C ≥ 75th percentile, and AGEs ≥ 75th percentile.CONCLUSIONS: A higher level of HbA1C was associated with a significant increase in the risk of atherogenic dyslipidemia and AGEs levels, and its clinical application is promising.
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