Size, density and cholesterol load of HDL predict microangiopathy, coronary artery disease and β-cell function in men with T2DM

Crossing family histories of diabetes and cardiovascular disease leads to unexpected outcomes in diabetic offspring

“…Cholesterol per particle (HDL‐CpP) and apoA‐I per particle (apoA‐IpP) were subsequently derived. Particulate HDL density was estimated using the ratio between apoA‐IpP as the numerator and the sum (apoA‐IpP + HDL‐CpP) as the denominator …”

“…It is unclear whether Lp(a), which is genetically controlled, is involved in accruing BCF loss in T2DM patients with an FH of DM. Functional alterations in high‐density lipoproteins (HDLs) have also been implicated in the accelerated loss of BCF, but their involvement in an FH of DM has not been determined …”

[HDL‐C/apoA‐I]: A multivessel cardiometabolic risk marker in women with T2DM

“…In this case, a single determination of HDL‐C merely represents an averaged and static estimate of the cholesterol load of different HDL subclasses and provides little indication pertaining to HDL qualities and RCT extent . In patients with the metabolic syndrome (MetS) and/or type 2 diabetes mellitus (T2DM), small‐dense and/or dysfunctional HDLs are common, and these anomalies operate in the broader context of atherogenic dyslipidaemia (AD), defined by the concurrence of low HDL‐C and hypertriglyceridemia …”

“…In the case of low‐density lipoprotein (LDL), concomitant measure of its major lipoprotein, namely, apolipoprotein B 100 (apoB), has clarified the epidemiological risk related to LDLs of different sizes and densities, and it would therefore appear relevant to also adjust HDL‐C to its major apolipoprotein, namely, apolipoprotein A‐I (apoA‐I). The easiest way to combine these 2 measures is to calculate their ratio [HDL‐C/apoA‐I], bearing in mind that unlike the single molecular ratio of apoB 100 vis‐à‐vis LDL, discoidal or spherical mature HDLs carry 2 or 4 apoA‐Is per particle . Such a ratio allows not only to estimate an average size for HDLs but also to derive useful indices of HDL number, cholesterol load, and density.…”

“…In T2DM males, the [HDL‐C/apoA‐I] ratio and the calculated indices of HDL composition or functionality predicted macrovascular risk and β‐cell function decline, as well as overall microangiopathy prevalence . It is not yet established whether such relationships are found in whole or in part in diabetic women.…”