U.K. Prospective Diabetes Study 27: Plasma lipids and lipoproteins at diagnosis of NIDDM by age and sex

Abstract

Plasma lipids and lipoproteins at diagnosis of NIDDM by age and sex U.K. PROSPECTIVE DIABETES STUDY GROUP OBJECTIVE-To compare fasting plasma lipids and lipoproteins in male and female patients at diagnosis of NIDDM and to examine age and sex differences in lipid concentrations. RESEARCH DESIGN A N D METHODS-Cross-sectional study of fasting plasma total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride in 2,139 male and 1,574 female white patients, aged 25-65 years, at diagnosis of NIDDM.RESULTS -At diagnosis of NIDDM, the mean age ± SD for men was 52 ± 9 and 53 ± 9 years for women; BMI was 28.3 ± 4.9 and 30.8 ±6.7 kg/m 2 , and fasting plasma glucose was 11.6 ± 3.6 and 12.4 ± 3.8 mmol/1, respectively. The mean total and LDL cholesterol were higher in female than in male NIDDM patients, 5.8 ± 1.2 vs. 5.5 ±1.1 and 3.9 ±1.1 vs. 3.6 ± 1.0 mmol/1 (both P < 0.001), respectively, while triglyceride levels were similar: geometric mean (1 SD interval) for men and women was 1.8 (1.1-3.1) vs. 1.8 (1.1-2.9) mmol/1. HDL cholesterol was higher in female than in male NIDDM patients, 1.09 ± 0.2 vs. 1.01 ± 0.24 mmol/1 (P < 0.001); the sex differential for HDL cholesterol was 7% in NIDDM patients compared with 22% in the general population. Data analysis by 5-year age bands showed a significant trend toward lower total cholesterol and triglyceride and higher HDL cholesterol in men diagnosed above the age of 50 years. In female NIDDM patients, lipid concentrations increased with age of diagnosis but reached a plateau above the age of 50 years. CONCLUSIONS-The effect of NIDDM, observed at diagnosis, on plasma lipid and lipoprotein levels is more pronounced in women than in men. This may explain in part why the cardiovascular risk is proportionally higher in female patients.

Clinical evaluation of Dyslipidemia among type II diabetic patients at Public hospital Penang, Malaysia

“…Probably reason lies in two bare facts; first possibility suggest that due to increase of triglycerides (>2.25 mmol/L) with low LDL and HDL ratio [23-30] and second possibility is the weight gain with no-exercise behavior and poor diet control [11-13,17,24,31-34]. …”

“…Although the causes of increased cardiovascular risks in both type 2 diabetes and metabolic syndrome are multifactorial, an atherogenic lipid profile characterized by elevated triglycerides and low levels of high-density lipoprotein (HDL) cholesterol are few major modifiable factor contributing progressively in cardiovascular risk [17]. Level of low-density lipoprotein (LDL) cholesterol typically is not elevated and in fact may even be below average.…”

Treatment of dyslipidemia in patients with type 2 diabetes

“…However, dyslipidemia may correlate more directly with cardiovascular complications [2], and mechanistic evidence is emerging regarding the greater lipocentric versus glucocentric nature of CVD risk in patients with type 2 diabetes [7,18]. Insulin resistance is central to the pathogenesis of type 2 diabetes and contributes to dyslipidemia [17].…”

“…However, significantly fewer patients with type 2 diabetes had HDL-C and TG at optimal levels compared with patients without type 2 diabetes (Figure 2) [27]. Consistent with the data from NHANES 1999-2000, data from the United Kingdom Prospective Diabetes Study (UKPDS) in 3713 newly diagnosed patients with type 2 diabetes reported that HDL-C levels were lower (by 9% [men] and 23% [women]) while TG levels were 50% higher in patients with type 2 diabetes than in nondiabetic patients; LDL-C values were similar (for males but higher in females) between those with and without type 2 diabetes [2]. As the pattern of elevated lipids was more pronounced in females, it was suggested to contribute to the greater cardiovascular risk in females compared with males [2].…”

“…Type 2 diabetes affects approximately 24 million individuals in the United States [1] and is associated with significant morbidity and mortality due to cardiovascular complications [2]. The incidence of cardiovascular disease (CVD) is more common in patients with type 2 diabetes than in the general population [3].…”