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Cardiovasc Diabetol. 2018 Dec 19;17(1):158. doi: 10.1186/s12933-018-0802-0.

Low cholesterol efflux capacity and abnormal lipoprotein particles in youth with type 1 diabetes: a case control study.

Author information

1
Division of Pediatric Endocrinology, Department of Pediatrics, Georgetown University, 4200 Wisconsin Avenue, N.W, 4th Floor, Washington, DC, 20016, USA. eg685@georgetown.edu.
2
Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
3
Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
4
Division of Pediatric Endocrinology, Department of Pediatrics, Children's National Health Systems, George Washington University, Washington, DC, USA.
5
Clinical Research Unit, Georgetown University, Washington, DC, USA.
6
Department of Biostatistics and Biomedical Informatics, MedStar Health Research Institute, Hyattsville, MD, USA.
7
Section of Lipoprotein Metabolism, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
8
Division of Cardiology, Georgetown University School of Medicine, Washington, DC, USA.
9
Section on Pediatric Diabetes and Metabolism, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA.

Abstract

BACKGROUND:

Patients with type 1 diabetes (T1DM) have increased mortality from cardiovascular disease (CVD). Risk factors for CVD include an elevation of LDL (LDLp) and small HDL (sHDLp) particles, and a decrease in reverse cholesterol transport i.e. HDL-cholesterol efflux capacity (CEC). Our objective was to compare lipoprotein particles and CEC between T1DM and healthy controls (HC) and to explore the associations between NMR lipid particles and cholesterol efflux.

METHODS:

78 patients with T1DM and 59 HC underwent fasting lipoprotein profile testing by NMR and measurements of CEC by cell-based method. The associations between NMR lipid particles with CEC were analyzed using multivariable linear regression models.

RESULTS:

Youth with T1DM had higher total LDLp 724 [(563-985) vs 622 (476-794) nmol/L (P = 0.011)] (Maahs et al. in Circulation 130(17):1532-58, 2014; Shah et al. in Pediatr Diabetes 16(5):367-74, 2015), sHDLp [11.20 (5.7-15.3) vs 7.0 (3.2-13.1) μmol/L (P = 0.021)], and lower medium HDLp [11.20 (8.5-14.5) vs 12.3 (9-19.4), (P = 0.049)] and lower CEC (0.98 ± 0.11% vs 1.05 ± 0.15%, P = 0.003) compared to HC. Moreover, CEC correlated with sHDLp (β = - 0.28, P = 0.045) and large HDLp (β = 0.46, P < 0.001) independent of age, sex, ethnicity, BMIz, HbA1c, hsCRP and total HDLp in the diabetic cohort.

CONCLUSIONS:

Youth with T1DM demonstrated a more atherogenic profile including higher sHDL and LDLp and lower CEC. Future efforts should focus on considering adding lipoprotein particles and CEC in CVD risk stratification of youth with T1DM. Trial registration Clinical Trials Registration Number NCT02275091.

KEYWORDS:

Adolescent; Cardiovascular risk; Cholesterol efflux; NMR; Type 1 diabetes

PMID:
30567548
PMCID:
PMC6299549
DOI:
10.1186/s12933-018-0802-0
[Indexed for MEDLINE]
Free PMC Article

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