LIPOPROTEINS, APOLIPOPROTEINS, AND LOW-DENSITY-LIPOPROTEIN SIZE AMONGDIABETICS IN THE FRAMINGHAM OFFSPRING STUDY

Diabetes mellitus has been shown to be associated with lipid abnormali ties. Prior studies have indicated that women with diabetes have a ris k of coronary heart disease similar to that of men. We compared lipid parameters in diabetic and nondiabetic participants in cycle 3 of the Framingham Offspring Study. Values for plasma total cholesterol (TC), triglyceride, lipoprotein, cholesterol, apolipoprotein (ape) A1, B, ap o and lipoprotein(a) [Lp(a)] and low-density lipoprotein (LDL) particl e size were analyzed in 174 diabetic and 3,757 nondiabetic subjects. D ata from a total of 2,025 men and 2,042 women participating in the thi rd examination (1983 to 1987) of the Framingham Offspring Study were s ubjected to statistical analysis. Male and female diabetics showed low er high-density lipoprotein (HDL) cholesterol, higher triglycerides, h igher very-low-density lipoprotein (VLDL) cholesterol, lower ape A1, a nd higher LDL particle scores, indicating smaller size, than nondiabet ics. Female diabetics also showed significantly higher TC and ape B va lues than nondiabetics. The results remained statistically significant after controlling for obesity and menopausal status. The presence of small dense LDL particles (pattern B) was highly associated with diabe tes and hypertriglyceridemia in both sexes, and the relative odds for pattern B remained significant in women but not in men after adjustmen t for age and hypertriglyceridemia. No differences in apo E isoform di stribution were found for diabetics and nondiabetics. Diabetes was not associated with elevated LDL cholesterol levels. In conclusion, diabe tics have lower HDL cholesterol and higher triglyceride levels and are more likely to have small dense LDL particles. Diabetes is not a seco ndary cause of elevated LDL cholesterol. Lipid screening of diabetics should include full quantification of lipids for proper assessment of potential atherosclerotic risk. Copyright (C) 1996 by W.B. Saunders Co mpany