SERUM-LIPIDS AND APOLIPOPROTEINS AND THEIR RELATIONSHIP WITH MACROVASCULAR DISEASE IN TYPE-1 DIABETES

In order to examine the relationship between serum lipids and apolipop roteins and macrovascular disease in patients with Type 1 diabetes mel litus, 50 patients with Type 1 diabetes mellitus attending the diabeti c clinics at St Mary's and St Charles' Hospitals, London were recruite d into a cross-sectional study. B-mode ultrasound was used to measure intima-media thickness and define an arterial ultrasound score for eac h patient as a non-invasive indicator of atherosclerotic change. Intim a-medial (i-m) thickness was significantly higher in those subjects wi th clinical evidence of macrovascular disease compared to those withou t macrovascular disease (0.865 +/- 0.191 vs 0.695 +/- 0.162 mm, p = 0. 0038). In the study group there were significant correlations between i-m thickness and age (r = 0.65, p < 0.01), total serum cholesterol (r = 0.32, p < 0.01), and serum fibrinogen (r = 0.43, p < 0.01) but no o ther lipid or apolipoprotein variable. When i-m thickness was correcte d for age there were significant correlations with total cholesterol ( r = 0.43, p : 0.01) and LDL-cholesterol (r = 0.42, p < 0.01). Whereas total and LDL-cholesterol and serum fibrinogen concentrations were rel ated to the extent of atherosclerotic disease by ultrasound techniques , there was no relationship with high density lipoprotein (HDL) or sub fraction cholesterol concentrations. HDL-cholesterol may not be a usef ul marker for cardiovascular disease in Type 1 diabetes.