INTERMEDIATE-DENSITY LIPOPROTEINS, DIABETES AND CORONARY-ARTERY DISEASE

The results of various studies suggest that hypertriglyceridaemia is a ssociated with an increased risk of coronary artery disease. It is unc lear, however, which particular triglyceride (TG)-rich lipoproteins co ntribute to the risk. Different types of TG-rich lipoprotein differ in function, composition, size and density. TG-rich lipoproteins in the range Svedberg flotation (Sf) 12-60 have been shown to be associated w ith angiographic severity in both diabetic and non-diabetic individual s. A study in people with type 2 diabetes found that those with modera te coronary artery disease had higher levels of both Sf 12-60 and Sf 6 0-400. Multivariate analysis showed that this association was independ ent of both low (LDL)- and high-density lipoprotein (HDL). The associa tion was not seen in patients with severe coronary artery disease, sug gesting that these lipoproteins may only be involved in the early stag es of atherogenesis. Further research has indicated that the risk corr elates positively to the postprandial levels of apolipoprotein B48 in the Sf 20-60 fraction. This suggests that elevated levels of chylomicr on remnants are involved in progression of coronary artery disease. (C ) 1998 Elsevier Science Ireland Ltd. All rights reserved.