Heterogeneity in associations between macronutrient intake and lipoproteinprofile in individuals with type 2 diabetes

OBJECTIVE - To evaluate associations between macronutrient intake and lipop rotein profile among individuals with type 2 diabetes who participated in t he San Luis Valley Diabetes Study (SLVDS) or the Insulin Resistance Atheros clerosis Study (IRAS), RESEARCH DESIGN AND METHODS- Diet was assessed by 24-h recall in the SLVDS (n = 421) and by validated food frequency interview in the IRAS (n = 437). Analyses adjusted for kilocalories, age, sex, and other covariates were con ducted separately for the two study groups. For the SLVDS, repeated observa tions were included in mixed model analyses (865 observations). For the IRA S, standard regression analyses were conducted. Recent weight history and l ime of diabetes diagnosis were evaluated as possible modifiers of associati ons between nutrient intake and lipoprotein profile. RESULTS - Higher reported intake of total dietary fat was related to signif icantly higher levels of LDL cholesterol (P < 0.05) in both studies and in all subgroups. Reported intake of total and saturated fat was associated po sitively with total cholesterol, although statistical significance was not reached for all subgroups. Higher reported carbohydrate intake was associat ed with increased triglyceride concentrations (P < 0.01) only among individ uals with previously undiagnosed diabetes in the SLVDS (n = 69) and only am ong individuals who gained weight (>5 lb, n = 87) during the previous year in the IRAS. CONCLUSIONS - Toward the goal of optimizing the lipoprotein profile of indi viduals with diabetes, these results emphasize the potential importance of reducing fat intake while recognizing that individualized approaches to die t are important to minimize the risk of cardiovascular disease.