Cardiovascular risk factors and LDL subfraction profile in Type 2 diabetesmellitus subjects with good glycaemic control

Objectives: To compare cardiovascular risk factors and LDL particle size in well-controlled Type 2 diabetes mellitus and normal subjects. Methods: Nin ety-three Type 2 diabetic males and 186 age-matched, male controls were stu died. Glycaemic control was stable for at least 3 months prior to recruitme nt. None were on insulin or lipid lowering therapy. Anthropometric indices, blood pressure, lipids, glucose, insulin, apolipoprotein Al and B, LDL sub fraction by density ultracentrifugation were obtained after an overnight fa st of 10 h. Results: Diabetic subjects (mean HbA(1c) 6.6% +/- 0.10) did not differ from controls in total cholesterol levels (5.04 +/- 0.08 vs. 5.16 /- 0.05 mmol/l, respectively) but had lower serum HDL cholesterol (0.98 +/- 0.03 vs. 1.12 +/- 0.02 mmol/l, P < 0.001), higher serum triglyceride (2.38 +/- 0.16 vs. 1.80 +/- 0.08 mmol/l, P < 0.001), lower LDL, and LDL, and hig her LDL, concentration. An LDL, concentration exceeding 100 mg/dl was found in 59.1% of diabetics and 39.1% of non-diabetics (P < 0.001). Diabetic sub jects also had higher body mass index, waist to hip ratio and insulin resis tance (HOMA). Difference in LDL subfraction between groups disappeared afte r adjustments were made for either triglyceride or HDL cholesterol. Conclus ion: Well controlled Type 2 diabetes mellitus subjects exhibit an increased cardiovascular burden through low HDL cholesterol and predominance of smal l, dense LDL particles. (C) 2001 Elsevier Science Ireland Ltd. All rights r eserved.