Sdjm. Niemeijer-kanters et al., Effect of intensive lipid-lowering strategy on low-density lipoprotein particle size in patients with type 2 diabetes mellitus, ATHEROSCLER, 156(1), 2001, pp. 209-216
Citations number
37
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
A preponderance of small dense LDL particles is strongly associated with th
e occurrence of atherosclerotic disease. Although several studies have docu
mented an increased prevalence of small dense LDL particles in diabetes mel
litus no data are available to show the effect of lipid-lowering treatment
upon the improvement of LDL particle size. In the present study we examined
the effect of lipid-lowering treatment, following an intensive lipid-lower
ing strategy for 30 weeks pursuing ADA recommended target lipid levels, on
LDL particle size in 50 type 2 diabetic patients with moderate hyperlipidem
ia. At week 0, 24 patients (48%) were characterized by small dense LDL phen
otype pattern B. After the treatment period a shift towards normal LDL part
icle size was observed in 17 patients but seven patients (29%) showed the m
ore atherogenic LDL subclass pattern B. After treatment, plasma HDL-cholest
erol was significantly lower (P < 0.05) in these patients compared to those
who had LDL subclass pattern A. Multivariate regression analysis revealed
VLDL-cholesterol or triglycerides and HDL3-cholesterol as independent deter
minants for LDL particle size. Change in HDL2-cholesterol was an independen
t determinant for change in LDL particle size. In conclusion, a strategy of
intensive lipid-lowering, with the intention to reduce triglyceride levels
below 1.7 mmol/l, may be insufficient to ensure improvement in LDL size in
all patients. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.