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The atherogenic dyslipidemia ratio [log(TG)/HDL-C] is associated with residual vascular risk, beta-cell function loss and microangiopathy in type 2 diabetes females.

Hermans MP, Ahn SA, Rousseau MF - Lipids Health Dis (2012)

Bottom Line: In T2DM males, AD was shown to correlate with β-cell function loss, yet it is not established whether this applies across gender.AD was significantly related to central fat, metabolic syndrome, sedentarity and skeletal sarcopenia, as well as to (hs)CRP, fibrinogen, uric acid, cystatin-C, Big ET-1, and 10-year UKPDS CV risk.This ratio associates with major non-LDL cardiometabolic variables and ranks predicted CAD risk.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Endocrinology and Nutrition, Université catholique de Louvain, Brussels, Belgium. michel.hermans@diab.ucl.ac.be

ABSTRACT

Background: Atherogenic dyslipidemia (AD), defined as low HDL-C plus elevated triglycerides (TG), comorbid to T2DM, increases cardiometabolic risk for CAD even when LDL-C is at target. In T2DM males, AD was shown to correlate with ő≤-cell function loss, yet it is not established whether this applies across gender.

Aim: To establish the prevalence and severity of AD in T2DM females, and to determine how it relates to cardiometabolic phenotype, glucose homeostasis, micro- and macrovascular complications, and 10-year absolute CV risk (UKPDS Risk Engine).

Methods: 340 T2DM females were ranked according to quintiles (Q) of the continuous variable log(TG)/HDL-C, with AD prevalence defined as HDL-C <50 mg.dL(-1) plus TG ‚Č•150 mg.dL(-1), and ő≤-cell function assessed with HOMA.

Results: AD prevalence was 35%; mean HDL-C and TG were 52 (15) and 160 (105) mg.dL(-1). AD was significantly related to central fat, metabolic syndrome, sedentarity and skeletal sarcopenia, as well as to (hs)CRP, fibrinogen, uric acid, cystatin-C, Big ET-1, and 10-year UKPDS CV risk. AD correlated stepwise with lower ő≤-cell function and hyperbolic product, and with accelerated loss of residual insulin secretion, higher HbA(1c) and prevalent microangiopathy.

Conclusions: log(TG)/HDL-C is a simple means to grade AD and residual macrovascular risk in T2DM females. This ratio associates with major non-LDL cardiometabolic variables and ranks predicted CAD risk. In addition, log(TG)/HDL-C identifies worsening glucose homeostasis, poorer glycemic control, and prevalent microangiopathy.

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Related in: MedlinePlus

United Kingdom Prospective Diabetes Study Risk Engine’s 10-year absolute predicted risk of developing non-fatal or fatal coronary artery disease (CAD; grey bars) or fatal CAD (solid bars) in 258 T2DM females according to quintiles of log (TG)/HDL-C ranking distribution. Within each quintile, data were obtained from subsets of patients (in % for each quintile) in primary cardiovascular prevention (Q I: 81%; Q II: 81%; Q III: 69%; Q IV: 78%; and Q V: 71%). HDL-C: high-density lipoprotein cholesterol; TG: triglycerides. Significance of differences between quintiles: both P<0.0001 (CAD and fatal CAD).
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Figure 1: United Kingdom Prospective Diabetes Study Risk Engine’s 10-year absolute predicted risk of developing non-fatal or fatal coronary artery disease (CAD; grey bars) or fatal CAD (solid bars) in 258 T2DM females according to quintiles of log (TG)/HDL-C ranking distribution. Within each quintile, data were obtained from subsets of patients (in % for each quintile) in primary cardiovascular prevention (Q I: 81%; Q II: 81%; Q III: 69%; Q IV: 78%; and Q V: 71%). HDL-C: high-density lipoprotein cholesterol; TG: triglycerides. Significance of differences between quintiles: both P<0.0001 (CAD and fatal CAD).

Mentions: In the entire cohort, 258 patients were in primary CV prevention, and as a result eligible for UKPDS risk estimation. Their mean 10-year absolute CV risk prediction was: 13 (11) % (CAD); 10 (10) % (fatal CAD); 11 (16) % (stroke) and 2 (3) % (fatal stroke). Figure1 illustrates UKPDS risk for CAD, after adjustment for inter-quintile differences in mean age: there were significant trends for stepwise heightened risk across Qs: 9% (CAD) and 7% (fatal CAD) (Q I) to 20% (CAD) and 16% (fatal CAD) (Q V; both p <0.0001). No increasing trends across Qs were observed for risk of stroke or lethal stroke (not illustrated).


The atherogenic dyslipidemia ratio [log(TG)/HDL-C] is associated with residual vascular risk, beta-cell function loss and microangiopathy in type 2 diabetes females.

Hermans MP, Ahn SA, Rousseau MF - Lipids Health Dis (2012)

United Kingdom Prospective Diabetes Study Risk Engine’s 10-year absolute predicted risk of developing non-fatal or fatal coronary artery disease (CAD; grey bars) or fatal CAD (solid bars) in 258 T2DM females according to quintiles of log (TG)/HDL-C ranking distribution. Within each quintile, data were obtained from subsets of patients (in % for each quintile) in primary cardiovascular prevention (Q I: 81%; Q II: 81%; Q III: 69%; Q IV: 78%; and Q V: 71%). HDL-C: high-density lipoprotein cholesterol; TG: triglycerides. Significance of differences between quintiles: both P<0.0001 (CAD and fatal CAD).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3539971&req=5

Figure 1: United Kingdom Prospective Diabetes Study Risk Engine’s 10-year absolute predicted risk of developing non-fatal or fatal coronary artery disease (CAD; grey bars) or fatal CAD (solid bars) in 258 T2DM females according to quintiles of log (TG)/HDL-C ranking distribution. Within each quintile, data were obtained from subsets of patients (in % for each quintile) in primary cardiovascular prevention (Q I: 81%; Q II: 81%; Q III: 69%; Q IV: 78%; and Q V: 71%). HDL-C: high-density lipoprotein cholesterol; TG: triglycerides. Significance of differences between quintiles: both P<0.0001 (CAD and fatal CAD).
Mentions: In the entire cohort, 258 patients were in primary CV prevention, and as a result eligible for UKPDS risk estimation. Their mean 10-year absolute CV risk prediction was: 13 (11) % (CAD); 10 (10) % (fatal CAD); 11 (16) % (stroke) and 2 (3) % (fatal stroke). Figure1 illustrates UKPDS risk for CAD, after adjustment for inter-quintile differences in mean age: there were significant trends for stepwise heightened risk across Qs: 9% (CAD) and 7% (fatal CAD) (Q I) to 20% (CAD) and 16% (fatal CAD) (Q V; both p <0.0001). No increasing trends across Qs were observed for risk of stroke or lethal stroke (not illustrated).

Bottom Line: In T2DM males, AD was shown to correlate with β-cell function loss, yet it is not established whether this applies across gender.AD was significantly related to central fat, metabolic syndrome, sedentarity and skeletal sarcopenia, as well as to (hs)CRP, fibrinogen, uric acid, cystatin-C, Big ET-1, and 10-year UKPDS CV risk.This ratio associates with major non-LDL cardiometabolic variables and ranks predicted CAD risk.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Endocrinology and Nutrition, Université catholique de Louvain, Brussels, Belgium. michel.hermans@diab.ucl.ac.be

ABSTRACT

Background: Atherogenic dyslipidemia (AD), defined as low HDL-C plus elevated triglycerides (TG), comorbid to T2DM, increases cardiometabolic risk for CAD even when LDL-C is at target. In T2DM males, AD was shown to correlate with ő≤-cell function loss, yet it is not established whether this applies across gender.

Aim: To establish the prevalence and severity of AD in T2DM females, and to determine how it relates to cardiometabolic phenotype, glucose homeostasis, micro- and macrovascular complications, and 10-year absolute CV risk (UKPDS Risk Engine).

Methods: 340 T2DM females were ranked according to quintiles (Q) of the continuous variable log(TG)/HDL-C, with AD prevalence defined as HDL-C <50 mg.dL(-1) plus TG ‚Č•150 mg.dL(-1), and ő≤-cell function assessed with HOMA.

Results: AD prevalence was 35%; mean HDL-C and TG were 52 (15) and 160 (105) mg.dL(-1). AD was significantly related to central fat, metabolic syndrome, sedentarity and skeletal sarcopenia, as well as to (hs)CRP, fibrinogen, uric acid, cystatin-C, Big ET-1, and 10-year UKPDS CV risk. AD correlated stepwise with lower ő≤-cell function and hyperbolic product, and with accelerated loss of residual insulin secretion, higher HbA(1c) and prevalent microangiopathy.

Conclusions: log(TG)/HDL-C is a simple means to grade AD and residual macrovascular risk in T2DM females. This ratio associates with major non-LDL cardiometabolic variables and ranks predicted CAD risk. In addition, log(TG)/HDL-C identifies worsening glucose homeostasis, poorer glycemic control, and prevalent microangiopathy.

Show MeSH
Related in: MedlinePlus