Advanced lipoprotein profile identifies atherosclerosis better than conventional lipids in type 1 diabetes at high cardiovascular risk

• Published in: Nutrition, metabolism, and cardiovascular diseases metabolism, and cardiovascular diseases, 2023-06, Vol.33 (6), p.1235-1244
• Main Authors: Serés-Noriega, Tonet, Ortega, Emilio, Giménez, Marga, Perea, Verónica, Boswell, Laura, Mariaca, Karla, Font, Carla, Mesa, Alex, Viñals, Clara, Blanco, Jesús, Vinagre, Irene, Pané, Adriana, Esmatjes, Enric, Conget, Ignacio, Amor, Antonio J.
• Format: Article
• Language: English
• Subjects: Adult; Advanced lipoprotein; Atherosclerosis; Atherosclerosis - diagnostic imaging; Atherosclerosis - epidemiology; Cardiovascular Diseases - diagnostic imaging; Cardiovascular Diseases - epidemiology; Cardiovascular risk; Carotid Intima-Media Thickness; Cholesterol; Cholesterol, HDL; Cholesterol, LDL; Cross-Sectional Studies; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - diagnosis; Diabetes Mellitus, Type 1 - epidemiology; Female; Heart Disease Risk Factors; Humans; LDL particles; Lipoprotein subclasses; Lipoproteins; Male; Nuclear magnetic resonance; Plaque, Atherosclerotic; Risk Factors; Type 1 diabetes; Ultrasound
• ISSN: 0939-4753; 1590-3729
• DOI: 10.1016/j.numecd.2023.03.025

People with type 1 diabetes (T1D) present lipoprotein disturbances that could contribute to their increased cardiovascular disease (CVD) risk. We evaluated the relationship between lipoprotein alterations and atherosclerosis in patients with T1D. Cross-sectional study in subjects with T1D, without previous CVD, but high-risk (≥40 years, nephropathy, or ≥10 years of evolution of diabetes with another risk factor). The presence of plaque (intima-media thickness ≥1.5 mm) in the different carotid segments was determined by ultrasound. The advanced lipoprotein profile was analysed by magnetic resonance imaging (1H NMR). We included 189 patients (42% women, 47.8 ± 10.7 years, duration of diabetes 27.3 ± 10.1 years, HbA1c 7.5% [7–8]). Those with carotid plaques (35%) were older, with longer diabetes duration, had a higher prevalence of hypertension, and showed lower and smaller LDL particles (LDL-P) and HDL particles (HDL-P), but higher VLDL particles (VLDL-P). Some LDL, HDL and VLDL-related parameters were associated with atherosclerosis in sex, age and statin use adjusted models (p