Impact of low-density lipoprotein particle size on carotid intima-media thickness in patients with type 2 diabetes mellitus

• Published in: Metabolism, clinical and experimental clinical and experimental, 2007-05, Vol.56 (5), p.608-613
• Main Authors: Hayashi, Yuzo, Okumura, Kenji, Matsui, Hideo, Imamura, Akiko, Miura, Manabu, Takahashi, Ryotaro, Murakami, Ryuichiro, Ogawa, Yasuhiro, Numaguchi, Yasushi, Murohara, Toyoaki
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carotid Artery, Common - diagnostic imaging; Carotid Artery, Common - metabolism; Carotid Artery, Common - pathology; Cholesterol, HDL - blood; Coronary Artery Disease - blood; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - etiology; Coronary Artery Disease - pathology; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - diagnostic imaging; Diabetes Mellitus, Type 2 - pathology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinology & Metabolism; Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Humans; Lipoproteins, LDL - blood; Male; Malondialdehyde - blood; Medical sciences; Metabolic diseases; Middle Aged; Multivariate Analysis; Particle Size; Tunica Intima - diagnostic imaging; Tunica Intima - metabolism; Tunica Intima - pathology; Ultrasonography
• ISSN: 0026-0495; 1532-8600
• DOI: 10.1016/j.metabol.2007.01.001

Abstract Small low-density lipoprotein (LDL) particles and modifications to LDL such as glycation and oxidation have been linked to the pathogenesis of atherosclerosis in patients with diabetes. We investigated whether LDL particle size, or the levels of glycated LDL or malondialdehyde-modified LDL (MDA-LDL) are associated with carotid intima-media thickness (IMT) in patients with type 2 diabetes mellitus. One hundred seventy-two patients with type 2 diabetes mellitus were enrolled. Carotid IMT was measured by high-resolution ultrasound, and LDL particle size and serum glycated LDL and MDA-LDL levels were determined. The 3 variables were significantly correlated with one another. Univariate analyses defined statistically significant correlations of carotid IMT with LDL size, hemoglobin A1c , glycated LDL, MDA-LDL, high-density lipoprotein (HDL) cholesterol, and age. The strongest association of IMT was with LDL size ( r = −0.406, P < .0001), followed by that with HDL cholesterol ( r = −0.225, P = .004). A stepwise multiple regression analysis revealed that LDL size and HDL cholesterol are independent predictors of carotid IMT. Neither glycated LDL nor MDA-LDL had a significant independent contribution to the severity of carotid IMT in the multivariate model. Low-density lipoprotein particle size, but not the glycated LDL or MDA-LDL level, was independently associated with carotid IMT in patients with type 2 diabetes mellitus regardless of antidiabetic and lipid-lowering medications. These results suggest that the measurement of LDL size may be more useful than quantification of modified LDLs for assessing atherosclerosis in patients with type 2 diabetes mellitus. Small LDL particles may be the most important predictor for the risk of cardiovascular disease in diabetic patients.