Atherogenic phenotype remains in elderly diabetic patients

Area of Science:

• Cardiology
• Endocrinology
• Geriatrics

Background:

• Plasma low-density lipoprotein cholesterol (LDL-C) levels typically decrease with age.
• Elderly diabetic patients often present with normal LDL-C levels, masking potential cardiovascular risks.
• The atherogenic phenotype, characterized by specific lipoprotein profiles, is associated with increased cardiovascular disease risk.

Purpose of the Study:

• To investigate whether elderly diabetic patients exhibit the atherogenic phenotype despite normal LDL-C levels.
• To compare lipoprotein profiles, specifically small dense LDL cholesterol (sLDL-C), between different age and diabetes status groups.

Main Methods:

• Study included 236 participants divided into four groups: middle-aged diabetic, middle-aged non-diabetic, elderly diabetic, and elderly non-diabetic.
• Measurements included LDL-C and small dense LDL-C (sLDL-C).
• Statistical analyses included ANOVA and multivariate regression to identify factors associated with the sLDL-C/LDL-C ratio.

Main Results:

• Elderly diabetics had lower LDL-C than middle-aged diabetics, though not significantly.
• Elderly diabetics showed significantly higher sLDL-C and sLDL-C/LDL-C ratios compared to elderly non-diabetics.
• Age, sex, diabetes mellitus, and plasma triglyceride levels were independent factors influencing the sLDL-C/LDL-C ratio.

Conclusions:

• Elderly diabetic patients can exhibit an atherogenic phenotype characterized by increased sLDL-C, even with normal LDL-C levels.
• The findings highlight the importance of assessing lipoprotein subclasses in elderly diabetics to identify elevated cardiovascular risk.
• This phenotype suggests a persistent atherogenic risk profile in older individuals with diabetes.