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Updated: Jan 31, 2026
Cholesterol Efflux Assay
Published on: March 6, 2012
Low cholesterol efflux capacity and abnormal lipoprotein particles in youth with type 1 diabetes: a case control
Evgenia Gourgari1, Martin P Playford2, Umberto Campia3
1Division of Pediatric Endocrinology, Department of Pediatrics, Georgetown University, 4200 Wisconsin Avenue, N.W, 4th Floor, Washington, DC, 20016, USA. eg685@georgetown.edu.
Insights
Youth with type 1 diabetes exhibit higher LDL particles and lower HDL cholesterol efflux capacity, indicating increased cardiovascular disease risk. These findings suggest incorporating lipoprotein particle analysis and CEC measurements for better risk assessment in T1DM patients.
Area of Science:
- Cardiovascular Science
- Metabolic Disorders
- Lipid Metabolism
Background:
- Type 1 diabetes (T1DM) is associated with elevated cardiovascular disease (CVD) mortality.
- Key CVD risk factors include altered lipoprotein profiles, such as increased LDL (LDLp) and small HDL particles (sHDLp), and reduced HDL-cholesterol efflux capacity (CEC).
Purpose of the Study:
- To compare lipoprotein particle concentrations and CEC between adolescents with T1DM and healthy controls (HC).
- To investigate the relationship between NMR-measured lipoprotein particles and CEC in T1DM patients.
Main Methods:
- Fasting lipoprotein profiles were assessed using Nuclear Magnetic Resonance (NMR) spectroscopy.
- Cholesterol efflux capacity (CEC) was measured using a cell-based assay.
- Multivariable linear regression models were employed to analyze associations between NMR lipid particles and CEC.
Main Results:
- Youth with T1DM displayed significantly higher total LDLp and sHDLp compared to HC.
- Patients with T1DM had lower medium HDLp and reduced CEC.
- CEC was independently correlated with sHDLp (negatively) and large HDLp (positively) in the T1DM cohort.
Conclusions:
- Adolescents with T1DM present a more atherogenic lipoprotein profile, characterized by elevated sHDL and LDLp and diminished CEC.
- Future CVD risk stratification strategies for youth with T1DM should consider the inclusion of lipoprotein particle data and CEC measurements.
Background:
Patients with type 1 diabetes (T1DM) have increased mortality from cardiovascular disease (CVD). Risk factors for CVD include an elevation of LDL (LDLp) and small HDL (sHDLp) particles, and a decrease in reverse cholesterol transport i.e. HDL-cholesterol efflux capacity (CEC). Our objective was to compare lipoprotein particles and CEC between T1DM and healthy controls (HC) and to explore the associations between NMR lipid particles and cholesterol efflux.
Methods:
78 patients with T1DM and 59 HC underwent fasting lipoprotein profile testing by NMR and measurements of CEC by cell-based method. The associations between NMR lipid particles with CEC were analyzed using multivariable linear regression models.
Results:
Youth with T1DM had higher total LDLp 724 [(563-985) vs 622 (476-794) nmol/L (P = 0.011)] (Maahs et al. in Circulation 130(17):1532-58, 2014; Shah et al. in Pediatr Diabetes 16(5):367-74, 2015), sHDLp [11.20 (5.7-15.3) vs 7.0 (3.2-13.1) μmol/L (P = 0.021)], and lower medium HDLp [11.20 (8.5-14.5) vs 12.3 (9-19.4), (P = 0.049)] and lower CEC (0.98 ± 0.11% vs 1.05 ± 0.15%, P = 0.003) compared to HC. Moreover, CEC correlated with sHDLp (β = - 0.28, P = 0.045) and large HDLp (β = 0.46, P < 0.001) independent of age, sex, ethnicity, BMIz, HbA1c, hsCRP and total HDLp in the diabetic cohort.
Conclusions:
Youth with T1DM demonstrated a more atherogenic profile including higher sHDL and LDLp and lower CEC. Future efforts should focus on considering adding lipoprotein particles and CEC in CVD risk stratification of youth with T1DM. Trial registration Clinical Trials Registration Number NCT02275091.
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