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HDL metabolism in diabetes.

Y D Chen, C Y Jeng, G M Reaven

    Diabetes/Metabolism Reviews
    |July 1, 1987
    PubMed
    Summary
    This summary is machine-generated.

    Diabetes significantly alters HDL metabolism, with distinct effects in Type 1 (IDDM) and Type 2 (NIDDM) diabetes. While IDDM lowers HDL turnover, NIDDM accelerates it, impacting cholesterol levels and cardiovascular risk differently.

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    Area of Science:

    • Endocrinology
    • Metabolic Disorders
    • Lipid Metabolism

    Background:

    • Diabetes mellitus is associated with significant alterations in high-density lipoprotein (HDL) metabolism.
    • The relationship between diabetes and HDL metabolism is complex and varies between different types of diabetes.

    Purpose of the Study:

    • To review and elucidate the differential effects of insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM) on HDL metabolism.
    • To explore the clinical implications of these metabolic changes, particularly concerning cardiovascular disease (CAD) risk.

    Main Methods:

    • Review of existing data and literature on HDL metabolism in diabetic patients.
    • Comparative analysis of HDL cholesterol levels and turnover rates in IDDM versus NIDDM populations.

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  • Examination of the impact of insulin therapy and other anti-diabetic treatments on HDL metabolism.

    • Main Results:

    • IDDM is characterized by decreased HDL turnover due to insulin deficiency, leading to lower HDL-cholesterol. However, insulin treatment normalizes or increases HDL-cholesterol, with no apparent role in macrovascular complications.
    • NIDDM shows accelerated HDL turnover, resulting in low HDL-cholesterol, which is linked to increased CAD morbidity and mortality.
    • Plasma insulin levels in NIDDM correlate inversely with HDL-cholesterol concentration.
    • Current anti-diabetic treatments have shown limited success in substantially increasing HDL-cholesterol levels in NIDDM patients.

    Conclusions:

    • HDL metabolism is profoundly affected by diabetes, with distinct mechanisms in IDDM and NIDDM.
    • While HDL changes may not be clinically significant in IDDM, they are associated with adverse cardiovascular outcomes in NIDDM.
    • Further research is needed to understand the precise mechanisms and develop effective therapeutic strategies for managing HDL metabolism in NIDDM.