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High-density lipoprotein (HDL) dysfunction is linked to diabetes complications. Altered HDL structure and function in type 1 and type 2 diabetes impair vascular health and beta-cell function.

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Area of Science:

  • Endocrinology
  • Cardiovascular Science
  • Metabolic Research

Background:

  • High-density lipoprotein (HDL) plays a crucial role in lipid metabolism and possesses protective functions.
  • Diabetes mellitus, including type 1 (T1DM) and type 2 (T2DM), is associated with significant alterations in HDL structure and function.

Purpose of the Study:

  • To critically appraise new insights into HDL structure and function in type 1 diabetes (T1DM) and type 2 diabetes (T2DM).

Main Methods:

  • Review of recent findings on HDL proteome and lipidome in diabetic patients.
  • Analysis of structure-function relationships of HDL in T1DM and T2DM.
  • Investigation of HDL's role in endothelial function, inflammation, and beta-cell survival.

Main Results:

  • In T1DM, impaired HDL antioxidative and vasodilatory functions correlate with renal impairment and inflammation.
  • HDL dysfunction is linked to subclinical vascular damage and end-organ damage in T1DM.
  • HDL may protect against T2DM by reducing ER stress and promoting beta-cell survival via oxysterol efflux.
  • The apoM-sphingosine-1-phosphate complex in HDL is vital for antidiabetic effects, including insulin resistance reduction and beta-cell protection.
  • In T2DM, altered HDL proteomic and lipidomic components impair mitochondrial function and endothelial cell apoptosis inhibition.

Conclusions:

  • HDL structure and function are significantly altered in both T1DM and T2DM, leading to impaired protective capabilities.
  • These alterations contribute to vascular complications, inflammation, and beta-cell dysfunction in diabetes.
  • Targeting HDL structure and function may offer therapeutic strategies for managing diabetes and its complications.