Hypertriglyceridemia in insulin dependent diabetes mellitus with peripheral vascular disease

Hypertriglyceridemias are the most frequent lipid disorders in diabetes mellitus with peripheral vascular disease. In spite of increasing knowledges the arteriosclerotic risk of hypertriglyceridemias is still controversial. In 77 insulin dependent diabetes (IDDM) (23 m, 54 f, age: 52 +/- 18 y. body weight: 119 +/- 21% to Brocal) with hypertriglyceridemia (TG greater than or equal to 200 mg/dl) and 97 IDDM (39 m, 68 f, age: 47 +/- 18 y, body weight: 116 +/- 22% to Broca) without lipid disorders (TG less than 200 mg/dl, CH less than 260 mg/dl) we investigated whether measurement of lipoprotein-lipids is better indicator of arteriosclerotic risk than total triglycerides. Peripheral vascular diseases (PVD) were present in 45% of patients with HTG and in 32% of patients without lipid disorders. In both groups patients with PVD had lower HDL-cholesterol (p less than 0.05 resp. p less than 0.0005) and higher VLDL-cholesterol (p less than 0.025 resp. p less than 0.005). A negative relationship between VLDL-cholesterol and HDL-cholesterol was only significant in IDDM without lipid disorders (p less than 0.001). Considering a ratio of VLDL/HDL-cholesterol of greater than or equal to 1.0 resp. less than 1.0 to be discriminating for patients with or without PVD 65.1% of all PVD (specifity) and 60.7% of all Non-PVD (sensitivity) could be correctly characterized. It is concluded, that in IDDM the ratio of VLDL/HDL-cholesterol is a better indicator for the arteriosclerotic risk than total triglycerides or total cholesterol.