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Altered small dense LDL profiles in long-standing controlled type 1 diabetes
Helena Sardà1,2, Arnau Solé3,4,5, Cristina Colom1
1Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau - Hospital Dos de Maig, Barcelona, Spain.
Frontiers in Endocrinology
|April 23, 2026
Summary
Individuals with type 1 diabetes exhibit an atherogenic small dense low-density lipoprotein (sdLDL) profile, even with controlled blood sugar. This study reveals key lipid regulators contributing to sdLDL enrichment, suggesting improved cardiovascular risk assessment.
Area of Science:
- Cardiovascular Science
- Metabolic Disorders
- Lipid Metabolism
Background:
- Type 1 diabetes increases cardiovascular disease (CVD) risk, independent of glycemic control.
- The specific role of small dense low-density lipoprotein (sdLDL) and its regulatory factors in type 1 diabetes remains under-investigated.
Purpose of the Study:
- To investigate the characteristics of sdLDL and its associated lipid-modulating proteins in individuals with type 1 diabetes.
- To explore the relationship between sdLDL parameters and key proteins like Apolipoprotein C3 (ApoC3), hepatic lipase (HL), endothelial lipase (EL), and cholesteryl ester transfer protein (CETP).
Main Methods:
- Cross-sectional study analyzing plasma from 69 individuals with type 1 diabetes and 24 healthy controls.
- Utilized homogeneous assays, NMR spectroscopy, and gradient gel electrophoresis to assess sdLDL-cholesterol (sdLDL-C), LDL size, and subclasses.
- Measured ApoC3, HL, EL, and CETP activity using immunoturbidimetric, ELISA, and functional assays.
Main Results:
- Individuals with type 1 diabetes showed significantly higher sdLDL-C, increased sdLDL-C/LDL-cholesterol ratio, and smaller LDL particle size compared to controls, despite adequate glycemic control (HbA1c 7.6%).
- Elevated ApoC3 and HL levels, alongside reduced CETP activity, were observed in the type 1 diabetes group.
- sdLDL-C positively correlated with ApoC3 and inversely with CETP activity.
Conclusions:
- Long-standing type 1 diabetes is associated with an atherogenic sdLDL profile, even with controlled glycemia and near-normal lipid levels.
- ApoC3, CETP, and HL significantly contribute to sdLDL enrichment in type 1 diabetes.
- Direct assessment of sdLDL may enhance cardiovascular risk stratification in patients with type 1 diabetes.
Keywords:
apolipoprotein C3cardiovascular disease riskcholesteryl ester transfer proteindirect assayhepatic lipasesmall dense LDL cholesteroltype 1 diabetesMore Related Videos
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