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HDL subparticles and coronary artery disease in NIDDM

T O'Brien1, T T Nguyen, B J Hallaway

  • 1The Atherosclerosis Research Unit, Division of Endocrinology/Metabolism, Mayo Clinic and Foundation, Rochester, MN 55905, USA.

Atherosclerosis
|April 5, 1996
PubMed

Insights

Reduced HDL cholesterol in non-insulin dependent diabetes mellitus (NIDDM) is linked to coronary artery disease (CAD). Apo A-I is the strongest predictor of CAD in NIDDM patients, despite lower HDL subparticle levels.

Area of Science:

  • Cardiovascular Medicine
  • Metabolic Disorders
  • Lipidology

Background:

  • Decreased high-density lipoprotein (HDL) cholesterol is a known risk factor for coronary artery disease (CAD) in patients with non-insulin dependent diabetes mellitus (NIDDM).
  • HDL cholesterol levels are influenced by various HDL subparticles, including those containing apolipoprotein A-I (LpAI) and those containing both apolipoprotein A-I and apolipoprotein A-II (LpAI/AII).

Purpose of the Study:

  • To compare the concentrations of HDL subparticles (LpAI and LpAI/AII) between subjects with and without NIDDM.
  • To investigate the relationship between these HDL subparticles and the presence of CAD in individuals with NIDDM.

Main Methods:

  • Lipid profiles, apolipoprotein A-I (apo A-I), and HDL subparticle levels were measured in 240 subjects with NIDDM and 248 age- and gender-matched controls.
  • Statistical analyses, including multivariate analysis, were performed to identify predictors of CAD.

Main Results:

  • Subjects with NIDDM exhibited higher triglycerides and lower HDL cholesterol, apo A-I, and LpAI/AII levels compared to controls. LpAI levels were similar between groups.
  • Diabetic subjects with CAD had significantly higher triglycerides and lower HDL cholesterol, apo A-I, LpAI, and LpAI/AII levels compared to diabetic subjects without CAD.
  • Multivariate analysis identified plasma apo A-I as the most significant predictor of CAD in NIDDM patients.

Conclusions:

  • The reduction in HDL cholesterol observed in NIDDM is primarily attributed to decreased concentrations of LpAI/AII particles.
  • While both LpAI and LpAI/AII levels are lower in NIDDM subjects with CAD, apo A-I emerges as the superior predictor for CAD risk in this population.

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