Intermediate-density lipoproteins, diabetes and coronary artery disease

The results of various studies suggest that hypertriglyceridaemia is associated with an increased risk of coronary artery disease. It is unclear, however, which particular triglyceride (TG)-rich lipoproteins contribute to the risk. Different types of TG-rich lipoprotein differ in function, composition, size and density. TG-rich lipoproteins in the range Svedberg flotation (Sf) 12-60 have been shown to be associated with angiographic severity in both diabetic and non-diabetic individuals. A study in people with type 2 diabetes found that those with moderate coronary artery disease had higher levels of both Sf 12 60 and Sf 60-400. Multivariate analysis showed that this association was independent of both low (LDL)- and high-density lipoprotein (HDL). The association was not seen in patients with severe coronary artery disease, suggesting that these lipoproteins may only be involved in the early stages of atherogenesis. Further research has indicated that the risk correlates positively to the postprandial levels of apolipoprotein B48 in the Sf 20-60 fraction. This suggests that elevated levels of chylomicron remnants are involved in progression of coronary artery disease.