Diabetic Dyslipidemia or 'Diabetes Lipidus'?

Diana Muačević-Katanec; Željko Reiner

Disclosures

Expert Rev Cardiovasc Ther. 2011;9(3):341-348. 

In This Article

Diabetic Dyslipidemia

A characteristic pattern, termed diabetic dyslipidemia, consists of specifically mild to marked elevation of triglyceride-rich lipoproteins (VLDLs) and VLDL remnants concentrations and low levels of HDL-C. Raised serum triglycerides and low HDL-C often precede the onset of T2DM for many years. In addition, LDL particles are converted to smaller, perhaps more atherogenic, lipoproteins termed 'small-dense LDLs'.[19–22]

Different mechanisms are responsible for the development of dyslipidemia in individuals with diabetes. Defects in insulin action and hyperglycemia could lead to dyslipidemia in patients with diabetes. In the case of T2DM, the obesity/insulin-resistant state that is at the basis of the development of this disease can in itself lead to lipid abnormalities independently of hyperglycemia. In poorly controlled T1DM hypertriglyceridemia and reduced HDL-C commonly occur, but in most cases insulin replacement in these patients correct these abnormalities. In T2DM, this phenotype is not usually fully corrected with glycemic control, suggesting that insulin resistance and not hyperglycemia per se are associated with this lipid abnormality.[23]

Insulin-controlled apoprotein production in the liver, regulation of lipoprotein lipase (LPL), actions of cholesteryl ester transfer protein (CETP) and peripheral actions of insulin on adipose tissue and muscles are considered to be important mechanisms responsible for diabetic dyslipidemia.[24,25]

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