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Isolated low-HDL cholesterol in Japanese patients with type 2 diabetes

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Abstract

Background

The clinical features of diabetic dyslipidemia are low levels of high-density lipo protein cholesterol (HDL-C) associated with hypertriglyceridemia. However, isolated low HDL-C, defined as low HDL-C in the absence of other lipid abnormalities, has not been well studied among patients with type 2 diabetes (T2DM).

Objective

We studied the prevalence of isolated low HDL-C and combined low HDL-C (i.e. low HDL-C combined with other lipid abnormalities) among patients with T2DM, compared clinical features, and studied the effect on coronary artery disease (CAD) risk for patients with the two types of low HDL-C.

Methods

The study population was 398 patients (238 men, 160 women) with T2DM. Their glucose, lipid metabolism, and atherosclerosis profiles were analyzed. The prevalence of CAD among those with low HDL-C was then studied for 173 male patients with T2DM.

Results

The prevalence of low HDL-C (HDL <40 mg/dL, for both sexes) was 33.7 % (n = 134); 12.6 % of the patients (n = 50) had isolated low HDL-C and 21.1 % (n = 84) had combined low HDL-C. Clinical indicators of diabetes and atherosclerosis were no different between patients with isolated or combined low HDL-C. Among the 173 male patients evaluated, it was re-confirmed that low HDL-C was an independent risk factor for CAD which did not depend on triglycerides and other risk factors. Risks for CAD were similar for men with isolated or combined low-HDL-C (34.1 vs. 32.4 %, respectively; no significant difference).

Conclusions

Although the prevalence of isolated low HDL-C in T2DM was the same as among the general population, it was clearly shown that prevalence of the combined type was higher. In limited analysis of male patients, CAD risk for both was shown to be equal. The risk associated with low HDL-C among the T2DM patients was assumed to be because of an increase in the combined type.

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Abbreviations

LDL-C:

Low-density lipoprotein cholesterol

CAD:

Coronary artery disease

HDL-C:

High-density lipoprotein cholesterol

TG:

Triglyceride

UKPDS:

United Kingdom Prospective Diabetes Study

T2DM:

Type 2 diabetes mellitus

WHO:

World Health Organization

JDCS:

Japan Diabetes Complications Study

ABCA1:

ATP-binding cassette transporter A1

JAS:

Japan Atherosclerosis Society

TC:

Total cholesterol

CAG:

Cardio-angiography

SD:

Standard deviation

ANOVA:

Analysis of variance

BMI:

Body mass index

CPR:

C-peptide immunoreactivity

IRI:

Immunoreactive insulin

IMT:

Intima media thickness

H-CRP:

Highly sensitive C-reactive protein

ABI:

Ankle brachial index

PWV:

Pulse wave velocity

HSL:

Hormone-sensitive lipase

VLDL:

Very-low-density lipoprotein

SREBP-1c:

Sterol regulatory element-binding protein 1c

miRNA:

Micro ribonucleic acid

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Conflict of interest

All authors, Matsumura K, Kimura Y, Hiroshi Murakami-1 H, Yamashita M, Matsuk i K, Tanabe J, Murakami-2 H, Matsui J, Tamasawa N, and Daimon M, declare that they have no conflict of interest.

Human rights statement and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (Hirosaki University Graduate School of Medicine) and with the Helsinki Declaration of 1964 and later revision.

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Hirosaki Graduate School of Medicine, Aomori, Japan

    Koki Matsumura, Yuki Kimura, Hiroshi Murakami, Maki Yamashita, Kota Matsuki, Jutaro Tanabe, Hiroshi Murakami, Jun Matsui & Makoto Daimon

  2. Department of Diabetes and Endocrinology, Aomori City Hospital, Katta 1-14-20, Aomori, 030-0821, Japan

    Naoki Tamasawa

Authors
  1. Koki Matsumura
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  2. Yuki Kimura
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Correspondence to Naoki Tamasawa.

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Matsumura, K., Kimura, Y., Murakami, H. et al. Isolated low-HDL cholesterol in Japanese patients with type 2 diabetes. Diabetol Int 6, 290–299 (2015). https://doi.org/10.1007/s13340-014-0200-0

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  • DOI: https://doi.org/10.1007/s13340-014-0200-0

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