Jul 13, 2018

Pathophysiology of Diabetic Dyslipidemia

Journal of Atherosclerosis and Thrombosis
Tsutomu Hirano

Abstract

Accumulating clinical evidence has suggested serum triglyceride (TG) is a leading predictor of atherosclerotic cardiovascular disease, comparable to low-density lipoprotein (LDL)-cholesterol (C) in populations with type 2 diabetes, which exceeds the predictive power of hemoglobinA1c. Atherogenic dyslipidemia in diabetes consists of elevated serum concentrations of TG-rich lipoproteins (TRLs), a high prevalence of small dense low-density lipoprotein (LDL), and low concentrations of cholesterol-rich high-density lipoprotein (HDL)2-C. A central lipoprotein abnormality is an increase in large TG-rich very-low-density lipoprotein (VLDL)1, and other lipoprotein abnormalities are metabolically linked to increased TRLs. Insulin critically regulates serum VLDL concentrations by suppressing hepatic VLDL production and stimulating VLDL removal by activation of lipoprotein lipase. It is still debated whether hyperinsulinemia compensatory for insulin resistance is causally associated with the overproduction of VLDL. This review introduces experimental and clinical observations revealing that insulin resistance, but not hyperinsulinemia stimulates hepatic VLDL production. LDL and HDL consist of heterogeneous particles with different size and...Continue Reading

Mentioned in this Paper

Very low density lipoprotein cholesterol
Metabolic Process, Cellular
Diabetes Mellitus, Non-Insulin-Dependent
Epicholesterol
Insulin Sensitivity
Size
HDL-Cholesterol Subclass 3 Measurement
Diabetic Nephropathy
LPL gene
Huntington DISEASE-LIKE 3 (Disorder)

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