Effect of improving glycemic control in patients with type 2 diabetes mellitus on low-density lipoprotein size, electronegative low-density lipoprotein and lipoprotein-associated phospholipase a2 distribution
The American Journal of Cardiology, 06/26/2012
Sanchez–Quesada JL et al. – Optimizing glycemic control in patients with type 2 diabetes promotes atheroprotective changes, including larger LDL size, decreased electronegative LDL, and a higher proportion of Lp–PLA2 activity in high–density lipoprotein.Methods
- 42 patients with type 2 diabetes on the basis of poor glycemic control and normal or near normal LDL cholesterol were recruited.
- Lifestyle counseling and pharmacologic hypoglycemic therapy were intensified to improve glycemic control, but lipid–lowering therapy was unchanged.
- At 4 ± 2 months, glycosylated hemoglobin had decreased by a mean of 2.1%, but the only effect on the lipid profile were statistically significant decreases in nonesterified fatty acids and apolipoprotein B concentration.
- LDL size increased and the proportion of electronegative LDL decreased significantly.
- In parallel, total Lp–PLA2 activity decreased significantly, promoting a redistribution of Lp–PLA2 activity toward a higher proportion in high–density lipoprotein.
- Improvements in glycemic control led to more marked changes in Lp–PLA2 activity and distribution in patients with diabetes who had not received previous lipid–lowering therapy.