STUDY OF LIPOPROTEIN PATTERNS AS AN ATHEROGENIC FACTOR IN T2DM PATIENTS AND THEIR FDRS
AbstractBackground: The present study was carried out to determine the lipoprotein patterns as anatherogenic factor in T2DM (Type 2 Diabetes Mellitus) patients and their FDRS (First DegreeRelatives). In various previous studies it has been reported that hyperinsulinemia andhyperlipidemia frequently coexist in T2DM patients which indicate that the diabetic state it self isassociated with atherogenic lipid disorders. Method: The present study included 26 Type 2DM(T2DM) patients and 21 apparently healthy First Degree Relative (FDRs) of T2DM patients.Twenty three age matched control not related to diabetics were also included in the study. Results:The BMI in male patients and FDRs were significantly higher as compared to controls but nosignificant difference was seen among the BMI of female FDRs. Fasting plasma glucose (FPG)levels of T2DM patients were significantly higher but no significant difference was observedamong the FDRs and controls. FPG did not show any significant correlation with the BMI indiabetic patients, FDRs and controls. The lipid profile of patients showed no significantdifference, except the mean LDL-Chol of female patients was significantly higher as compared tofemale controls. HDL-Chol of males FDRs was significantly lower as compared to male controls.LDL-Chol of female FDRs was significantly lower than the female controls. No significantdifference was observed in the total cholesterol and the triglycerides level of the patients of T2DMand FDRs but those cases in which pre-beta band appear upon lipoprotein electrophoresis hadsignificantly higher triglyceride levels as compared to those patients in which pre-beta band didnot appear. Conclusion: Lipoproteins of the T2DM patients and FDRs group were found to behighly disturbed as compared to the control group and they show a trend of developingatherogenic states in future.Key Words: Type 2 Diabetes Mellitus (T2DM), First Degree Relatives (FDRs), Body Mass Index(BMI), Lipoproteins, Fasting Plasma Glucose (FPG), Coronary Artery Disease
Jawaid SA, Jafary MH. Training of nurses in diabetic care.
Pak J Med Sci 2003;19(2):67–9.
Edelman SV. Type II diabetes mellitus. Adv-Intern-Med
Axelsen M. Smith U, Eriksson JW, Taskinen MR, Jansson
PA. Postprandial hypertriglyceridemia and insulin resistance
in normoglycemic first-degree relatives of patients with type
diabetes. Ann Intern Med 1999;131(1):27–31.
Al-Nuaim AR, Famuyiwa O, Geer W. Hyperlipidemia
among Saudi diabetic patients. Pattern and clinical
characteristics. Ann Saudi Med 1995;15(3):240–3.
Stewart MW, Humphriss DB, Mitcheson J, Webster J,
Walker M, Laker MF. Lipoprotein composition and serum
apolipoproteins in normoglycaemic first degree relatives of
non-insulin dependant diabetic patients. Atherosclerosis
Schlenck A, Herbeth B, Siest G, Visvikis S. Characterization
and quantification of serum lipoprotein subtractions by
capillary isotachophoresis: relationships with lipid,
apolipoproteins, and lipoprotein levels. Journal of Lipid
Mahley RW, Innerarity TL, Rall SC, Weisgraber KH. Plasma
lipoproteins: apolipoprotein structure and function. Journal of
Lipid Research 1984;25:1277–94.
Uddin F, Miah AK. Lipid profile and its relation to fasting insulin
level in non-insulin dependent diabetes mellitus (NIDDM).
Bangladesh Med Res Counc Bull 1995;21(2):64–72.
Fabryova L, Cagan S. Relation between insulin resistance
and small, dense lipoproteins with low density and the
development of atherosclerosis in type 2 diabetes mellitus.
Bratisl Lek Listy 1998;99(3-4):138–45.
Berk-Planken II, Hoogerbrugge N, Stolk RP, Bootsma AH,
Jansen H. Atorvastatin dose-dependently decreases hepatic
lipase activity in type 2 diabetes: effect of sex and the LIPC
promoter variant. Diabetes Care 2003;26(2):427–32.
Hidaka H, Tozuka M, Meyer B, Yamauchi K, Sugono M,
Nakabayashi T, Katsuyama T. Characterization of triglyceride
rich lipoproteins with very light density by ultracentrifugation
and agarose gel electophoresis using triglyceride- and
cholesterol-staining. Ann Clin Lab Sci 2003;33(2):167–78.
Friedwald WT, Levy RI, Fredrickson DS. Clin Chem.
;18:499. Cited by Varley’s Practical Clinical
Biochemistry 1988; 6th ed, pp 462.
Stejskal D, Adamovska S, Bartek J, Jurakova R, Proskova J.
Resistin-concentrations in persons with type 2 diabetes
mellitus and in individuals with acute inflammatory disease.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub
Perry IJ, Wannamethee SG, Walker MK, Thomson AG,
Whincup PH, Shaper AG. Prospective study of risk factors
for development of non-insulin dependent diabetes in middle
aged British men. BMJ 1995;310:560–4.
Chang SA, Kim HS, Yoon KH, Ko SH, Kwon HS, Kim et al.
Body mass index is the most important determining factor for
the degree of insulin resistance in non-obese type 2 diabetic
patients in Korea. Metabolism 2004;53(2):142–6.
Colditz GA, Willett WC, Rotnitzky A, Manson JE. Weight
gain as a risk factor for clinical diabetes mellitus in women.
Ann Interna Med. 122:481–6.
Habib SS, Aslam M. Risk Factors, knowledge and health status
in diabetic patients. Saudi Med J 2003;24(11):1219–24.
Nauck MA, Meier JJ, Wolfersdorff AV, Tillil H, Creutzfeldt
W, Kobberling J. A 25-year follow-up study of glucose
tolerance in first-degree relatives of type 2 diabetic patients:
association of impaired or diabetic glucose tolerance with
other components of the metabolic syndrome. Acta Diabetol
Cam H, Pusuroglu K, Aydin A, Ercan M. Effects of
hemorheological factors on the development of hypertension
in diabetic children. J Trop Pediatr 2003;49(3):164–7.
Cozma LS, Luzio SD, Dunseath GJ, Langendorg KW, Pieber
T, Owen TR. Comparison of the Effects of Three
Insulinotropic Drugs on Plasma Insulin Levels After a
Satandard Meal. Diabetes Care 2002;25,1271–6.
Woolf SH, Rothemich SF. New Diabetes Guidelines: A
Closer Look at the Evidence. American family physician
Wei M, Gibbons LW, Mitchell TL, Kampert JB, Lee CD,
Blair SN. The Association between Cardiorespiratory Fitness
and Impaired Fasting Glucose and Type 2 Diabetes Mellitus
in Men. Ann of Inter Med 1999;130:89–96.
McClain MR . Modifiable Risk Factors For Diabetes
Detectable In Young Adults With Diabetic parents. Prev Med
Sanchez-Quesada JL, Perez A, Caixas A, Rigla M, Payes A,
Benitez S, Ordonez-Llanos J. Effect of Glycemic Optimization
on Electronegative Low–Density Lipoprotein in Diabetes:
Relation to Nonezymatic Glycosylation and Oxidative
Modification. J of Clin Endocrin & Met 2001;86:3243–9.
Parhofer KG, Laubach E, Geiss HC, Otto C. Effect of
glucose control on lipid levels in patients with type 2
diabetes. Dtsch Med Wochenschr 2002;127(18):958–62.
Laasko M, Pyorala K, Voutilainen E, Marniemi J. Plasma
insulin and serum lipids and lipoproteins in middle-aged sub
dependant diabetic and non-diabetic subjects. Ann J
Demant T. Diabetic dyslipoproteinemia: physiophthological
bases and treatment prospects. Fosrtschr Med Orig
Petersen M, Pedersen H, Major–Pedersen A, Jensen T,
Marckmann P. Effect of Fish Oil Versus Com oil
Supplementation on LDL and HDL Subclasses in Type 2
Diabetic Patients. Diabetes Care 2002;25:1704–8.
Eschwege E. The dysmetabolic syndrome, insulin resistance
and increased cardiovascular (CV) morbidity and mortality in
J Ayub Med Coll Abbottabad;19(4)
type 2 diabetes: aetiological factors in the development of CV
complications. Diabetes Metab 2003;29(4 Pt 2):6S19–27.
Steinmetz A. Treatment of diabetic dyslipoproteinemia. Exp
Clin Endocrinol Diabetes 2003;111(5):239–45.
Gurlek A, Bayraktar M, Kirazli S. Increased plasminogen
activator inhibitor-1 activity in offspring of type 2 diabetic
patients. Diabetes Care 2000; 23:1035-7.
Ali N, Afzal N, Ahmad MZ, Shahjahan S, Shaikh AS.
Obesity indices and lipid levels in healthy relatives of T2DM
patients. Pak. PGMJ 2003;14(4):189–93.
Noble RP. Electrophoretic separation of plasma lipoproteins
in agarose gel. Journal of Lipid Research 1986;9:693–700.
Ravel R. In Clinical Laboratory Medicine, 3rd ed., Year Book
Medical publishers 1978: pp 251–7.
Tonutti L, Taboga C, Noacco C. Comparison of the efficacy
of pantethine, acipimox, and bezafibrate on plasma lipids and
index of cardiovascular risk in diabetics with dyslipidemia.
Minerva Med 1991;82:657–63.
Arsenio L, Bodria P, Magnati G, Pola P, Savi L, Girilli M.
Effectiveness of long-term treatment with pantethine in
patients with dyslipidemia. Clin Ther 1986;8:537–45.
Genest JJ Jr, Martin-Munley SS, McNamara JR, Ordovas
JM, Jenner J, Myers RH et al. Familial lipoprotein disorders
in patients with premature coronary artery disease.
Durruty P, Diaz J, Zanetti L, de la Varas MA, Garcia de los
Rios M. Microalbuminuria, lipid changes and coronary heart
disease in non-insulin-dependent diabetics. Rev Med Chil