Comprehensive assessment of lipoprotein subfraction profiles according to glucose metabolism status, and association with insulin resistance in subjects with early-stage impaired glucose metabolism

作者：Lee Jie Eun; Min Se Hee; Lee Dong Hwa; Oh Tae Jung; Kim Kyoung Min; Moon Jae Hoon; Choi Sung Hee; Park Kyong Soo; Jang Hak Chul; Lim Soo^*

来源：International Journal of Cardiology, 2016, 225: 327-331.

DOI：10.1016/j.ijcard.2016.10.015

• Atherogenic dyslipidemia
• Lipoprotein subfraction profile
• Small dense low-density lipoprotein
• Glucose metabolism
• Impaired fasting glucose

Background: Early detection of atherogenic dyslipidemia is crucial. We investigated lipoprotein subfraction parameters according to glucose metabolism status.
Methods: We recruited 1255 lipid-lowering drug-naive subjects with normal fasting glucose (NFG; n = 200, 15.9%), impaired fasting glucose (IFG; n = 443, 35.3%), or type 2 diabetes (T2D; n = 612, 48.8%). Lipoprotein subfractions (1-7) were determined by polyacrylamide gel electrophoresis, separating low-density lipoprotein (LDL) into large buoyant LDL (lbLDL, LDL1-2) and small dense LDL (sdLDL, LDL3-7). Lipoprotein subfraction parameters including the sdLDL% (LDL3-7/LDL1-7), the sdLDL/lbLDL ratio (LDL3-7/LDL1-2), and weighted LDL subfraction (LDLSF) scores, were compared between groups. Their associations with insulin resistance, estimated using the homeostasis model assessment of insulin resistance, were examined.
Results: The concentrations of sdLDL particles were significantly higher in subjects with T2D and IFG than in those with NFG (15.78 +/- 13.47 mg/dl and 14.60 +/- 14.33 mg/dl, respectively, vs. 12.22 +/- 12.31 mg/dl). Compared with those with NFG, subjects with IFG or T2D had significantly a higher sdLDL% (15.98 +/- 15.26% vs. 19.50 +/- 16.21% or 21.46 +/- 16.81%, respectively), a higher sdLDL/lbLDL ratio (0.24 +/- 0.30 vs. 0.31 +/- 0.37 or 0.35 +/- 0.39), and a higher LDLSF score (2.08 +/- 0.91 vs. 2.30 +/- 1.14 or 2.36 +/- 1.17). These lipoprotein subfraction parameters had stronger associations with insulin resistance compared to conventional lipid profiles in the IFG and T2D groups.
Conclusions: Atherogenic dyslipidemia is initiated in an early stage of impaired glucose metabolism, when early intervention might be required.

• 出版日期2016-12-15