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20-12-2010 | Diabetes | Article

Atherogenic dyslipidemia ratio can assess residual cardiometabolic risk

Abstract

Free abstract

MedWire News: A lipoprotein ratio that estimates atherogenic dyslipidemia can be used to assess residual cardiometabolic risk and glucose homeostasis in men with Type 2 diabetes, researchers claim.

The ratio of the log transformation of triglyceride (logTG) levels to high-density lipoprotein (HDL) cholesterol was strongly associated with insulin resistance and its cardiometabolic phenotype, including fat distribution, liver steatosis, and sedentary markers.

Log(TG)/HDL cholesterol was also linked to a marked gradient in the residual risk of future coronary artery disease and related to insulin secretion and the rate of β-cell function loss.

The researchers say: "This atherogenic dyslipidemia ratio is therefore exquisitely suited to assess both non-LDL [low-density lipoprotein] residual vascular risk and glucose homeostasis determinants in diabetic patients."

Atherogenic dyslipidemia, defined as decreased HDL cholesterol plus raised TG, confers an increased risk for coronary artery disease even when LDL cholesterol is on target but is rarely assessed due to a lack of consensus in screening methods, say Michel Hermans (Cliniques Universitaires St-Luc, Brussels, Belgium) and colleagues.

Log(TG)/HDL cholesterol in 585 men with Type 2 diabetes, in whom mean HDL cholesterol levels were 44 mg/dl (1.14 mmol/l) and mean TG was 204 mg/dl (2.30 mmol/l).

Atherogenic dyslipidemia, defined as HDL cholesterol levels of less than 40 mg/dl (1.03 mmol/l) plus TG of at least 150 mg/dl (3.86 mmol/l), was present in 35% of participants and correlated with lower β-cell function, accelerated loss of insulin secretion, and worse glycated hemoglobin levels.

Atherogenic dyslipidemia was also related to a high prevalence of coronary artery disease, and its 10-year absolute risk as defined by the Type-2-diabetes specific UK Prospective Diabetes Study calculator, with this risk rising from 15% to 29% for the first and fifth quintiles of logTG/HDL cholesterol, respectively.

Reporting in the journal Cardiovascular Diabetology, the researchers conclude: "In Type 2 diabetes, this atherogenic dyslipidemia ratio is a simple means to assess both non-LDL-related residual vascular risk and glucose homeostasis."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Anita Wilkinson