Dyslipidemia in the metabolic syndrome and type 2 diabetes mellitus.
Abstract
Patients with type 2 diabetes mellitus or the metabolic syndrome have a unique dyslipidemia characterized by hypertriglyceridemia; elevated blood levels of apolipoprotein B; small, dense low-density lipoprotein (LDL) cholesterol; and low levels of high-density lipoprotein (HDL) cholesterol, in particular HDL(2)-C. Treatment of the dyslipidemia associated with these disorders should focus on correcting the abnormal lipoprotein levels as well as LDL and HDL heterogeneity. Statins and fibrates are useful for treating elevated LDL in patients with and without diabetes or the metabolic syndrome. In addition, thiazolidinediones or niacin in combination with a statin show promise for correcting defects in LDL and HDL heterogeneity. The ultimate goal of treatment in this patient population is to prevent the development and progression of coronary artery disease.
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Mild hypertriglyceridemia, typically seen in treated type 2 diabetes, is probably related to central obesity and insulin resistance.
“Mild hypertriglyceridemia, typically seen in treated type 2 diabetes, is probably related to the presence of central obesity and insulin resistance (83).”
From Evaluation and Treatment of Hypertriglyceridemia: An Endocrine Society Clinical Practice Guideline (2012) · cites this paper as [83]
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“Specifically his study found that: apoA1 was depleted in LDL fraction from MetSyn subjects possibly reflecting a lower level of the very large, buoyant HDL subspecies associated with MetSyn [47]; LDL/IDL fractions from MetSyn subjects were enriched with apoC2 and apoC3, possibly due to the accumulation of VLDL remnant…”
BackgroundLipoprotein-associated PAF-acetylhydrolase activity in subjects with the metabolic syndrome
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“The high TG levels in turn can alter the composition of LDL-C and HDL-C, making these lipid particles more atherogenic (23).”
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“Some reports suggest that elevated TGs levels alone are associated with developing diabetes and cardiovascular disease,(20) whereas others suggest that elevated TGs levels with high low-density lipoprotein (LDL) and low high-density lipoprotein (HDL) have a synergistic effect.(21,22) In addition, subjects with a body…”
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Background
- Authors
- Brunzell, J. D., & Ayyobi, A. F.
- Affiliations
- University of Washington (US)
- Corresponding author
- Ayyobi, Amir F
- ORCID
- Brunzell, John D
- Venue
- The American Journal of Medicine
- Publisher
- Elsevier BV
- Published
- 2003-12
- Volume
- 115
- Issue
- 8
- Pages
- 24-28
- ISSN
- 0002-9343 (ISSN-L)
- OpenAlex
- W2030751874
- Cited by
- 155
- References
- 63
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 6 · 2022: 2 · 2021: 2 · 2020: 4 · 2019: 4 · 2018: 6 · 2017: 4 · 2016: 4 · 2015: 4 · 2014: 12 · 2013: 10 · 2012: 12
- FWCI
- 2.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Keywords
- dyslipidemia, metabolic syndrome, type 2 diabetes, hypertriglyceridemia, apolipoprotein B, small dense LDL, HDL cholesterol, HDL2-C, lipoprotein heterogeneity, statins, fibrates, thiazolidinediones, nicotinic acid, coronary heart disease prevention
- MeSH terms
- Coronary Artery Disease, Diabetes Mellitus, Type 2, Humans, Hyperlipidemias, Lipase, Cholesterol, HDL, Cholesterol, LDL, Receptor, Insulin, Risk Factors, Metabolic Syndrome
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