Cited by 155Lipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and LipoproteinsLipid metabolism and disorders

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Dyslipidemia in the metabolic syndrome and type 2 diabetes mellitus.

Brunzell, John D, Ayyobi, Amir F·2003·The American Journal of Medicine

DOI 10.1016/j.amjmed.2003.08.011

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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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Salaramoli, S., Mehri, S., Yarmohammadi, F., Hashemy, S. I., & Hosseinzadeh, H. (2022) · PubMed · doi:10.22038/ijbms.2022.59627.13231 · Cited by 30
Atherogenic changes in low-density lipoprotein particle profiles were not observed in non-obese women with polycystic ovary syndrome
Kim, J. J., Chae, S. J., Choi, Y. M., Hwang, K. R., Song, S. H., Yoon, S. H., Kim, S. M., Ku, S., Kim, S. H., Kim, J. G., et al. (2013) · Human Reproduction · doi:10.1093/humrep/det057 · Cited by 24
“…insulin-resistant state: decreased levels of high-density lipoprotein-cholesterol (HDL-C) and apolipoprotein (apo) A-I and increased levels of triglycerides (TG), apoB and very low-density lipoprotein (VLDL) (Sniderman et al., 2001; Barter et al., 2003; Brunzell and Ayyobi, 2003; Taskinen, 2003).”
Background
Achievement of specified low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol apolipoprotein B, and high-sensitivity C-reactive protein levels with ezetimibe/simvastatin or atorvastatin in metabolic syndrome patients with and without atherosclerotic vascular disease (from the VYMET study)
Robinson, J. G., Ballantyne, C. M., Hsueh, W. A., Rosen, J., Lin, J., Shah, A. K., Lowe, R. S., Hanson, M. E., & Tershakovec, A. M. (2011) · Journal of clinical lipidology · doi:10.1016/j.jacl.2011.06.004 · Cited by 23
Differences in Expression of Cardiovascular Risk Factors among Type 2 Diabetes Mellitus Patients of Different Age
Kalofoutis, C., Piperi, C., Zisaki, A., Singh, J., HARRIS, F., Phoenix, D. A., ALAVERAS, A., & Kalofoutis, A. (2006) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1372.001 · Cited by 23
Alterations in triglyceride rich lipoproteins are related to endothelial dysfunction in metabolic syndrome
Lucero, D., Lopez, G. I., Gorzalczany, S. B., Duarte, M., Ballerga, E. G., Sorda, J. A., Schreier, L. E., & Zago, V. (2016) · Clinical Biochemistry · doi:10.1016/j.clinbiochem.2016.04.016 · Cited by 23
Temporal changes in concentrations of lipids and apolipoprotein B among adults with diagnosed and undiagnosed diabetes, prediabetes, and normoglycemia: findings from the National Health and Nutrition Examination Survey 1988--1991 to 2005--2008
Ford, E. S., Li, C., & Sniderman, A. D. (2013) · Cardiovascular Diabetology · doi:10.1186/1475-2840-12-26 · Cited by 20
Trichosanthes CucumerinaFruit Extenuates Dyslipidemia, Protein Oxidation, Lipid Peroxidation and DNA Fragmentation in the liver of high-fat diet-fed rats
Ajiboye, T. O., Akinpelu, S. A., Muritala, H. F., Ogunbode, S. M., Adeleye, A. O., Oladiji, A. T., & Oloyede, O. B. (2014) · Journal of Food Biochemistry · doi:10.1111/jfbc.12080 · Cited by 20
Overexpression of apolipoprotein A5 in mice is not protective against body weight gain and aberrant glucose homeostasis
Pamir, N., McMillen, T. S., Li, Y., Lai, C.-M., Wong, H., & LeBoeuf, R. C. (2009) · Metabolism · doi:10.1016/j.metabol.2008.11.018 · Cited by 19
“Hypertriglyceridemia is a feature of the metabolic syndrome (1,2) and is frequently associated with obesity, insulin resistance (2–4) and atherosclerosis (5).”
Background
Supplementation with n-3, n-6, n-9 fatty acids in an insulin-resistance animal model: does it improve VLDL quality?
Lucero, D., Olano, C., Bursztyn, M., Morales, C., Stranges, A., Friedman, S., Macri, E. V., Schreier, L. E., & Zago, V. (2017) · Food & Function · doi:10.1039/c7fo00252a · Cited by 19
Murine models to investigate the influence of diabetic metabolism on the development of atherosclerosis and restenosis
Navarro, H. G. (2007) · Frontiers in bioscience · doi:10.2741/2400 · Cited by 18
Phytotherapy for Polycystic Ovarian Syndrome: A review of the literature and evaluation of practitioners’ experiences
Rooney, S., & Pendry, B. A. (2014) · Journal of Herbal Medicine · doi:10.1016/j.hermed.2014.05.001 · Cited by 19
Metabolic Syndrome in First Episode Schizophrenia, Based on the National Mental Health Registry of Schizophrenia (NMHR) in a General Hospital in Malaysia: A 10-Year Retrospective Cohort Study
Lee, A., Ng, C. G., Koh, O. H., Gill, J. S., & Aziz, S. A. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15050933 · Cited by 19
Microalbuminuria among type-2 diabetes mellitus patients in Pokhara, Nepal.
Sigdel, M., Rajbhandari, N., Basnet, S., Nagila, A., Basnet, P., & Tamrakar, B. K. (2008) · PubMed · Cited by 16
The Current and Emerging Role of Statins in the Treatment of PCOS: The Evidence to Date
Kolnikaj, T. S., Herman, R., Janež, A., & Jensterle, M. (2024) · Medicina · doi:10.3390/medicina60020244 · Cited by 18
“Dyslipidemia is characterized by elevated levels of low-density lipoprotein (LDL) and triglycerides, low levels of high-density lipoprotein (HDL), and increased total cholesterol and lipoprotein concentrations, which collectively contribute to a high CVD risk profile [70,71].”
Background
Role of Glycation in Type 2 Diabetes Mellitus and Its Prevention through Nymphaea Species
Ishrat, N., Khan, H., Patel, O. P., Mahdi, A. A., Mujeeb, F., & Ahmad, S. (2021) · BioMed Research International · doi:10.1155/2021/7240046 · Cited by 17
A novel peroxisome proliferator–activated receptor α/γ dual agonist ameliorates dyslipidemia and insulin resistance in prediabetic rhesus monkeys
Ding, S.-Y., Tigno, X. T., Braileanu, G., Ito, K., & HANSEN, B. C. (2007) · Metabolism · doi:10.1016/j.metabol.2007.05.019 · Cited by 14
“Both insulin resistance and dyslipidemia, characterized as elevated plasma triglyceride (TG) and reduced high-density lipoprotein cholesterol (HDL-C) levels, play important roles in the development of type 2 diabetes mellitus [1-3] and usually precede impaired glucose tolerance and hyperglycemia [4,5].”
Background
A review of the efficacy of rosuvastatin in patients with type 2 diabetes
Tuomilehto, J. O., Leiter, L. A., & Kallend, D. G. (2004) · International Journal of Clinical Practice · doi:10.1111/j.1368-504x.2004.00390.x · Cited by 14
Tattoo-induced psoriasis.
Orzan, O. A., Popa, L. G., Vexler, E. S., Olaru, I. D., Voiculescu, V. M., & Bumbăcea, R. S. (2014) · Europe PMC (PubMed Central) · Cited by 13
Anti-diabetic Effect of Material Fermented Using Rice Bran and Soybean as the Main Ingredient by Bacillus sp.
Lim, S. (2010) · Journal of the Korean Society for Applied Biological Chemistry · doi:10.3839/jksabc.2010.035 · Cited by 13
“Type II diabetes is usually accompanied with a change in blood lipids such as an increase in blood triglycerides and/or cholesterol [Brunzell and Ayyobi, 2003; Krauss, 2004].”
Background
Determinants of evolving metabolic and cardiovascular benefit/risk profiles of rosiglitazone therapy during the natural history of diabetes: molecular mechanisms in the context of integrated pathophysiology
Sgarra, L., Addabbo, F., Potenza, M. A., & Montagnani, M. (2012) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00038.2012 · Cited by 13
“Hyperglycemia fosters the nonenzymatic formation of advanced glycosylated end products (AGEs) and promotes activation of key mediators regulating proinflammatory and proatherosclerotic target genes in endothelial cells, vascular smooth muscle cells, and macrophages (18, 21).”
Background
Bezafibrate induces myotoxicity in human rhabdomyosarcoma cells via peroxisome proliferator-activated receptor α signaling
Zhao, Y., Okuyama, M., Hashimoto, H., Tagawa, Y., Jomori, T., & Yang, B. (2009) · Toxicology in Vitro · doi:10.1016/j.tiv.2009.08.001 · Cited by 13
Leptin Receptor Gene Gln223Arg Polymorphism Is Not Associated with Hypertension: A Preliminary Population-Based Cross-Sectional Study
Pena, G. D. G., Guimarães, A. L. S., Veloso, R. R., Reis, T. C., Gomes, C. S., Neto, J. F. R., & Velásquez-Meléndez, G. (2014) · Cardiology Research and Practice · doi:10.1155/2014/879037 · Cited by 13
Impact of high-density lipoprotein cholesterol level in patients with variant angina pectoris
Sugano, Y., Anzai, T., Yagi, T., & Noma, S. (2008) · International Journal of Cardiology · doi:10.1016/j.ijcard.2008.11.053 · Cited by 12
“A variety of lipid disorders based on lipoprotein abnormalities, including elevated plasma triglyceride and apoprotein B, increased small LDL particles, and a reduced level of HDLC, is observed in the metabolic syndrome [24,25].”
Background
Synthesis, characterization, and efficacy evaluation of a new anti-diabetic vanadyl(II) thiamine hydrochloride complex in streptozotocin-induced diabetic rats
El-Shazly, S. A., Ahmed, M. M., Ibrahim, Z. S., & Refat, M. S. E.-D. (2015) · International Journal of Immunopathology and Pharmacology · doi:10.1177/0394632015576036 · Cited by 11
Recomendations on non-pharmacological interventions in women with PCOS to reduce body weight and improve metabolic disorders [Zalecenia dotyczące postępowania niefarmakologicznego u kobiet z PCOS celem zmniejszenia masy ciała i poprawy zaburzeń metabolicznych]
Dutkowska, A., Konieczna, A., Breska-Kruszewska, J., Krzyczkowska-Sendrakowska, M., Kowalska, I., & Rachoń, D. (2019) · Endokrynologia Polska · doi:10.5603/ep.a2019.0006 · Cited by 14
CRP/HDL–C and Monocyte/HDL-C ratios as Predictors of Metabolic Syndrome in Patients With Type 2 Diabetes Mellitus
Đešević, M., Hasić, S., Lepara, O., Jahić, R., Kurtović, A., & Fajkić, A. (2023) · Acta Informatica Medica · doi:10.5455/aim.2023.31.254-259 · Cited by 10
“…irregularities in lipid metabolism inherent for T2DM and MetS, obesity in both groups of patients is accompanied by an increase in low-density lipid (LDL) and a decrease in high-density lipid (HDL), affecting a primary endothelial structure for the development of atherosclerotic changes (8).”
Background
A Randomized, Double-Blind Study of Fenofibric Acid Plus Rosuvastatin Compared With Rosuvastatin Alone in Stage 3 Chronic Kidney Disease
Weinstein, D. L., Williams, L. A., Carlson, D. M., Kelly, M. T., Burns, K. M., Setze, C. M., Lele, A., & Stolzenbach, J. C. (2013) · Clinical Therapeutics · doi:10.1016/j.clinthera.2013.06.013 · Cited by 12
Effect of Rhodiola rosea Rhizomes and Punica granatum Fruit Peel on the Metabolic Processes and Physiological Activity of Rats Fed with Excessive Fat Diet
Lieshchova, M. A., & Brygadyrenko, V. V. (2023) · Food Technology and Biotechnology · doi:10.17113/ftb.61.02.23.7913 · Cited by 11
“Brunzell and Ayyobi (39) and Rios et al.”
Background
Clinical use of thiazolidinediones: recommendations
Abrahamson, M. J. (2003) · The American Journal of Medicine · doi:10.1016/j.amjmed.2003.08.016 · Cited by 10
Effects of fluvastatin slow-release (xl 80 mg) versus simvastatin (20 mg) on the lipid triad in patients with type 2 diabetes
Bevilacqua, M. T., Righini, V., Barrella, M., Vago, T., Chebat, E., & Dominguez, L. J. (2005) · Advances in Therapy · doi:10.1007/bf02849947 · Cited by 10
Diretriz Brasileira de Dislipidemias e Prevenção da Aterosclerose – 2025
Rached, F. H., Miname, M. H., Rocha, V. Z., Zimerman, A., Cesena, F. Y., Sposito, A. C., Santos, R. D., Behr, P. E. B., Bianco, H. T., Alves, R. J., et al. (2025) · Arquivos Brasileiros de Cardiologia · doi:10.36660/abc.20250640 · Cited by 42
One-Year Efficacy and Safety of Rosuvastatin + Fenofibric Acid Combination Therapy in Patients with Mixed Dyslipidemia
Ferdinand, K. C., Davidson, M. H., Kelly, M. T., & Setze, C. M. (2012) · American Journal of Cardiovascular Drugs · doi:10.2165/11597940-000000000-00000 · Cited by 9
“Mixed dyslipidemia is characterized by elevated triglycerides (TG), increased serum levels of apolipoprotein B (ApoB), and low levels of high-density lipoprotein cholesterol (HDL-C), particularly the HDL2-C fraction, with or without increased levels of low-density lipoprotein cholesterol (LDL-C).([1-3]) In addition, c…”
Glucose and Low-Density Lipoprotein Cholesterol Lowering in Elderly Patients with Type 2 Diabetes
Marrs, J. C. (2012) · Drugs & Aging · doi:10.2165/11599290-000000000-00000 · Cited by 9
“Hyperlipidaemia in patients with type 2 diabetes is associated with high atherogenic risk and is characterized by elevated triglyceride levels, low high-density lipoprotein cholesterol (HDL-C) levels, and a shift towards small, dense, low-density lipoprotein particles.([6,8-10]) Although low-density lipoprotein choles…”
Background
Tratamiento de la hipertrigliceridemia: fibratos frente a ácidos grasos omega-3
Ros, E., & Laguna, J. C. (2006) · Revista Española de Cardiología Suplementos · doi:10.1016/s1131-3587(06)74826-9 · Cited by 9
Elevated Membrane Cholesterol Disrupts Lysosomal Degradation to Induce β-Amyloid Accumulation
Takeuchi, S., Ueda, N., Suzuki, K., Shimozawa, N., Yasutomi, Y., & Kimura, N. (2018) · American Journal Of Pathology · doi:10.1016/j.ajpath.2018.10.011 · Cited by 9
Genistein effectiveness in improvement of glucose and lipid metabolism and homocysteine levels: A systematic review and meta-analysis
Braxas, H., Musazadeh, V., Zarezadeh, M., & Ostadrahimi, A. (2023) · Journal of Functional Foods · doi:10.1016/j.jff.2023.105433 · Cited by 8
Obesidad, dislipemia y síndrome metabólico
Fernández, E. L., Rubio, B. O., Martínez, C. B., & Laclaustra, M. (2005) · Revista Española de Cardiología Suplementos · doi:10.1016/s1131-3587(05)74117-0 · Cited by 8
Associations between apolipoprotein CIII concentrations and microalbuminuria in type 2 diabetes
Hu, Z., Ren, L., Wang, C., Liu, B., & Song, G. (2014) · Experimental and Therapeutic Medicine · doi:10.3892/etm.2014.1830 · Cited by 8
“The high TG levels in turn can alter the composition of LDL-C and HDL-C, making these lipid particles more atherogenic (23).”
Effects of orlistat on serum androgen levels among iranian obese women with polycystic ovarian syndrome
Salehpour, S., Hosseini, S., Nazari, L., Saharkhiz, N., & Zademodarres, S. (2018) · JBRA · doi:10.5935/1518-0557.20180033 · Cited by 8
Obese First-Degree Relatives of Patients with Type 2 Diabetes with Elevated Triglyceride Levels Exhibit Increased β-Cell Function
Torres‐Rasgado, E., Porchia, L. M., Ruiz‐Vivanco, G., González-Mejía, M. E., Báez-Duarte, B. G., Pulido‐Perez, P., Rivera, A., Romero, J. R., & Pérez-Fuentes, R. (2014) · Metabolic Syndrome and Related Disorders · doi:10.1089/met.2014.0095 · Cited by 7
“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…”
The Metabolic Syndrome
Ruderman, N. B., & Shulman, G. I. (2010) · Elsevier eBooks · doi:10.1016/b978-1-4160-5583-9.00044-7 · Cited by 7
Metabolic Syndrome and its Impact on Cardiovascular Diseases
Edla, N. K. J. P. S. (2014) · Journal of Metabolic Syndrome · doi:10.4172/2167-0943.1000142 · Cited by 7
“Weight loss in obese individuals has been associated with a marked reduction in visceral fat and in turn a reduction in FFA levels leading to improved insulin sensitivity [11,12].”
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)
DOI: 10.1016/j.amjmed.2003.08.011
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
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: The American Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › 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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Dyslipidemia in the metabolic syndrome and type 2 diabetes mellitus.

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