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Interaction between Glucose and Lipid Metabolism: More than Diabetic Dyslipidemia
Open accessAbstract
Glucose and lipid metabolism are linked to each other in many ways. The most important clinical manifestation of this interaction is diabetic dyslipidemia, characterized by elevated triglycerides, low high density lipoprotein cholesterol (HDL-C), and predominance of small-dense LDL particles. However, in the last decade we have learned that the interaction is much more complex. Hypertriglyceridemia and low HDL-C cannot only be the consequence but also the cause of a disturbed glucose metabolism. Furthermore, it is now well established that statins are associated with a small but significant increase in the risk for new onset diabetes. The underlying mechanisms are not completely understood but modulation of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG CoA)-reductase may play a central role as genetic data indicate that mutations resulting in lower HMG CoA-reductase activity are also associated with obesity, higher glucose concentrations and diabetes. Very interestingly, this statin induced increased risk for new onset type 2 diabetes is not detectable in subjects with familial hypercholesterolemia. Furthermore, patients with familial hypercholesterolemia seem to have a lower risk for type 2 diabetes, a phenomenon which seems to be dose-dependent (the higher the low density lipoprotein cholesterol, the lower the risk). Whether there is also an interaction between lipoprotein(a) and diabetes is still a matter of debate.
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![Fig. 2 Animal studies indicate that knock-out and overexpression of apolipoprotein A1 (apoA1) affect many metabolic pathways related to diabetes development [21]. Whether the results observed in rodents are also valid in humans is unknown. HDL, high density lipoprotein; HbA1c, glycosylated hemoglobin.](/paper-figures/9abc4b829b6e49e98c1b56a50c372825/interaction-between-glucose-and-lipid-metabolism-more-than-diabetic-dyslipidemia-figure-2.jpg)
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“Low HDL-C levels are also associated with systemic inflammation, e.g. with cigarette smoking, chronic inflammatory diseases or chronic kidney disease (Fig. 3) [45, 46].”
From HDL cholesterol: reappraisal of its clinical relevance (2017) · cites this paper as [45]
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Metadata
- Authors
- Parhofer, K. G.
- Affiliations
- Ludwig-Maximilians-Universität München (DE)
- Corresponding author
- Parhofer, Klaus G.
- ORCID
- Parhofer, Klaus G.
- Venue
- Diabetes & Metabolism Journal
- Publisher
- Korean Diabetes Association
- Published
- 2015
- Volume
- 39
- Issue
- 5
- Pages
- 353
- ISSN
- 2233-6079 (ISSN-L)
- 2233-6087
- PMC
- PMC4641964
- OpenAlex
- W2114340826
- Cited by
- 458
- References
- 52
- Citations by year
- 2026: 29 · 2025: 61 · 2024: 62 · 2023: 58 · 2022: 48 · 2021: 64 · 2020: 37 · 2019: 33 · 2018: 28 · 2017: 21 · 2016: 16
- FWCI
- 3.28
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Diabetes & Metabolism Journal (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Keywords
- diabetic dyslipidemia, hypertriglyceridemia, low HDL cholesterol, small dense LDL, statin-induced diabetes, HMG-CoA reductase, type 2 diabetes, familial hypercholesterolemia, LDL cholesterol, lipoprotein(a), obesity
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