Abstract
Hypercholesterolemia is an important atherogenic risk factor in type II diabetes,
and although coronary artery disease (CAD) is frequent in these patients, it is not
known whether cholesterol and lipoprotein metabolism differ in patients with (CAD
+) and without CAD (CAD −). Our aim was to study cholesterol metabolism and lipoprotein
kinetics in mildly hypercholesterolemic type II diabetic men with and without CAD
under similar dietary conditions. Despite similar serum and lipoprotein cholesterol
levels, and kinetics of total and dense LDL apo B, light and dense LDL particles were
cholesterol-enriched only in CAD + subjects. Apolipoprotein A-II level was lower in
CAD + than in CAD − subjects (27.1 ± 0.7 versus 30.9 ± 0.7 mg/dl, P < 0.05), HDL cholesterol and apolipoprotein A-I kinetics were similar in the two
groups. Cholesterol absorption was significantly higher in the CAD + versus CAD −
subjects (27 ± 2 versus 20 ± 3%, P < 0.05). In multiple logistic stepwise regression analysis with CAD as the dependent
variable, cholesterol absorption efficiency and serum plant sterol/cholesterol proportions
were the only variables significantly associated with CAD. In conclusion, in mildly
hypercholesterolemic type II diabetic patients, the only metabolic parameter differentiating
CAD patients from non-CAD ones was significantly higher cholesterol absorption efficiency
in the coronary patients, which could contribute to the finding of the atherogenic
cholesterol-rich dense LDL subfraction in these patients. Thus, a treatment causing
cholesterol malabsorption by sitostanol alone or in combination with statin could
be beneficial in these patients.
Keywords
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References
- Diabetes and cardiovascular risk factors: the Framingham study.Circulation. 1979; 59: 8-13
Stamler J, Wentworth D, Neaton J, Schoenberger JA, Feigal D for the MRFIT Research Group. Diabetes and risk of coronary, cardiovascular, and all causes mortality: findings for 356 000 men screened by the Multiple Risk Factor Intervention Trial (MRFIT). Circulation 1984;70(suppl 2):II-161.
- Five-year incidence of coronary heart disease related to major risk factors and metabolic control in newly diagnosed non-insulin-dependent diabetes.Nutr Metab Cardiovasc Dis. 1991; 1: 135-140
- 5-year incidence of atherosclerotic vascular disease in relation to general risk factors, insulin level, and abnormalities in lipoprotein composition in non-insulin-dependent diabetic and nondiabetic subjects.Circulation. 1990; 82: 27-36
- Insulin and cardiovascular disease. Paris Prospective Study.Diabetes Care. 1991; 14: 461-469
- Dyslipidemia in type II diabetes. Implications for therapeutic intervention.Diabetes Care. 1991; 14: 1144-1159
- Lipoprotein physiology in nondiabetic and diabetic states. Relationship to atherogenesis.Diabetes Care. 1991; 14: 839-855
- Non-insulin-dependent diabetes mellitus, abnormal lipoprotein metabolism, and atherosclerosis.Metabolism. 1987; 36: 1-8
- Apolipoprotein B levels and altered lipoprotein composition in diabetes.Diabetes. 1974; 23: 827-834
- Abnormal lipoprotein composition in normolipidemic diabetic patients.Diabetes Care. 1990; 13: 792-796
- Lipoprotein compositional abnormalities and insulin resistance in type II diabetic patients with mild hyperlipidemia.Arterioscler Thromb. 1993; 13: 1046-1052
- LDL subclass phenotypes and triglyceride metabolism in non-insulin-dependent diabetes.Arterioscler Thromb. 1992; 12: 1496-1502
- Low density lipoprotein sub-class patterns and risk of myocardial infarction.J Am Med Assoc. 1988; 260: 1917-1921
- Increased superoxide production by mononuclear cells of patients with hypertriglyceridemia and diabetes.Diabetes. 1988; 37: 832-837
- Glycosylation of low-density lipoprotein enhances cholesteryl ester synthesis in human monocytederived macrophages.Diabetes. 1988; 37: 550-557
- Glucosylation of low-density lipoproteins to an extent comparable to that seen in diabetes slows their catabolism.Diabetes. 1984; 33: 130-134
- Cholesterol metabolism in patients with coronary heart disease.Ann Clin Res. 1971; 3: 313-322
- Coronary artery disease and bile acid synthesis in familial hypercholesterolemia.Atherosclerosis. 1987; 63: 159-166
- Overproduction of low density lipoproteins associated with coronary heart disease.Arteriosclerosis. 1983; 3: 40-46
Knuts L-R, Rastas M, Haapala P. Micro-Nutrica. Version 1.0. Helsinki:Kansaneläkelaitos, 1991.
- A simplified method for the determination of chromic oxide (Cr2O3) when used as an index substance.Science. 1952; 116: 634-635
- Evaluation of a continuous isotope feeding method for measurement of cholesterol absorption in man.J Lipid Res. 1978; 19: 967-971
- Gas-liquid chromatographic determination of fecal neutral sterols using a capillary column.Clin Chim Acta. 1982; 124: 245-248
- Quantitative isolation and gas-liquid chromatographic analysis of total dietary and fecal neutral steroids.J Lipid Res. 1965; 6: 411-424
- Quantitative isolation and gas-liquid chromatographic analysis of total fecal bile acids.J Lipid Res. 1965; 6: 397-410
Lipid and Lipoprotein Analysis. Manual of Laboratory Operations, Lipid Research Clinic Program. Washington D.C.: DHEW Publication No NIH/75-628. 1974:63–70.
- Effects of ketoconazole on cholesterol precursors and low density lipoprotein kinetics in hypercholesterolemia.J Lipid Res. 1993; 34: 59-67
- A rapid micromethod for apolipoprotein E phenotyping directly in serum.J Lipid Res. 1987; 28: 445-463
- Simultaneous determination of retinol and alpha-tocopherol in serum or plasma by liquid chromatography.Clin Chem. 1983; 29: 708-712
- Evaluation of a method for study of kinetics of autologous apolipoprotein A-I.J Lipid Res. 1991; 32: 867-875
- Efficient trace-labeling of proteins with iodine.Nature. 1958; 182: 53
- The metabolism of very low density lipoproteins..Biochim Biophys Acta. 1972; 260: 212-221
- Non-cholesterol sterols, absorption and synthesis of cholesterol and apolipoprotein A-I kinetics in a Finnish lecithin-cholesterol acyltransferase deficient family.Atherosclerosis. 1992; 95: 25-33
- The theory of tracer experiments with [131I]-labeled plasma proteins.Phys Med Biol. 1957; 2: 36-53
- Serum plant sterols and cholesterol precursors reflect cholesterol absorption and synthesis in volunteers of a randomly selected male population.Am J Epidemiol. 1990; 131: 20-31
- Intestinal cholesterol absorption efficiency in man is related to apoprotein E phenotype.J Clin Invest. 1987; 80: 578-581
- The candidate for coronary heart disease — discriminating power of biochemical hereditary and anthropometric measurements.J Am Med Assoc. 1959; 170: 149-152
- Familial occurrence of mild hyperlipoproteinaemias.Clin Genet. 1972; 3: 271-280
- Faecal fat, bile acid excretion, and body height in familial hypercholesterolaemia and hyperglyceridaemia.Scand J Clin Lab Invest. 1972; 30: 85-88
- Effect of egg cholesterol and dietary fats on plasma lipids, lipoproteins, and apoproteins of normal women consuming natural diets.J Lipid Res. 1987; 28: 518-527
- Cholesterol absorption: regulation of cholesterol synthesis and elimination and within-population variations of serum cholesterol levels.Am J Clin Nutr. 1989; 49: 629-635
- Effects of dietary cholesterol on the regulation of total body cholesterol in man.J Lipid Res. 1971; 12: 233-247
- Dietary cholesterol and ischaemic heart disease.Lancet. 1989; I: 1177-1179
Miettinen TA, Strandberg T, Vanhanen H, Gylling H, for the 4S Group. Non-cholesterol serum sterols in Scandinavian Simvastatin Survival Study. XII International Symposium on Drugs Affecting Lipid Metabolism, November 7–10, 1995 Houston Texas. Abstracts, p. 34.
- Serum cholesterol and cholesterol and lipoprotein metabolism in hypercholesterolaemic NIDDM patients before and during sitostanol ester-margarine treatment.Diabetologia. 1994; 37: 773-780
Article info
Publication history
Accepted:
June 20,
1996
Received in revised form:
June 17,
1996
Received:
January 22,
1996
Identification
Copyright
© 1996 Elsevier Science Ireland Ltd. Published by Elsevier Inc. All rights reserved.
