Increased transvascular lipoprotein transport in diabetes: association with albuminuria and systolic hypertension.
BACKGROUND
Diabetes is associated with a highly increased risk of atherosclerosis, especially if hypertension or albuminuria is present.


OBJECTIVE
We hypothesized that the increased transvascular lipoprotein transport in diabetes may be further accelerated if hypertension or albuminuria is present, possibly explaining increased intimal lipoprotein accumulation and thus atherosclerosis.


METHODS
The study was cross-sectional and was performed in 1999-2002.


METHODS
The study took place in the referral center.


METHODS
The patients included 60 with diabetes mellitus (27 with type 1 diabetes and 33 with type 2 diabetes) and 42 healthy controls. All were randomly recruited.


METHODS
We used an in vivo method for measurement of transvascular transport of low-density lipoprotein (LDL). Autologous 131I-LDL was reinjected iv, and the 1-h fractional escape rate was taken as an index of transvascular transport.


RESULTS
Transvascular LDL transport was 1.8 (1.6-2.0), 2.3 (2.0-2.6), and 2.6 (1.3-4.0)%/[h x (liter/m2)] in healthy controls, diabetic controls, and diabetes patients with systolic hypertension or albuminuria, respectively (P = 0.013; F = 4.5; df =2; ANOVA). These differences most likely were not caused by altered hepatic LDL receptor expression, glycosylation of LDL, small LDL size, or medicine use.


CONCLUSIONS
Transvascular LDL transport is increased in patients with diabetes mellitus, especially if systolic hypertension or albuminuria is present. Accordingly, lipoprotein flux into the arterial wall could be increased in these patients, possibly explaining accelerated development of atherosclerosis.
Jensen
Jan Skov
JS
Department of Nephrology and Endocrinology P, The National University Hospital, Copenhagen, Denmark. jsje@c.dk
Feldt-Rasmussen
Bo
B
Borch-Johnsen
Knut
K
Jensen
Kurt Svarre
KS
Nordestgaard
Børge Grønne
BG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000150:complications / Q000453:epidemiology / Q000378:metabolism*; D001161:Arteriosclerosis / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism; D001794:Blood Pressure; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000453:epidemiology / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology / Q000378:metabolism*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010316:Particle Size; D011973:Receptors, LDL / Q000737:chemistry / Q000378:metabolism*; D012307:Risk Factors
D011973:Receptors, LDL