HbA1c negatively correlates with LCAT activity in type 2 diabetes.
OBJECTIVE
Abnormal high-density lipoproteins (HDL) metabolism is a major cardiovascular risk factor in type 2 diabetes mellitus (DM2). Lecithin:cholesterol acyltransferase (LCAT) increases HDL size by transferring 2-acyl groups from lecithin or phosphatidylethanolamine to unesterified cholesterol. The purpose of this study was to determine the independent correlates of LCAT activity in DM2 patients.


METHODS
A total of 45 (male: 20) consecutive adult DM2 patients aging 50.0+/-7.0 years (range: 40-64 years) with a median diabetes duration of 4 years (range: 2-18) were studied. Exclusion criteria were: smoking, positive history of cardiovascular, thyroid, renal or liver disease, pregnancy, treatment with metformin, insulin, lipid lowering drugs, angiotensin-converting enzyme inhibitors, aspirin or antioxidant supplements. Univariate and multivariate analyses were performed.


RESULTS
From a comprehensive list of variables studied, only HbA1c (rho=-0.951) and oxidized LDL (rho=-0.779) had statistically significant correlation with LCAT activity (p<0.001). These two variables were themselves strongly correlated to each other (rho=0.809, p<0.001). To eliminate potential confounding effects, we performed multivariate analysis, where HbA1c emerged as a strong independent predictor of LCAT activity (adjusted OR=-0.928, p<0.001).


CONCLUSIONS
Glycemia-induced glycation of HDL decreases LCAT activity. The fact that HbA1c is an accurate measure of glycation and can therefore reflect glycated HDL levels explains the association found in the present study. In conclusion, HbA1c provides an easy-to-assess, accurate measure of LCAT activity in DM2.
Nakhjavani
Manouchehr
M
Endocrinology and Metabolism Research Center, Vali-Asr Hospital, Imam Khomeini Medical Complex, School of Medicine, Medical Sciences/University of Tehran, Tehran, Iran. nakhjavanim@sina.tums.ac.ir
Esteghamati
Alireza
A
Esfahanian
Fatemeh
F
Ghanei
Azam
A
Rashidi
Armin
A
Hashemi
Saeideh
S
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000201:enzymology / Q000503:physiopathology; D005215:Fasting; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008055:Lipids / Q000097:blood; D008875:Middle Aged; D015999:Multivariate Analysis; D018579:Patient Selection; D007862:Phosphatidylcholine-Sterol O-Acyltransferase / Q000097:blood*
D001786:Blood Glucose; D002784:Cholesterol; D006442:Glycated Hemoglobin; D008055:Lipids; D007862:Phosphatidylcholine-Sterol O-Acyltransferase