Lipid transfer to HDL in type-2 diabetic patients: associations with microalbuminuria, statin, and insulin.
BACKGROUND
Type-2 diabetes mellitus (T2DM) is an isolated risk factor for coronary artery disease, especially when associated with microalbuminuria (MA). Structural and functional changes in lipoproteins have not yet been fully elucidated in this context.


OBJECTIVE
To assess lipid transfer (T) to HDL in type-2 diabetic patients and its association with microalbuminuria and treatment with statins or insulin.


METHODS
Thirty-three patients with type-2 diabetes mellitus and 34 age-matched control subjects were studied. A synthetic cholesterol-rich nanoemulsion radiolabeled with (3)H- triglycerides (TG) and 14C-free cholesterol (FC) or (3)H- cholesteryl ester (CE) and 14C-phospholipids (PL) was incubated with plasma. Both the nanoemulsion and lipoproteins were precipitated, except for HDL, which was counted for radioactivity.


RESULTS
PLT (%) was higher in the T2DM group than in the control group (25.2 +/- 3.2 and 19.7 +/- 3.2 respectively; p < 0.001), as was free cholesterol (% FC): 9.1 +/- 2.7 and 6.3 +/- 1.5 respectively; p < 0.001. The diagnosis of microalbuminuria (MA) was not associated with changes in lipid transfers. Insulin therapy was associated with lower PLT rates: 23.5 +/- 2.1 versus 26.1 +/- 3.3; p = 0.018. Statin therapy, in turn, was associated with a drop in all lipid transfers - CET 3.5 +/- 0.9; PLT: 23.8 +/- 2.0; TGT: 3.9 +/- 0.8; FCT: 7.4 +/- 1.3 - as compared to the group that was not on statin therapy (CET: 5.9 +/- 2.4; PLT: 26.9 +/- 3.6; TGT: 6.4 +/- 2.2; FCT: 11.1 +/- 2.6).


CONCLUSIONS
Type-2 diabetes mellitus increased lipid transfer to HDL particles, whereas statin therapy decreased all lipid transfers. The presence of MA was not associated with changes in lipid transfer.
Instituto do Coração (InCor), Hospital do Coração, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brasil. gilsonfilho@cardiol.br
Gilson Soares
GS
Feitosa-Filho
Talita de Mattos
Tde M
Seydell
Alina Coutinho Rodrigues
AC
Feitosa
Raul Cavalcante
RC
Maranhão
José Antônio Franchini
JA
Ramires
D000328:Adult; D000419:Albuminuria / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism; D015992:Body Mass Index; D016022:Case-Control Studies; D053480:Cholesterol Ester Transfer Proteins / Q000187:drug effects / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008075:Lipoproteins, HDL / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D049294:Phospholipid Transfer Proteins / Q000378:metabolism
D053480:Cholesterol Ester Transfer Proteins; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; D007328:Insulin; D008075:Lipoproteins, HDL; D049294:Phospholipid Transfer Proteins