title: Early-onset type 2 diabetes: higher burden of atherogenic apolipoprotein particles during statin treatment.
abstract: OBJECTIVE
  To determine the burden of atherogenic apolipoprotein particles in early-onset type 2 diabetes (T2D) compared to those with later-onset disease during statin treatment.
  
  
  METHODS
  Early and later-onset T2D was defined as current age below and above 40 years respectively. Conventional lipid profile, LDL, non-HDL cholesterol, apolipoprotein B and A1 were determined in those without cardiovascular disease treated with simvastatin to achieve LDL cholesterol <2 mmol/l.
  
  
  RESULTS
  Fifty subjects were recruited (early-onset n=24 and later-onset n=26). The mean age was 34.5 and 59.6 years and mean age of diagnosis was 29.1 and 49.1 years for early and later-onset T2D respectively. Obesity, dyslipidaemia, microalbuminuria, glycaemic control and diabetes complication burden were similar in both cohorts. Early-onset subjects received non-significantly higher simvastatin dose (37.5 vs. 31.9 mg daily, p=NS). On-treatment LDL cholesterol was similar in both cohorts (early vs. later-onset; 2.12 vs. 1.97 mmol/l, p=NS). Fasting triglyceride, non-HDL, apo B and B/A1 ratio were significantly higher in early-onset cohort. There was no difference in apo A1, HDL and total cholesterol/HDL ratio. Apo B level remained significantly higher among early-onset subjects after adjustment for insulin treatment. Lower current age and age of diagnosis were significant predictors of higher apo B level.
  
  
  CONCLUSIONS
  The burden of atherogenic apolipoprotein particles was greater in early-onset T2D despite adequate statin treatment indicating an adverse phenotype for vascular disease.
authors: Diabetes Centre, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK. soon_song@hotmail.com
authors: S H
authors: SH
authors: Song
authors: T A
authors: TA
authors: Gray
mesh_terms: D000328:Adult; D017668:Age of Onset; D001053:Apolipoproteins / Q000032:analysis / Q000378:metabolism; D050197:Atherosclerosis / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism; D008078:Cholesterol, LDL / Q000032:analysis / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D016903:Drug Monitoring / Q000379:methods; D050171:Dyslipidemias / Q000150:complications / Q000188:drug therapy / Q000378:metabolism; D015340:Epidemiologic Research Design; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000493:pharmacokinetics; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D050356:Lipid Metabolism / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012307:Risk Factors
chemical_list: D001053:Apolipoproteins; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; D007328:Insulin