Endothelial lipase and reverse cholesterol transport in type 2 diabetes mellitus.
Aims/Introduction:  Endothelial lipase (EL) plays an important role in high-density lipoprotein (HDL) metabolism and experimental data suggest that EL might be proatherogenic. We have investigated whether serum EL concentration is associated with changes in serum capacity to induce cholesterol efflux and arterial stiffness in type 2 diabetes.


METHODS
Serum EL was assayed by ELISA in 172 diabetic patients and 175 controls. The ability of serum to induce cholesterol efflux was measured using a cell culture system and arterial stiffness was determined by measuring pulse wave velocity (PWV) between carotid and femoral arteries.


RESULTS
Diabetic patients had significantly higher C-reactive protein (CRP) and EL (27.7 ± 16.6 ng/mL vs 24.0 ± 11.3, P < 0.05). Cholesterol efflux to serum mediated through scavenger receptor class B type I was impaired (15.1 ± 2.5%vs 16.7 ± 3.1, respectively, P < 0.01). In controls, serum EL correlated with cholesterol efflux to serum (r = -0.16, P = 0.025), but only a trend was seen in the diabetic patients. Linear regression showed that in controls, HDL, serum EL and waist circumference were major independent determinants of cholesterol efflux; whereas in the diabetic cohort, the major independent determinants of cholesterol efflux were HDL, CRP and age. PWV was increased in the diabetic patients (P < 0.01), but no association between serum EL and PWV was seen in either groups.


CONCLUSIONS
Serum EL was increased in diabetic patients, but impaired serum capacity to induce cholesterol efflux in these patients was mainly related to low HDL and subclinical inflammation. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2010.00016.x, 2010).
Department of Medicine, University of Hong Kong, Hong Kong.
Sammy Wm
SW
Shiu
Department of Medicine, University of Hong Kong, Hong Kong.
Huali
H
Zhou
Department of Medicine, University of Hong Kong, Hong Kong.
Ying
Y
Wong
Department of Medicine, University of Hong Kong, Hong Kong.
Kathryn Cb
KC
Tan
Cholesterol efflux; Endothelial lipase; Reverse cholesterol transport