title: Associations between intensive diabetes therapy and NMR-determined lipoprotein subclass profiles in type 1 diabetes.
abstract: Our objective is to define differences in circulating lipoprotein subclasses between intensive versus conventional management of type 1 diabetes during the randomization phase of the Diabetes Control and Complications Trial (DCCT). NMR-determined lipoprotein subclass profiles (NMR-LSPs), which estimate molar subclass concentrations and mean particle diameters, were determined in 1,294 DCCT subjects after a median of 5 years (interquartile range: 4-6 years) of randomization to intensive or conventional diabetes management. In cross-sectional analyses, we compared standard lipids and NMR-LSPs between treatment groups. Standard total, LDL, and HDL cholesterol levels were similar between randomization groups, while triglyceride levels were lower in the intensively treated group. NMR-LSPs showed that intensive therapy was associated with larger LDL diameter (20.7 vs. 20.6 nm, P = 0.01) and lower levels of small LDL (median: 465 vs. 552 nmol/l, P = 0.007), total IDL/LDL (mean: 1,000 vs. 1,053 nmol/l, P = 0.01), and small HDL (mean: 17.3 vs. 18.6 μmol/l, P < 0.0001), the latter accounting for reduced total HDL (mean: 33.8 vs. 34.8 μmol/l, P = 0.01). In conclusion, intensive diabetes therapy was associated with potentially favorable changes in LDL and HDL subclasses in sera. Further research will determine whether these changes contribute to the beneficial effects of intensive diabetes management on vascular complications.
authors.affiliation: Department of Biostatistics and Epidemiology University of Oklahoma Health Sciences Center, Oklahoma City, OK.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Camperdown, Sydney, NSW, Australia Centre for Experimental Medicine, Queen's University of Belfast, Northern Ireland, UK.
authors.forename: Alicia J
authors.initials: AJ
authors.lastname: Jenkins
authors.affiliation: Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK.
authors.forename: Arpita
authors.initials: A
authors.lastname: Basu
authors.affiliation: Department of Biostatistics and Epidemiology University of Oklahoma Health Sciences Center, Oklahoma City, OK.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Stoner
authors.affiliation: Division of Endocrinology, Medical University of South Carolina, Charleston, SC Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC.
authors.forename: Maria F
authors.initials: MF
authors.lastname: Lopes-Virella
authors.affiliation: Division of Endocrinology, Medical University of South Carolina, Charleston, SC Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Klein
authors.affiliation: Centre for Experimental Medicine, Queen's University of Belfast, Northern Ireland, UK Section of Endocrinology and Diabetes, University of Oklahoma Health Sciences Center, Oklahoma City, OK t.lyons@qub.ac.uk.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Lyons
mesh_terms: D000293:Adolescent; D000328:Adult; D002784:Cholesterol / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D008075:Lipoproteins, HDL / Q000097:blood* / Q000737:chemistry / Q000187:drug effects; D008077:Lipoproteins, LDL / Q000097:blood* / Q000737:chemistry / Q000187:drug effects; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D016032:Randomized Controlled Trials as Topic
chemical_list: D007328:Insulin; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D002784:Cholesterol
keywords: atherosclerosis; clinical trial; dyslipidemia; high density lipoprotein; intensive diabetes treatment; low density lipoprotein; nuclear magnetic resonance