The mixed benefit of low lipoprotein(a) in type 2 diabetes
Abstract Background Lipoprotein(a) (Lp(a)), a variant low-density lipoprotein (LDL), is a major genetic risk factor for cardiovascular disease. It is unknown whether an inverse relationship exists between Lp(a) and β-cell function (BCF), as for LDL-cholesterol (LDL-C) lowering by statins. We therefo...
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| Format: | Article |
| Language: | English |
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BMC
2017-09-01
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| Series: | Lipids in Health and Disease |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12944-017-0564-9 |
| _version_ | 1818033127863353344 |
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| author | Michel P. Hermans Sylvie A. Ahn Michel F. Rousseau |
| author_facet | Michel P. Hermans Sylvie A. Ahn Michel F. Rousseau |
| author_sort | Michel P. Hermans |
| collection | DOAJ |
| description | Abstract Background Lipoprotein(a) (Lp(a)), a variant low-density lipoprotein (LDL), is a major genetic risk factor for cardiovascular disease. It is unknown whether an inverse relationship exists between Lp(a) and β-cell function (BCF), as for LDL-cholesterol (LDL-C) lowering by statins. We therefore assessedthe cardiometabolic phenotype of 340 men with type 2 diabetes mellitus (T2DM) in relation to Lp(a), focusing on BCF and hyperbolic product [BxS], which adjusts BCF to insulin sensitivity and secretion. Methods Two groups were analyzed according to Lp(a) quartiles (Q): a (very-)low Lp(a) (Q1;n = 85) vs a normal-to-high Lp(a) group (Q2-Q4;n = 255). Results In the overall cohort, mean Lp(a) was 52 nmol.L−1. Median Lp(a) was 6 nmol.L−1 (Q1) vs 38 nmol.L−1 (Q2-Q4). There were no differences between groups regarding age; education; diabetes duration; body mass index; body composition and smoking. Q1 had significantly worse glycemic control, higher systolic blood pressure, more severe metabolic syndrome, and more frequent hepatic steatosis. Insulin sensitivity was significantly lower (− 37%) in Q1, who also had lesser hyperbolic product (− 27%), and higher [BxS] loss rate (+ 15%). Q1 also had higher frequency (+31%) and severity (+20%) of atherogenic dyslipidemia. Microangiopathy and neuropathy were higher in Q1 (+ 34% and + 48%, respectively), whereas Q2-Q4 patients had increased macroangiopathy (+ 51%) and coronary artery disease (CAD; + 94%). Conclusions Low Lp(a) appears both beneficial and unhealthy in T2DM. It is associated with unfavourable cardiometabolic phenotype, lesser BCF, poorer glycemic control, and increased microvascular damage despite being linked to markedly reduced CAD, suggesting that Lp(a)-related vascular risk) follows a J-shaped curve. |
| first_indexed | 2024-12-10T06:18:20Z |
| format | Article |
| id | doaj.art-9b0e5a3086284bf095392510c27403e3 |
| institution | Directory Open Access Journal |
| issn | 1476-511X |
| language | English |
| last_indexed | 2024-12-10T06:18:20Z |
| publishDate | 2017-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Lipids in Health and Disease |
| spelling | doaj.art-9b0e5a3086284bf095392510c27403e32022-12-22T01:59:24ZengBMCLipids in Health and Disease1476-511X2017-09-011611810.1186/s12944-017-0564-9The mixed benefit of low lipoprotein(a) in type 2 diabetesMichel P. Hermans0Sylvie A. Ahn1Michel F. Rousseau2Division of Endocrinology and Nutrition, Cliniques universitaires St-Luc and Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de LouvainDivision of Cardiology, Cliniques universitaires St-Luc and Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de LouvainDivision of Cardiology, Cliniques universitaires St-Luc and Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de LouvainAbstract Background Lipoprotein(a) (Lp(a)), a variant low-density lipoprotein (LDL), is a major genetic risk factor for cardiovascular disease. It is unknown whether an inverse relationship exists between Lp(a) and β-cell function (BCF), as for LDL-cholesterol (LDL-C) lowering by statins. We therefore assessedthe cardiometabolic phenotype of 340 men with type 2 diabetes mellitus (T2DM) in relation to Lp(a), focusing on BCF and hyperbolic product [BxS], which adjusts BCF to insulin sensitivity and secretion. Methods Two groups were analyzed according to Lp(a) quartiles (Q): a (very-)low Lp(a) (Q1;n = 85) vs a normal-to-high Lp(a) group (Q2-Q4;n = 255). Results In the overall cohort, mean Lp(a) was 52 nmol.L−1. Median Lp(a) was 6 nmol.L−1 (Q1) vs 38 nmol.L−1 (Q2-Q4). There were no differences between groups regarding age; education; diabetes duration; body mass index; body composition and smoking. Q1 had significantly worse glycemic control, higher systolic blood pressure, more severe metabolic syndrome, and more frequent hepatic steatosis. Insulin sensitivity was significantly lower (− 37%) in Q1, who also had lesser hyperbolic product (− 27%), and higher [BxS] loss rate (+ 15%). Q1 also had higher frequency (+31%) and severity (+20%) of atherogenic dyslipidemia. Microangiopathy and neuropathy were higher in Q1 (+ 34% and + 48%, respectively), whereas Q2-Q4 patients had increased macroangiopathy (+ 51%) and coronary artery disease (CAD; + 94%). Conclusions Low Lp(a) appears both beneficial and unhealthy in T2DM. It is associated with unfavourable cardiometabolic phenotype, lesser BCF, poorer glycemic control, and increased microvascular damage despite being linked to markedly reduced CAD, suggesting that Lp(a)-related vascular risk) follows a J-shaped curve.http://link.springer.com/article/10.1186/s12944-017-0564-9Lipoprotein(a)DiabetesInsulin secretionMicrovascularAtherogenic dyslipidemiaCAD |
| spellingShingle | Michel P. Hermans Sylvie A. Ahn Michel F. Rousseau The mixed benefit of low lipoprotein(a) in type 2 diabetes Lipids in Health and Disease Lipoprotein(a) Diabetes Insulin secretion Microvascular Atherogenic dyslipidemia CAD |
| title | The mixed benefit of low lipoprotein(a) in type 2 diabetes |
| title_full | The mixed benefit of low lipoprotein(a) in type 2 diabetes |
| title_fullStr | The mixed benefit of low lipoprotein(a) in type 2 diabetes |
| title_full_unstemmed | The mixed benefit of low lipoprotein(a) in type 2 diabetes |
| title_short | The mixed benefit of low lipoprotein(a) in type 2 diabetes |
| title_sort | mixed benefit of low lipoprotein a in type 2 diabetes |
| topic | Lipoprotein(a) Diabetes Insulin secretion Microvascular Atherogenic dyslipidemia CAD |
| url | http://link.springer.com/article/10.1186/s12944-017-0564-9 |
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