Dyslipidemia in Type 1 Diabetes: A Masked Danger

Vergès, Bruno

doi:10.1016/j.tem.2020.01.015

Cited by 82 publications

(87 citation statements)

References 100 publications

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“…Moreover, a positive relationship between cardiac hypertrophy and plasma insulin concentration has been reported [30]. An interesting result of our study is that patients in the higher insulin dose group showed significantly elevated level of triglycerides [31]. It has been reported that in the setting of hyperglycemia, insulin resistance and hypertriglyceridemia, the myocardium ability to use glucose as an energy source is impaired and a switch to use free fatty acids occurs [32].…”

Section: Plos Onesupporting

confidence: 60%

Echocardiographic parameters according to insulin dose in young patients affected by type 1 diabetes

et al. 2020

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Insulin dose has been found to associate to several cardiometabolic risk factors in type 1 diabetes. Changes over time in body weight and composition may partly explain this association. However, no data are available on the relationship between insulin dose and echocardiographic parameters of both systolic and diastolic function in type 1 diabetes. Therefore, the aim of the present study was to examine systolic and diastolic echocardiographic parameters in relation to insulin dose in young patients with type 1 diabetes. The study was carried out on 93 consecutive outpatients with type 1 diabetes with a mean age of 32.8 ± 9.8 years. All patients were examined with a transthoracic echocardiography. Clinical and laboratory data were collected. The median value of daily insulin dose was used to categorized patients in two groups: high and low insulin dose group. Patients belonging to the high insulin dose group showed higher levels of cardiometabolic risk factors such as BMI, triglycerides and TG/HDL cholesterol ratio. Indexes of both systolic and diastolic function were similar in both groups except isovolumetric relaxation time (IVRT), that was significantly prolonged in patients of the high insulin group (94.4 ± 15.0 vs 86.7 ± 13.1 ms, p = 0.008). In the multivariate regression analysis, insulin dose was positively and significantly associated with IVRT. In this study we report an association between insulin dose and impaired active diastolic myocardial relaxation. Future studies are needed to further explore this observation.

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Section: Plos Onesupporting

confidence: 60%

Echocardiographic parameters according to insulin dose in young patients affected by type 1 diabetes

et al. 2020

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“…However, most of our results were adjusted for statin treatment, and a sensitivity analysis performed in patients without lipid-lowering treatment led to similar results (either in the differences between T1DM vs. controls, between-gender differences, or in the correlations between NMR-lipoproteins and other clinical and laboratory variables). In addition, some studies have suggested that individuals with well-controlled T1DM could have lower LDL-cholesterol levels than their non-diabetic counterparts due to decreases in VLDL production or increases in LDL catabolism [53]. Since our sample of T1DM participants was fairly controlled (median HbA1c of 7.4%), this fact could partially explain our main findings.…”

Section: Strengths and Limitationsmentioning

confidence: 75%

“…[49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68] vs. 59.5 [50.7-73] mg/dL, in controls vs. T1DM, respectively…”

mentioning

confidence: 99%

Advanced lipoprotein profile disturbances in type 1 diabetes mellitus: a focus on LDL particles

Amor

Castelblanco

Hernández

et al. 2020

Cardiovasc Diabetol

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Background: Lipoprotein disturbances have been associated with increased cardiovascular disease (CVD) risk in type 1 diabetes mellitus (T1DM). We assessed the advanced lipoprotein profile in T1DM individuals, and analysed differences with non-diabetic counterparts. Methods: This cross-sectional study involved 508 adults with T1DM and 347 controls, recruited from institutions in a Mediterranean region of Spain. Conventional and advanced (assessed by nuclear magnetic resonance [NMR] spectroscopy) lipoprotein profiles were analysed. Crude and adjusted (by age, sex, statin use, body mass index and leukocyte count) comparisons were performed. Results: The median (interquartile range) age of the study participants was 45 (38-53) years, 48.2% were men. In the T1DM group, the median diabetes duration was 23 (16-31) years, and 8.1% and 40.2% of individuals had nephropathy and retinopathy, respectively. The proportion of participants with hypertension (29.5 vs. 9.2%), and statin use (45.7% vs. 8.1%) was higher in the T1DM vs. controls (p < 0.001). The T1DM group had a better conventional (all parameters, p < 0.001) and NMR-lipid profile than the control group. Thus, T1DM individuals showed lower concentrations of atherogenic lipoproteins (VLDL-particles and LDL-particles) and higher concentrations of anti-atherogenic lipoproteins (HDL-particles) vs. controls, even after adjusting for several confounders (p < 0.001 for all). While non-diabetic women had a more favourable lipid profile than non-diabetic men, women with T1DM had a similar concentration of LDL-particles compared to men with T1DM (1231 [1125-1383] vs. 1257 [1128-1383] nmol/L, p = 0.849), and a similar concentration of small-LDL-particles to non-diabetic women (672.8 [614.2-733.9] vs. 671.2 [593.5-761.4] nmol/L, respectively; p = 0.790). Finally, T1DM individuals showed higher discrepancies between NMR-LDL-particles and conventional LDLcholesterol than non-diabetic subjects (prevalence of LDL-cholesterol < 100 mg/dL & LDL-particles > 1000 nmol/L: 38 vs. 21.2%; p < 0.001). All these differences were largely unchanged in participants without lipid-lowering drugs (T1DM, n = 275; controls, n = 317).

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“…The present approach to diagnosing dyslipidaemia is based on the clinical measurement of the three main types of serum lipids, namely HDL cholesterol, LDL cholesterol and triglycerides 7 . However, since HDL‐cholesterol metabolism might be compromised in type 1 diabetes, the identification of alternative biomarkers is critically important 3–6 …”

Section: Introductionmentioning

confidence: 99%

Changes in the lipidome in type 1 diabetes following low carbohydrate diet: Post‐hoc analysis of a randomized crossover trial

Al-Sari

Schmidt

Suvitaival

et al. 2021

Endocrino Diabet & Metabol

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Aims Lipid metabolism might be compromised in type 1 diabetes, and the understanding of lipid physiology is critically important. This study aimed to compare the change in plasma lipid concentrations during carbohydrate dietary changes in individuals with type 1 diabetes and identify links to early‐stage dyslipidaemia. We hypothesized that (1) the lipidomic profiles after ingesting low or high carbohydrate diet for 12 weeks would be different; and (2) specific annotated lipid species could have significant associations with metabolic outcomes. Methods Ten adults with type 1 diabetes (mean ± SD: age 43.6 ± 13.8 years, diabetes duration 24.5 ± 13.4 years, BMI 24.9 ± 2.1 kg/m2, HbA1c 57.6 ± 2.6 mmol/mol) using insulin pumps participated in a randomized 2‐period crossover study with a 12‐week intervention period of low carbohydrate diet (< 100 g carbohydrates/day) or high carbohydrate diet (> 250 g carbohydrates/day), respectively, separated by a 12‐week washout period. A large‐scale non‐targeted lipidomics was performed with mass spectrometry in fasting plasma samples obtained before and after each diet intervention. Longitudinal lipid levels were analysed using linear mixed‐effects models. Results In total, 289 lipid species were identified from 14 major lipid classes. Comparing the two diets, 11 lipid species belonging to sphingomyelins, phosphatidylcholines and LPC(O‐16:0) were changed. All the 11 lipid species were significantly elevated during low carbohydrate diet. Two lipid species were most differentiated between diets, namely SM(d36:1) (β ± SE: 1.44 ± 0.28, FDR = 0.010) and PC(P‐36:4)/PC(O‐36:5) (β ± SE: 1.34 ± 0.25, FDR = 0.009) species. Polyunsaturated PC(35:4) was inversely associated with BMI and positively associated with HDL cholesterol (p < .001). Conclusion Lipidome‐wide outcome analysis of a randomized crossover trial of individuals with type 1 diabetes following a low carbohydrate diet showed an increase in sphingomyelins and phosphatidylcholines which are thought to reduce dyslipidaemia. The polyunsaturated phosphatidylcholine 35:4 was inversely associated with BMI and positively associated with HDL cholesterol (p < .001). Results from this study warrant for more investigation on the long‐term effect of single lipid species in type 1 diabetes.

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Dyslipidemia in Type 1 Diabetes: A Masked Danger

Cited by 82 publications

References 100 publications

Echocardiographic parameters according to insulin dose in young patients affected by type 1 diabetes

Echocardiographic parameters according to insulin dose in young patients affected by type 1 diabetes

Advanced lipoprotein profile disturbances in type 1 diabetes mellitus: a focus on LDL particles

Changes in the lipidome in type 1 diabetes following low carbohydrate diet: Post‐hoc analysis of a randomized crossover trial

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