Lipoprotein Subclasses and Cardiovascular Disease Risk in Insulin-Resistant Diabetes

Cobble, Michael; Mize, Patrick D.; Brinton, Eliot A.

doi:10.1007/978-1-4614-7554-5_2

Cited by 2 publications

(2 citation statements)

References 128 publications

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“…A dose-response relationship between the number of protective behaviours and above or below median level lipoprotein particle subclass size or concentration was also observed in multivariable logistic regression models. These results demonstrate that adopting a healthy lifestyle may be an effective approach to improve lipoprotein profiles defined by higher or lower subclass concentrations [9,32], attenuate atherogenesis, prevent CVD and chronic disease risk and promote healthy ageing.…”

Section: Discussionmentioning

confidence: 75%

Protective lifestyle behaviours and lipoprotein particle subclass profiles in a middle-to older-aged population

et al. 2020

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Background and aims: Lipoprotein particle size is associated with increased atherosclerosis and cardiovascular disease risk. Certain lifestyle behaviours may be cardioprotective. We examined lipoprotein particle size and concentration relationships with a protective lifestyle behaviour (PLB) score. Methods: This was a cross-sectional analysis of 2045 middle-to older-aged adults. Lipoprotein particle subclass size and concentrations were determined using nuclear magnetic resonance spectroscopy. Five protective behaviours included never smoking, moderate alcohol intake, moderate to vigorous physical activity, a high-quality diet (upper 40% Dietary Approaches to Stop Hypertension score) and a normal body mass index (BMI) (18.5-24.9 kg/m 2 ). Linear and logistic regression analyses tested individual protective behaviour and PLB score associations with lipoprotein subclasses. Results: Individual behaviour associations varied according to lipoprotein subclass, with normal BMI showing the greatest number of significant relationships. Logistic regression analyses revealed that subjects with the fewest number of protective behaviours had 1.4-2.8 increased odds of having less favourable lipoprotein profiles defined as above or below median level lipoprotein particle subclass size or concentration. Following additional adjustment for BMI, significant trend relationships were observed between the PLB score and large and medium very low-density lipoprotein (p = 0.001 and p < 0.001), total and smaller low-density lipoprotein (LDL) concentrations (p = 0.008 and p < 0.001), LDL size (p = 0.003) and a lipoprotein insulin resistance score (p = 0.003). Conclusions: Results show a cumulative protective effect of healthy lifestyle behaviours against an unfavourable potentially pro-atherogenic lipoprotein profile in middle-to older-aged adults, highlighting the importance of lifestyle promotion in healthy ageing.

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Section: Discussionmentioning

confidence: 75%

Protective lifestyle behaviours and lipoprotein particle subclass profiles in a middle-to older-aged population

et al. 2020

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“…LDL particle number (LDL-P) and LDL particle size better predict CVD risk than the standard LDL-C measure [25]. Given similar total LDL-C levels, greater levels of sLDL-P result in greater LDL-P. LDL-P may be particularly helpful in improving accuracy of CVD risk prediction among individuals with T2DM [26, 27]. Thus, advanced lipoprotein testing that goes beyond the standard lipid measure of LDL-C may better reflect the effects of dietary interventions on CVD risk.…”

Section: Introductionmentioning

confidence: 99%

Lipid findings from the Diabetes Education to Lower Insulin, Sugars, and Hunger (DELISH) Study

Mason¹,

Saslow

Moran³

et al. 2019

Nutr Metab (Lond)

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Background A carbohydrate-restricted (CR) diet can improve glycemic control in people with type 2 diabetes mellitus (T2DM). There are concerns, however, that the high dietary fat content of CR diets can increase low-density lipoprotein cholesterol (LDL-C), thus increasing cardiovascular disease (CVD) risk. Quantifying CVD risk associated with changes in LDL-C in the context of CR diets is complicated by the fact that LDL-C reflects heterogeneous lipids. For example, small LDL particle number (sLDL-P) is more closely associated with CVD risk than is total LDL-C, and CR diets tend to decrease the proportion of sLDL-C in LDL-C, which standard lipid measures do not indicate. Advanced lipoprotein assays, such as nuclear magnetic resonance (NMR) testing, can subfractionate lipoproteins by size and density and may better depict the effects of CR diets on CVD risk. Methods Adults ( N = 58) with T2DM ( n = 37 women; baseline HbA1c ≥ 6.5%) completed a 6-month group-based CR diet intervention. We obtained a standard lipid panel, advanced lipoprotein assays (NMR testing), and two 24-h diet recalls at baseline and post-intervention (6 months). Participants also completed home-based blood ketone testing (a biological index of dietary adherence) during the final five weeks of the intervention. Results From baseline to post-intervention, participants had increased mean HDL-C, decreased triglycerides and triglyceride/HDL ratio, decreased mean sLDL-P, and increased LDL size, which reflect reductions in CVD risk ( p s < 0.05). Participants did not have statistically significant changes in total cholesterol, non-HDL-C cholesterol, LDL-P, or HDL-P. Twelve participants (23.1%) had a ≥ 5% increase in sLDL-P. Exploratory analyses revealed that participants with sLDL-P increases of ≥ 5% reported larger increases in servings of red meat than participants without sLDL-P increases of ≥ 5% (+ 0.69 vs − 0.29 servings; p = 0.033). Changes in saturated fat intake were not associated with changes in sLDL-P. Conclusions Among most participants, we observed changes in several lipid measures consistent with decreased CVD risk. Approximately one in four participants evidenced increases in sLDL-P. Further research should clarify whether individuals with increased sLDL-P after implementing a CR diet can reverse observed increases by limiting red meat consumption. Trial registration ClinicalTrials.gov, NCT03207711 , Registered 6/11/2017. Retrospectively registered.

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Lipoprotein Subclasses and Cardiovascular Disease Risk in Insulin-Resistant Diabetes

Cited by 2 publications

References 128 publications

Protective lifestyle behaviours and lipoprotein particle subclass profiles in a middle-to older-aged population

Protective lifestyle behaviours and lipoprotein particle subclass profiles in a middle-to older-aged population

Lipid findings from the Diabetes Education to Lower Insulin, Sugars, and Hunger (DELISH) Study

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