Nuclear magnetic resonance lipoproteins are associated with carotid atherosclerosis in type 1 diabetes and pre‐eclampsia

Abstract

AimsPersistence of lipoprotein abnormalities in type 1 diabetes (T1D) and/or pre‐eclampsia could be associated with cardiovascular disease (CVD). We assessed differences in the advanced lipoprotein profiles according to the presence of both conditions and their differential association with atherosclerosis.Material and methodsWe recruited 112 women without CVD and last pregnancy ≥5 years previously, divided into four groups (n = 28 per group): (a) T1D and previous pre‐eclampsia; (b) T1D without pre‐eclampsia; (c) pre‐eclampsia without T1D; and (d) controls (without T1D/pre‐eclampsia). Groups were matched by several risk factors, and diabetes duration and retinopathy in T1D. Carotid intima‐media thickness (IMT) and the presence of plaque (IMT ≥1.5 mm) were assessed by ultrasonography. The lipoprotein profile was evaluated by nuclear magnetic resonance (NMR) spectroscopy.ResultsThe participants were 44.9 ± 7.8 years old. Carotid plaque presence was 20.5%, with a higher prevalence in T1D and/or pre‐eclampsia vs controls (P < .05). High‐density lipoprotein (HDL)‐related variables differed among groups, mainly driven by an increase in T1D (P < .05), whereas triglyceride‐related variables were increased in pre‐eclampsia [medium very low‐density lipoprotein (VLDL) particles and triglyceride enrichment in HDL and low‐density lipoprotein (LDL)]. Overall, in multivariate‐adjusted models, LDL‐related variables were the most strongly associated with atherosclerosis (P < .05). In age‐ and statin‐adjusted models, previous pre‐eclampsia showed an independent association with triglyceride‐related variables (plaque: medium‐VLDL‐particles, OR 1.550 [1.013‐2.374]; HDL‐cholesterol/HDL‐triglycerides ratio, OR 0.411 [0.175‐0.967]). Regarding T1D, HDL‐parameters were also differentially associated (maximum‐IMT: HDL‐cholesterol/HDL‐particles ratio, β = −.258, P = .036).ConclusionsNMR lipoproteins were differentially and independently associated with atherosclerosis in T1D/pre‐eclampsia. Further studies are needed to ascertain the role of NMR parameters as CVD biomarkers in this high‐risk population.

The novel inflammatory biomarker GlycA and triglyceride-rich lipoproteins are associated with the presence of subclinical myocardial dysfunction in subjects with type 1 diabetes mellitus

“…Regarding T1DM, the advanced characteristics of VLDL has been positively and independently associated with arterial stiffness [ 43 ]. Likewise, similar associations have also been described in T1DM women with previous pre-eclampsia with carotid atherosclerosis [ 44 ].…”

Predictive Value of the Advanced Lipoprotein Profile and Glycated Proteins on Diabetic Retinopathy

“…The relationship between either advanced lipoprotein characteristics or glycoproteins with atherogenicity has recently been reported in both subjects with T1D [ 31 , 42 ] and T2D [ 23 , 39 ]; however, their contribution to DR has not been previously evaluated. Therefore, we focused on assessing the relationship between the characteristics of circulating lipoprotein and glycoprotein and DR in T1D and T2D subjects, and whether they contributed to a better prediction of the presence and severity of DR. Our data showed that neither lipoprotein parameters nor glycoproteins determined by NMR enhanced the prediction of DR presence or severity in our T1D and T2D cohorts.…”

“…Of note, we recently found hidden derangements in the lipoprotein profile of T1D using a nuclear magnetic resonance (NMR) spectroscopy approach in apparently normolipidemic T1D subjects [ 30 ]. This approach also allowed the identification of lipoprotein characteristics associated with preclinical atherosclerosis in T1D subjects [ 31 ] and newly diagnosed T2D subjects [ 23 ]. However, the added predictive potential shown by the advanced lipoprotein profile to diagnose DR has not yet been reported.…”

Effects of pre-eclampsia on HDL-mediated cholesterol efflux capacity after pregnancy

“…Alterations in HDL size, particular that of preβ-HDL have not been explored long-term after pregnancy nor in women with a pregnancy associated with PE. In the only study to have reported long term lipoprotein particle changes after pregnancy, PE was associated with increased large HDL particle concentrations up to 9 years after delivery [ 43 ]. However, since this analysis also included women with type 1 diabetes the effect of PE specifically on particle changes and levels of preβ-HDL remains unknown.…”