Very low-density lipoprotein cholesterol is associated with extent and severity of coronary artery disease in patients with type 2 diabetes mellitus

Abstract

Objective: Patients with type 2 diabetes mellitus usually have multiple cardiovascular disease risk factors. The objective of this study was to examine the severity and associated risk factors in coronary artery disease patients with type 2 diabetes mellitus. Methods: Two hundred and five coronary artery disease patients with type 2 diabetes mellitus and 205 age-, gender- and smoking-matched coronary artery disease patients without type 2 diabetes mellitus were recruited from the Department of Cardiology of our hospital. Demographic and clinical data were collected for all participants. Severity of coronary artery disease was assessed using Gensini scoring system, the number of diseased coronary arteries, and the extent of coronary stenosis. Results: Coronary artery disease patients with type 2 diabetes mellitus had higher Gensini scores (p < 0.01), more numbers of diseased coronary arteries (p < 0.001), and higher degrees of coronary stenosis (p = 0.05) than coronary artery disease patients without type 2 diabetes mellitus. The plasma levels of very low-density lipoprotein cholesterol (p < 0.001) and triglycerides (p < 0.001) were also higher in coronary artery disease patients with type 2 diabetes mellitus than in coronary artery disease patients without type 2 diabetes mellitus. In coronary artery disease patients with type 2 diabetes mellitus, very low-density lipoprotein cholesterol was positively correlated with Gensini scores (r = 0.15, p = 0.03), the number of diseased coronary arteries (r = 0.15, p = 0.04), and the extent of coronary stenosis (r = 0.14, p = 0.05) by partial correlation analysis after controlling for other lipid parameters, and independently associated with Gensini scores (beta = 0.18, p = 0.02) and the number of diseased coronary arteries (odds ratio = 2.09, p = 0.05) after adjusting for other cardiovascular risk factors in the following multiple regression analysis. Conclusion: Very low-density lipoprotein cholesterol may represent a marker for the severity of coronary artery disease and be a target for the treatment in diabetic patients. Further research is needed to determine whether very low-density lipoprotein cholesterol plays a causal role of coronary artery disease in diabetic patients.

Epidemiological‐clinical and paraclinical particularities of acute coronary syndrome without persistent ST‐segment elevation in type 2 diabetes mellitus: Retrospective comparative study in a Malagasy population

“…This could be explained by the often-multifocal coronary involvement in diabetes mellitus. 35 The increase in cardiac troponin is significantly more marked in our diabetics than in nondiabetics. Indeed, cardiac troponin elevations above the 99th percentile measured by a highly sensitive test have been frequently encountered in a T2DM patient population.…”

“…In our diabetic patients, the leads significantly most affected on the ECG were extended anterior, septal and with at least two leads. This could be explained by the often‐multifocal coronary involvement in diabetes mellitus 35 . The increase in cardiac troponin is significantly more marked in our diabetics than in nondiabetics.…”

Integrative metabolomics differentiate coronary artery disease, peripheral artery disease, and venous thromboembolism risks

“…Specifically, 28 metabolites increased the risk for both CAD and PAD and 2 metabolites had opposite causal effects in CAD and VTE. Of the 28 metabolites many were VLDL traits, and indeed, VLDL pathways have been implicated in both CAD 26 and PAD. 27 VLDL is a precursor to LDL and is considered to be a marker of atherogenic lipoprotein remnants.…”

Dietary Iron Restriction Improves Muscle Function, Dyslipidemia, and Decreased Muscle Oxidative Stress in Streptozotocin-Induced Diabetic Rats

“…Oxidative stress is a key factor involved in the development of muscle fatigue [6,7]. Dyslipidemia is another hallmark of diabetes associated with a higher risk of cardiovascular disease [8]; hereby, the decrease in blood lipids improves cardiovascular outcomes [9,10]. Dyslipidemia has been related to impaired muscle function in rodents [11] and humans [12].…”