Although cardiovascular disease (CVD) is greatly increased in type 1 diabetes mellitus (T1DM), patients typically have apparently healthy lipid profiles. Simple measurement of plasma lipids however does not provide information regarding lipoprotein particle size which in the nondiabetic population is independently predictive of CVD. Plasma lipids and lipoprotein subclasses (using polyacrylamide gel-tube electrophoresis) were studied in reproductive age women with T1DM and compared to a matched control group. Outcomes were correlated with carotid intima-media thickeness (CIMT), a validated marker of atherosclerosis. Compared to nondiabetic women, T1DM women were younger (29 vs 34 years) and of lower BMI (24.7 vs 31.3 kg/m2), with all data reported as median. Total (TC) and LDL-cholesterol (LDL-C) did not differ between groups. Triglyceride (TG) levels were lower (0.76 vs 0.91 mmol/l, P=0.0331) and HDL-cholesterol (HDL-C) greater (1.65 vs 1.49 mmol/l, P=0.00331) in T1DM. T1DM women had a greater proportion (46% vs 5%, P<0.0001) of small LDL-C particles, lower mean LDL particle size (269 vs 272 Æ, P<0.0001) and a greater percentage of small-dense-LDL particles (%SDLDL; 3 vs 0%, P<0.0001). CIMT correlated positively in T1DM with %SDLDL (r 0.2983, P=0.0098) and negatively with LDL size (r−0.3118, P=0.0068), but did not correlate with TC, HDL-C, LDL-C or TG. Despite apparently healthy lipid profiles, women with T1DM have a greater proportion than nondiabetic women of atherogenic small LDL particles. The likelihood that this is clinically relevant is strengthened by the observed correlation of CIMT with particle size and lack of correlation with standard lipid profile. Further studies are needed to explore the mechanisms underlying these abnormalities.
20 - 23 May 2017
European Society of Endocrinology