Conference Diabetic DLP-2019

Diabetic Dyslipidemia

The number of people with DM will increase from ∼415 million today up to 550 million by 2030.

Recent data indicate that DM per se increases CVD risk about two-fold on average

prevalence of DD : various studies varied between 35 and 56% and is strongly associated with increased cardiovascular risk

Definition:

     DMT2

1. TG : elevated

2. HDL-C : decreased

3. LDL-C : elevated, borderline, or normal.   

    (LDL-C concentration may be misleading because there will be more small & dense LDL  particles for any cholesterol concentration)

Pathogenesis of diabetic dyslipidemia

1.TRL remnants,

2.small dense LDL

3.small dense HDL

 comprise the atherogenic lipid profile

Pathophysiology of dyslipidemia

The core features of the phenotype are underpinned by insulin resistance and result in abnormal metabolism and quantity of TG rich lipoproteins (TRLs) derived either from the intestine (as chylomicrons) or the liver (as VLDL)

TRLs—including chylomicrons, VLDL, and their remnants—carry a single ApoB molecule, also like LDL particles.

Therefore, the malignant nature of diabetic dyslipidaemia is not always revealed by the lipid measures used in clinical practice, as LDL-C levels may remain within the normal range.

 It may be better revealed by non-HDL-C levels.