DYSLIPIDEMIA IN DIABETES

DYSLIPIDEMIA IN DIABETES

MAHTAB NIROOMAND M.D.

Assistant professor of Endocrinology

SBUMS

Tehran 1391/11/19

Out-line

Pathophysiology and types of dyslipidemia in DM

TG:
- Key feature of diabetic dyslipidemia : increased production of VLDL by the liver in response to elevations in FFAs.
- Insulin mediates the uptake of FFAs by striated muscle, reducing the levels presented to the liver,
- Insulin resistance results in the opposite effect, increasing the levels of FFAs available to the liver.
- in T2DM : Reduced lipoprotein lipase activity leads to an accumulation of triglyceride-rich lipoproteins in the plasma.
- TG-rich lipoproteins also reduced levels of HDL-C by increasing the transfer of cholesterol from these particles.
HDL-C:
- levels of HDL-c (cardioprotective lipid fraction), are decreased.
- The HDL-C may also be less effective at protecting LDL-C from oxidative stress
LDL-C:
- LDL-C particles are generally smaller and more dense than typical LDL-C particles.
- Small, dense LDL-C particles are more susceptible to oxidation, particularly in the setting of poor glucose control.
- Glycation of LDL in diabetes, impairing recognition of the lipoprotein by its hepatoreceptor and extending its half-life.