Ratio of triglycerides to HDL cholesterol is an indicator of LDL particle size in patients with type 2 diabetes and normal HDL cholesterol levels
Ratio of triglycerides to HDL cholesterol is an indicator of LDL particle size in patients with type 2 diabetes and normal HDL cholesterol levels
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DOI：
10.2337/diacare.23.11.1679
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发表时间：
2000-11-01
期刊：
影响因子：
16.2
通讯作者：
Halimi, S
中科院分区：
文献类型：
--
作者：
Boizel, R;Benhamou, PY;Halimi, S
目的：在2型糖尿病患者中，正常的高密度脂蛋白胆固醇水平不排除低密度脂蛋白颗粒可能较小。虽然分析低密度脂蛋白亚组分的技术不太可能在临床实践中使用，但基于常规血脂谱预测低密度脂蛋白大小可能有助于心血管风险的评估。研究设计和方法-60名2型糖尿病患者在停止调脂治疗后，血糖控制可接受，高密度脂蛋白胆固醇水平大于或等于1 mmol/L。低密度脂蛋白的大小由2-20%的PAGE确定；小低密度脂蛋白患者(n=30)与中、大低密度脂蛋白患者(n=30)进行比较。结果：两组患者的临床特征、药物治疗、生活方式和糖尿病相关并发症的发生率相似。低密度脂蛋白大小与血浆甘油三酯呈负相关(R2=0.52)，与高密度脂蛋白呈正相关(R2=0.14)。然而，甘油三酯与高密度脂蛋白的摩尔比与低密度脂蛋白大小之间的负相关性更强(R2=0.59)。在90%的低密度脂蛋白颗粒较小的患者(95%可信区间为79.3-100)和16.5%的低密度脂蛋白颗粒较大的患者中，这一比率为1.33。以1.33的甘油三酯/高密度脂蛋白胆固醇比值作为临界值，区分LDI值较小的患者优于1.70和1.45 mm ol/l的甘油三酯。结论：甘油三酯/高密度脂蛋白胆固醇比值可能与低密度脂蛋白的病理生理过程有关，并与临床血管疾病的风险有关。它可能适合于需要早期和积极治疗血脂异常的患者的选择。
OBJECTIVE - In patients with type 2 diabetes, a normal HDL cholesterol level does not rule out that LDL particles may be small. Although techniques for analyzing LDL subfractions are not likely to be used in clinical practice, a prediction of LDL size based on a regular lipid profile may be useful for assessment of cardiovascular risk.RESEARCH DESIGN AND METHODS - Sixty patients with type 2 diabetes with acceptable glycemic control and an HDL cholesterol level greater than or equal to1 mmol/l were recruited after cessation of lipid-altering treatments. LDL size was determined by 2-20% PAGE; patients having small LDL (n = 30) were compared with those having intermediate or large LDL (n = 30).RESULTS - Clinical characteristics, pharmacological therapies, lifestyle, and prevalence of diabetes-related complications were similar in both patient groups. LDL size correlated negatively with plasma triglycerides (TGs) (R-2 = 0.52) and positively with HDL cholesterol (R-2 = 0.14). However, an inverse correlation between the TG-to-HDL cholesterol molar ratio and LDL size was even stronger (R-2 = 0.59). The ratio was >1.33 in 90% of the patients with small LDL particles (95% CI 79.3-100) and 16.5% of those with larger LDI particles. A cutoff point of 1.33 for the TG-to-HDL cholesterol ratio distinguishes between patients having small LDI values better than TG cutoff of 1.70 and 1.45 mmol/l.CONCLUSIONS - The TG-to-HDL cholesterol ratio may be related to the processes involved in LDL size pathophysiology and relevant with regard to the risk of clinical vascular disease. It may be suitable for the selection of patients needing an earlier and aggressive treatment of lipid abnormalities.