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Higher levels of small dense low‐density lipoprotein ( LDL ) are associated with cardiac autonomic neuropathy in patients with Type 2 diabetes
Author(s) -
Jang E.H.,
Park Y.M.,
Hur J.,
Kim M.K.,
Ko S.H.,
Baek K.H.,
Song K.H.,
Lee K.W.,
Kwon H.S.
Publication year - 2013
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.12176
Subject(s) - medicine , diabetes mellitus , odds ratio , cholesterol , endocrinology , triglyceride , type 2 diabetes , high density lipoprotein , cardiology , gastroenterology
Aim To investigate the relationship between small dense LDL cholesterol and cardiac autonomic neuropathy among patients with Type 2 diabetes. Methods A total of 175 patients who had not taken lipid‐lowering agents previously were enrolled consecutively in this study. Small dense LDL cholesterol level was measured using polyacrylamide tube gel electrophoresis, which fractionates LDL cholesterol into seven components according to particle size and charge. We analysed the mean LDL cholesterol particle size and the proportion of small dense LDL cholesterol. Results The mean (± sd ) patient age was 56 (± 14) years, the mean (± sd ) duration of diabetes was 10.3 (± 8.3) years, the mean (± sd ) proportion of small dense LDL cholesterol was 21.3 (± 17.6)% and the mean (± sd ) LDL cholesterol size was 26.33 (± 0.8) nm. Men with cardiac autonomic neuropathy had a longer duration of diabetes compared with those without cardiac autonomic neuropathy. Women with cardiac autonomic neuropathy had a larger waist circumference, higher plasma triglyceride levels, smaller mean (± sd ) LDL cholesterol size [26.8 (± 4.3) nm vs 26.4 (± 6.9) nm; P < 0.01] and larger mean (± sd ) proportion of small dense LDL cholesterol [10.1 (± 9.9)% vs 19.1 (± 16.8)%; P < 0.01] compared with those without cardiac autonomic neuropathy. After adjusting for other confounding risk factors, the triglyceride/ HDL cholesterol ratio (odds ratio = 1.698, 95% CI : 1.07–2.69; P = 0.025) and mean LDL cholesterol size (odds ratio = 0.873, 95% CI : 0.77–0.99; P = 0.038) remained as independent risk factors for cardiac autonomic neuropathy in women. Conclusions A more atherogenic lipid profile such as the triglyceride: HDL cholesterol ratio and a smaller mean LDL cholesterol particle size were related to the prevalence of cardiac autonomic neuropathy in women with Type 2 diabetes.