Macroangiopathy in diabetes mainly consists of an accelerated form of atherosclerosis. Despite the high prevalence of risk factors, no more than 25% of the additional cardiovascular risk in diabetes can be explained by known risk factors. Lipoprotein abnormalities play a fundamental part in this context. In particular, high VLDL concentrations, smaller LDL particles, and reduced levels of the HDL2 subclass are hallmarks of type 2 diabetic patients with extrahepatic insulin resistance, hypertension, obesity and microalbuminuria, and they may help to explain why type 2 diabetic patients are prone to cardiovascular disease. Low Apolipoprotein AII levels in diabetic patients also seem to be relevant, since these patients frequently have reduced concentrations of HDL cholesterol, and these apo anomalies may predict fatal vascular events in such patients. As for small, dense LDL particles, which are more susceptible to oxidation and glycation, with a fundamental role in atherosclerosis, several studies have confirmed that the concentration of plasma triglyceride is the most important determinant of variability in LDL size. Oxidized LDL play a major part in the formation and development of atherosclerotic plaques. Oxidative modifications make LDL immunogenic and autoantibodies against oxidized LDL reportedly predict the progression of coronary artery disease. Judging from our data, humoral immune response could play a different role in different stages of the development of atherosclerosis. Patients with coronary heart disease, be they diabetic or not, very often have low levels of HDL cholesterol, but little information are available on the possible qualitative changes in their HDL. In a recent investigation, we demonstrated that 2D gel electrophoresis, followed by enzymatic digestion and MALDI MS, is an effective tool for characterizing Apolipoprotein AI changes, and modified-Apo AI levels are considerably higher in individuals with type 2 diabetes. In conclusion, there is evidence of a close connection between lipoprotein abnormalities and macroangiopathy in type 2 diabetes and this could help to explain the additional cardiovascular risk associated with diabetes. © 2010 Nova Science Publishers, Inc.
The role of lipoprotein abnormalities as risk factors for macroangiopathy in type 2 diabetes
Lapolla A.;Sartore G.
2011
Abstract
Macroangiopathy in diabetes mainly consists of an accelerated form of atherosclerosis. Despite the high prevalence of risk factors, no more than 25% of the additional cardiovascular risk in diabetes can be explained by known risk factors. Lipoprotein abnormalities play a fundamental part in this context. In particular, high VLDL concentrations, smaller LDL particles, and reduced levels of the HDL2 subclass are hallmarks of type 2 diabetic patients with extrahepatic insulin resistance, hypertension, obesity and microalbuminuria, and they may help to explain why type 2 diabetic patients are prone to cardiovascular disease. Low Apolipoprotein AII levels in diabetic patients also seem to be relevant, since these patients frequently have reduced concentrations of HDL cholesterol, and these apo anomalies may predict fatal vascular events in such patients. As for small, dense LDL particles, which are more susceptible to oxidation and glycation, with a fundamental role in atherosclerosis, several studies have confirmed that the concentration of plasma triglyceride is the most important determinant of variability in LDL size. Oxidized LDL play a major part in the formation and development of atherosclerotic plaques. Oxidative modifications make LDL immunogenic and autoantibodies against oxidized LDL reportedly predict the progression of coronary artery disease. Judging from our data, humoral immune response could play a different role in different stages of the development of atherosclerosis. Patients with coronary heart disease, be they diabetic or not, very often have low levels of HDL cholesterol, but little information are available on the possible qualitative changes in their HDL. In a recent investigation, we demonstrated that 2D gel electrophoresis, followed by enzymatic digestion and MALDI MS, is an effective tool for characterizing Apolipoprotein AI changes, and modified-Apo AI levels are considerably higher in individuals with type 2 diabetes. In conclusion, there is evidence of a close connection between lipoprotein abnormalities and macroangiopathy in type 2 diabetes and this could help to explain the additional cardiovascular risk associated with diabetes. © 2010 Nova Science Publishers, Inc.
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