Jane Ferguson
Last active: 4/2/2019

Very low density lipoprotein cholesterol associates with coronary artery calcification in type 2 diabetes beyond circulating levels of triglycerides.

Prenner SB, Mulvey CK, Ferguson JF, Rickels MR, Bhatt AB, Reilly MP
Atherosclerosis. 2014 236 (2): 244-50

PMID: 25105581 · PMCID: PMC4209900 · DOI:10.1016/j.atherosclerosis.2014.07.008

OBJECTIVE - While recent genomic studies have focused attention on triglyceride (TG) rich lipoproteins in cardiovascular disease (CVD), little is known of very low-density lipoprotein cholesterol (VLDL-C) relationship with atherosclerosis and CVD. We examined, in a high-risk type-2 diabetic population, the association of plasma VLDL-C with coronary artery calcification (CAC).

METHODS - The Penn Diabetes Heart Study (PDHS) is a cross-sectional study of CVD risk factors in type-2 diabetics (n = 2118, mean age 59.1 years, 36.5% female, 34.1% Black). Plasma lipids including VLDL-C were calculated (n = 1879) after ultracentrifugation.

RESULTS - In Tobit regression, VLDL-C levels were positively associated with increasing CAC after adjusting for age, race, gender, Framingham risk score, body mass index, C-reactive protein, exercise, medication and alcohol use, hemoglobin A1c, and diabetes duration [Tobit ratio (TR) and 95% confidence interval (CI) 0.38 (0.12-0.65), P = 0.005] and even after inclusion of apolipoprotein B data [TR 0.31 (0.03-0.58), P = 0.030]. Approximately 3-fold stronger effect was observed in women [TR 0.75 (0.16-1.34), P = 0.013] than men [TR 0.20 (-0.10-0.50), P = 0.189; gender interaction P = 0.034]. Plasma VLDL-C was related more strongly to CAC scores than TG levels (e.g., Akaike information criteria of 7263.65 vs. 7263.94) and had stronger CAC association in individuals with TGs >150 mg/dl (TR 0.80, P = 0.010) vs. those with TGs <150 mg/dl (TR 0.27, P = 0.185).

CONCLUSIONS - In PDHS, VLDL-C is associated with CAC independent of established CVD risk factors, particularly in women, and may have value even beyond apolipoprotein B levels and in patients with elevated TGs.

Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

MeSH Terms (25)

Aged Alcohol Drinking Apolipoproteins B Blood Pressure Body Mass Index Calcinosis Cholesterol, VLDL Comorbidity Coronary Artery Disease Cross-Sectional Studies Diabetes Mellitus, Type 2 Ethnic Groups Exercise Female Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors Hyperlipidemias Hypoglycemic Agents Male Middle Aged Pennsylvania Risk Factors Severity of Illness Index Smoking Triglycerides

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