Association of Low Plasma High Density Lipoprotein (HDL)-Cholesterol Concentration with Documented Coronary Artery Disease in Males with Non-Insulin Dependent Diabetes Mellitus

Summary

Plasma lipid and lipoprotein concentrations were determined in 30 males without diabetes or symptomatic coronary artery disease (CAD), and compared to the values in age-matched and weight-matched males (n=55) with non-insulin-dependent diabetes mellitus (NIDDM). Patients with NIDDM were further subdivided into those with (n=30) and without (n=25) CAD. Mean (±SEM) plasma triglyceride concentrations were significantly increased (P < 0.001) over control values (96±5 mg/dl) in patients with NIDDM, whether with (172±14 mg/dl) or without documented CAD (164±25 mg/dl). Plasma cholesterol concentrations were also higher (P < 0.001) than normal (168±5 mg/dl) in both groups of patients with NIDDM (201±11 and 199±7 mg/dl, respectively, in patients with and without evidence of CAD). Plasma LDL-cholesterol concentrations were also greater (P < 0.001) than normal (104±4 mg/dl) in patients with NIDDM, but were again similar in the group of diabetics (120±9 vs 128±6 mg/dl). However, plasma HDL-cholesterol concentrations were only reduced below control values in diabetes patients with CAD (30±1 mg/dl), whereas patients with NIDDM and no subjective evidence of CAD had HDL-cholesterol concentrations (37±3 mg/dl) which were similar to normal values (38±2 mg/dl). As a result, the ratio of LDL-cholesterol to HDL-cholesterol was highest in patients with NIDDM and CAD (4.2±0.3), lowest in the control population (2.8±0.2), and intermediate in those patients with NIDDM without subjective or objective evidence of CAD (3.6±0.3). The data suggest that a low plasma HDL-cholesterol concentration may play a crucial role in determining which patients with NIDDM get CAD.

Key-Words

HDL-Cholesterol - Non-Insulin-Dependent Diabetes Mellitus (NIDDM) - Coronary Artery Disease