| Summary: | <p>Abstract</p> <p>Background</p> <p>Atherogenic dyslipidemia (AD), defined as low HDL-C plus elevated triglycerides (TG), comorbid to T2DM, increases cardiometabolic risk for CAD even when LDL-C is at target. In T2DM males, AD was shown to correlate with β-cell function loss, yet it is not established whether this applies across gender.</p> <p>Aim</p> <p>To establish the prevalence and severity of AD in T2DM females, and to determine how it relates to cardiometabolic phenotype, glucose homeostasis, micro- and macrovascular complications, and 10-year absolute CV risk (<it>UKPDS</it> Risk Engine).</p> <p>Methods</p> <p>340 T2DM females were ranked according to quintiles (Q) of the continuous variable <it>log</it>(TG)/HDL-C, with AD prevalence defined as HDL-C <50 mg.dL<sup>-1</sup> plus TG ≥150 mg.dL<sup>-1</sup>, and β-cell function assessed with HOMA.</p> <p>Results</p> <p>AD prevalence was 35%; mean HDL-C and TG were 52 (15) and 160 (105) mg.dL<sup>-1</sup>. AD was significantly related to central fat, metabolic syndrome, sedentarity and skeletal sarcopenia, as well as to <sub>hs</sub>CRP, fibrinogen, uric acid, cystatin-C, Big ET-1, and 10-year <it>UKPDS</it> CV risk. AD correlated stepwise with lower β-cell function and hyperbolic product, and with accelerated loss of residual insulin secretion, higher HbA<sub>1c</sub> and prevalent microangiopathy.</p> <p>Conclusions</p> <p><it>log</it>(TG)/HDL-C is a simple means to grade AD and residual macrovascular risk in T2DM females. This ratio associates with major non-LDL cardiometabolic variables and ranks predicted CAD risk. In addition, <it>log</it>(TG)/HDL-C identifies worsening glucose homeostasis, poorer glycemic control, and prevalent microangiopathy.</p>
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