Effects of insulin therapy and glycemic control on distribution of HDL alpha and pre-beta subfractions in non insulin-dependent diabetic subjects.

Abstract

The heterogeneous population of HDL particles can be separated into six classes which may provide a more sensitive index of cardiovascular risk than HDL cholesterol. The aim of this study was therefore to evaluate HDL distribution in NIDDM.Twenty-five individuals were treated with diet and sulfonylurea and 14 with insulin; both groups had similar plasma lipid profiles and BMI, but the insulin-treated subjects were older and their diabetes was of longer duration. The major findings were a greater proportion of apoA1 in alpha 1-HDL in the insulin-treated group (24.3 +/- 5.2% vs 20.8 +/- 4.0%), which is a desirable profile, and a greater proportion of pre-beta 1-HDL, which are the initial acceptors of cellular cholesterol.Our results suggest a beneficial influence of insulin treatment on reverse cholesterol transport. Moreover, glycemic control (HbA1c) also related to alpha 3-HDL significantly (r = 0.51; p < 0.01), indicating an association between poorer glycemic control and an adverse HDL profile.