Serum oxidized-LDL is associated with diabetes duration independent of maintaining optimized levels of LDL-cholesterol

Abstract

Oxidized low-density lipoprotein (ox-LDL) plays a key role in the progression of atherosclerosis and diabetes complications. The aim of this study was first, to evaluate the association between ox-LDL and diabetes duration, and second, to examine serum level of ox-LDL in patients with prolonged diabetes and a desirable LDL-cholesterol level. A total of 36 type-2 diabetic patients with a diabetes duration of more than 5 years, 36 newly diagnosed diabetic patients, and 36 age-, sex- and BMI-matched healthy participants were recruited. Healthy participants and newly diagnosed patients were not receiving any treatment. All patients with prolonged diabetes had desirable LDL-cholesterol levels (<100 mg/dL), according to the adult treatment panel-III guidelines. While LDL-cholesterol was significantly lower in patients with diabetes duration >5 years, in comparison to newly diagnosed patients (P < 0.01), ox-LDL was significantly higher in patients with prolonged diabetes (P < 0.001). The ox-LDL-to-LDL ratio was dramatically higher in patients with diabetes duration >5 years in comparison to newly diagnosed patients and healthy participants (P < 0.001). Ox-LDL was significantly associated with diabetes duration (r = 0.519, P = 0.001). In multivariate analysis, this association remained significant (beta = 0.501, P = 0.003) after adjustment for potential confounders. In conclusion, this study showed that the serum ox-LDL level increases with the length of diabetes, even though the patients' LDL-cholesterol level is maintained at a desirable level. Our findings highlight that possibly more attention should be focused on markers of oxidative stress in the management of lipids in diabetic patients.