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. 2014 Oct;236(2):244-50.
doi: 10.1016/j.atherosclerosis.2014.07.008. Epub 2014 Jul 22.

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

Stuart B Prenner  1 , Claire K Mulvey  1 , Jane F Ferguson  1 , Michael R Rickels  2 , Anish B Bhatt  1 , Muredach P Reilly  3
Affiliations

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

Stuart B Prenner et al. Atherosclerosis. 2014 Oct.

Abstract

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.

Keywords: Subclinical atherosclerosis; Triglycerides; VLDL-C.

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Conflict of interest statement

S.B.P, C.K.M, J.F.F, K.R.R, A.B.B, and M.P.R report no other potential conflicts of interest relevant to this article.

Figures

Figure 1
Figure 1
Distribution of plasma VLDL-C across categories of low (<150 mg/dl) and high (>150 mg/dl) plasma triglyceride values. Abbreviations: TG=triglyceride VLDL=very-low density lipoprotein
See this image and copyright information in PMC

Comment in

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