Purpose The purpose of this study was to characterize type I and type II diabetes by apolipoprotein-defined apoA-I and apoB-containing lipoprotein subclasses.
Background Traditional characterization of plasma lipoproteins has been based on their physical properties including density, size, and electric charge. However, due to compositional and metabolic heterogeneity of lipoprotein density classes, we have employed an alternative classification system of lipoproteins based on apolipoproteins as pivotal and unique determinants of the structural, metabolic, and functional properties of lipoproteins. This concept has now been applied to the characterization and comparison of lipoprotein profiles of type I (n = 35) and type II (n = 49) diabetic patients.
Methods Two major apolipoprotein-defined apoA-I-containing lipoprotein subclasses, LpA-I and LpA-I:A-II, were measured by a differential electroimmunoassay, while the major apoB-containing lipoprotein subclasses including cholesterol-rich LpB and LpB:E and triglyceride-rich LpB:C, LpB:C:E and LpA-II:B:C:D:E were determined by a sequential immunoprecipitation procedure.
Results There were no significant differences in the levels of lipids, apolipoproteins, and apolipoprotein-defined lipoprotein subclasses between well-controlled type I diabetic patients and asymptomatic, normolipidemic controls (n = 40). In contrast, subjects with type II diabetes had significantly lower levels of HDL-C, apoA-I, LpA-I, and LpA-I:A-II and significantly higher levels of triglycerides, VLDL-C, apoC-III, and triglyceride-rich LpB:C and LpA-II:B:C:D:E subclasses than those of type I diabetic subjects or normal controls. There were no statistically significant differences in the levels of total cholesterol, LDL-C, and cholesterol-rich LpB and LpB:E between type I and II diabetic and control subjects.
Conclusion The atherogenic dyslipidemia of type II diabetes is characterized by increased levels of triglyceride-rich, but not cholesterol-rich, apolipoprotein-defined lipoprotein subclasses. The lipoprotein profile of well-controlled type I diabetes is similar, if not identical, to that of normolipidemic, asymptomatic subjects.
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