Key result
Metabolic syndrome was associated with significantly lower cholesterol efflux capacity compared to no metabolic syndrome, while glucose tolerance status had no impact.
Why the study?
Does glucose tolerance status or metabolic syndrome affect HDL cholesterol efflux capacity in subjects at high cardiometabolic risk?
Cross-Sectional (n=552)
No
Does glucose tolerance status or metabolic syndrome affect HDL cholesterol efflux capacity in subjects at high cardiometabolic risk?
Metabolic syndrome, but not impaired glucose metabolism or type 2 diabetes, is associated with impaired HDL cholesterol efflux capacity, which is partly dependent on plasma HDL-C levels and low-grade inflammation.
Metabolic syndrome may impair HDL efflux independent of glucose status; cross-sectional data leave open causal links and clinical relevance.
Type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS) increase atherosclerotic cardiovascular disease risk. Cholesterol efflux capacity (CEC) is a key metric of the anti-atherosclerotic functionality of high-density lipoproteins (HDL). The present study aimed to delineate if T2DM and MetS cross-sectionally associate with altered CEC in a large high cardiometabolic risk population. CEC was determined from THP-1 macrophage foam cells towards apolipoprotein B-depleted plasma from 552 subjects of the CODAM cohort (288 controls, 126 impaired glucose metabolism [IGM], 138 T2DM). MetS was present in 297 participants. CEC was not different between different glucose tolerance categories but was lower in MetS (P < 0.001), at least partly attributable to lower HDL cholesterol (HDL-C) and apoA-I levels (P < 0.001 for each). Low grade inflammation was increased in IGM, T2DM and MetS as determined by a score comprising 8 different biomarkers (P < 0.05-< 0.001; n = 547). CEC inversely associated with low-grade inflammation taking account of HDL-C or apoA-I in MetS (P < 0.02), but not in subjects without MetS (interaction: P = 0.015). This study demonstrates that IGM and T2DM do not impact the HDL CEC function, while efflux is lower in MetS, partly dependent on plasma HDL-C levels. Enhanced low-grade inflammation in MetS may conceivably impair CEC even independent of HDL-C and apoA-I.
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Annema et al. (2016) conducted a cross-sectional in Metabolic syndrome and Type 2 diabetes mellitus (n=552). Metabolic syndrome vs. No metabolic syndrome was evaluated on Cholesterol efflux capacity (p=<0.001). Metabolic syndrome was associated with significantly lower cholesterol efflux capacity compared to no metabolic syndrome, while glucose tolerance status had no impact.
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