Key result
Diabetes mellitus, especially with systolic hypertension or albuminuria, was associated with increased transvascular LDL transport compared to healthy controls (2.6 vs 1.8 %/[h x (liter/m2)]; P=0.013).
Why the study?
Does diabetes mellitus, especially with concurrent systolic hypertension or albuminuria, increase transvascular LDL transport compared to healthy controls?
Cross-Sectional (n=102)
No
Does diabetes mellitus, especially with concurrent systolic hypertension or albuminuria, increase transvascular LDL transport compared to healthy controls?
Answers are grounded in this paper and cite their sources.
May indicate mechanism for excess cardiovascular risk in diabetes; hypothesis-generating and requires prospective confirmation before clinical implications.
CONTEXT: Diabetes is associated with a highly increased risk of atherosclerosis, especially if hypertension or albuminuria is present. OBJECTIVE: We hypothesized that the increased transvascular lipoprotein transport in diabetes may be further accelerated if hypertension or albuminuria is present, possibly explaining increased intimal lipoprotein accumulation and thus atherosclerosis. DESIGN: The study was cross-sectional and was performed in 1999-2002. SETTING: The study took place in the referral center. PATIENTS: The patients included 60 with diabetes mellitus (27 with type 1 diabetes and 33 with type 2 diabetes) and 42 healthy controls. All were randomly recruited. MAIN OUTCOME MEASURE: We used an in vivo method for measurement of transvascular transport of low-density lipoprotein (LDL). Autologous 131I-LDL was reinjected iv, and the 1-h fractional escape rate was taken as an index of transvascular transport. RESULTS: Transvascular LDL transport was 1.8 (1.6-2.0), 2.3 (2.0-2.6), and 2.6 (1.3-4.0)%/[h x (liter/m2)] in healthy controls, diabetic controls, and diabetes patients with systolic hypertension or albuminuria, respectively (P = 0.013; F = 4.5; df =2; ANOVA). These differences most likely were not caused by altered hepatic LDL receptor expression, glycosylation of LDL, small LDL size, or medicine use. CONCLUSIONS: Transvascular LDL transport is increased in patients with diabetes mellitus, especially if systolic hypertension or albuminuria is present. Accordingly, lipoprotein flux into the arterial wall could be increased in these patients, possibly explaining accelerated development of atherosclerosis.
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Jensen et al. (2005) conducted a cross-sectional in Diabetes mellitus (n=102). Diabetes with or without systolic hypertension or albuminuria vs. Healthy controls was evaluated on 1-h fractional escape rate of autologous 131I-LDL (index of transvascular transport) (p=0.013). Diabetes mellitus, especially with systolic hypertension or albuminuria, was associated with increased transvascular LDL transport compared to healthy controls (2.6 vs 1.8 %/[h x (liter/m2)]; P=0.013).
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