Reconstituted HDL infusion restores endothelial function in patients with type 2 diabetes mellitus

ApoA-I apolipoprotein A-I FAV forearm tissue volume FBF forearm blood flow L-NMMA N G monomethyl-L-arginine M/C ratio of flow in infused measurement and non-infused control arm NO nitric oxide rHDL reconstituted HDL SNP sodium nitroprusside To the Editor: HDL-cholesterol is inversely correlated with cardiovascular events in all major epidemiological studies 1.HDL-increasing strategies have demonstrated that HDL-cholesterol increase is associated with decreased cardiovascular risk in high-risk individuals such as patients with type 2 diabetes 2.Endothelial dysfunction, a hallmark of type 2 diabetes patients, has been shown to predict future cardiovascular events 3.Therefore, we investigated the effect of reconstituted HDL (rHDL) on endothelial function measured both acutely (4 h after infusion) and 7 days after infusion in type 2 diabetes patients.Control volunteers were measured only at baseline and 4 h after infusion.Seven non-smoking patients with type 2 diabetes (four men and three women, BMI 24.4±1.6 kg/m 2 ) and seven matched control volunteers (four men and three women, BMI 22.9±1.8kg/m 2 ) were enrolled.Inclusion criteria for type 2 diabetes patients were: (1) fasting glucose >7.0 mmol/l; (2) no insulin therapy; and (3) triacylglycerol and LDL-cholesterol levels <2.0 and <3.5 mmol/l, respectively.Matched control individuals were volunteers who were recruited via advertisements.The presence of macrovascular disease (ECG abnormalities, abnormal anklebrachial index or a history of cardiovascular events) served as exclusion criteria.Female participants were postmenopausal and not using hormone replacement therapy.The study protocol was performed at least 4 weeks after discontinuation of vasoactive medication, including ACE inhibitors, angiotensin receptor blockers and non-steroidal anti-inflammatory drugs.None of the patients or control volunteers used lipid-lowering medication.The Internal