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Open Access Research

The atherogenic dyslipidemia ratio [log(TG)/HDL-C] is associated with residual vascular risk, beta-cell function loss and microangiopathy in type 2 diabetes females

Michel P Hermans1*, Sylvie A Ahn2 and Michel F Rousseau2

Author Affiliations

1 Division of Endocrinology and Nutrition, Université catholique de Louvain, Brussels, Belgium

2 Division of Cardiology, Université catholique de Louvain, Brussels, Belgium

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Lipids in Health and Disease 2012, 11:132  doi:10.1186/1476-511X-11-132

Published: 9 October 2012

Abstract

Background

Atherogenic dyslipidemia (AD), defined as low HDL-C plus elevated triglycerides (TG), comorbid to T2DM, increases cardiometabolic risk for CAD even when LDL-C is at target. In T2DM males, AD was shown to correlate with β-cell function loss, yet it is not established whether this applies across gender.

Aim

To establish the prevalence and severity of AD in T2DM females, and to determine how it relates to cardiometabolic phenotype, glucose homeostasis, micro- and macrovascular complications, and 10-year absolute CV risk (UKPDS Risk Engine).

Methods

340 T2DM females were ranked according to quintiles (Q) of the continuous variable log(TG)/HDL-C, with AD prevalence defined as HDL-C <50 mg.dL-1 plus TG ≥150 mg.dL-1, and β-cell function assessed with HOMA.

Results

AD prevalence was 35%; mean HDL-C and TG were 52 (15) and 160 (105) mg.dL-1. AD was significantly related to central fat, metabolic syndrome, sedentarity and skeletal sarcopenia, as well as to hsCRP, fibrinogen, uric acid, cystatin-C, Big ET-1, and 10-year UKPDS CV risk. AD correlated stepwise with lower β-cell function and hyperbolic product, and with accelerated loss of residual insulin secretion, higher HbA1c and prevalent microangiopathy.

Conclusions

log(TG)/HDL-C is a simple means to grade AD and residual macrovascular risk in T2DM females. This ratio associates with major non-LDL cardiometabolic variables and ranks predicted CAD risk. In addition, log(TG)/HDL-C identifies worsening glucose homeostasis, poorer glycemic control, and prevalent microangiopathy.

Keywords:
HDL-C; Triglycerides; Cardiovascular risk; Microangiopathy; β-cell function; Hyperbolic product; Gender; Diabetes