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Type 2 diabetes, dyslipidemia, and vascular risk: rationale and evidence for correcting the lipid imbalance.
Am Heart J. 2005 Nov; 150(5):859-70.AH

Abstract

Type 2 diabetes is an important cardiovascular risk factor. A significant component of the risk associated with type 2 diabetes is thought to be because of its characteristic lipid "triad" profile of raised small dense low-density lipoprotein levels, lowered high-density lipoprotein, and elevated triglycerides (TGs). Trials of statins and fibrates have included substantial numbers of patients with diabetes and indicate that lipid lowering reduces cardiovascular event rates in these patients. However, statins alone do not always address all the lipid abnormalities of diabetes. Fibrates, which have low affinity for peroxisome proliferator-activated receptor alpha (PPARalpha), improve most aspects of the atherogenic dyslipidemia of diabetes. Chronic elevations of free fatty acids (FFA) induce insulin resistance and contribute to the lipid triad of diabetes. Therefore, reducing their levels is likely to ameliorate insulin resistance and improve the lipid triad of diabetes. PPARs are intimately involved in the regulation of FFA: PPARalpha modulation increases FFA catabolism and PPARgamma agonism (eg, by thiazolidinediones) increases TG lipolysis, FFA transport, conversion of FFA to TGs, and safe storage of FFA. Integrating potent PPARalpha and PPARgamma activity may deliver greater improvement of the diabetic dyslipidemic profile and its attendant risks than selective PPAR activation.

Authors+Show Affiliations

Carmena R
University of Valencia, Valencia, Spain. carmena@uv.es

MeSH

Cardiovascular DiseasesDiabetes Mellitus, Type 2DyslipidemiasHumansHydroxymethylglutaryl-CoA Reductase InhibitorsLipid MetabolismLipoproteinsPPAR alphaRisk Factors

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

16290951

Citation

Carmena, Rafael. "Type 2 Diabetes, Dyslipidemia, and Vascular Risk: Rationale and Evidence for Correcting the Lipid Imbalance." American Heart Journal, vol. 150, no. 5, 2005, pp. 859-70.
Carmena R. Type 2 diabetes, dyslipidemia, and vascular risk: rationale and evidence for correcting the lipid imbalance. Am Heart J. 2005;150(5):859-70.
Carmena, R. (2005). Type 2 diabetes, dyslipidemia, and vascular risk: rationale and evidence for correcting the lipid imbalance. American Heart Journal, 150(5), 859-70.
Carmena R. Type 2 Diabetes, Dyslipidemia, and Vascular Risk: Rationale and Evidence for Correcting the Lipid Imbalance. Am Heart J. 2005;150(5):859-70. PubMed PMID: 16290951.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Type 2 diabetes, dyslipidemia, and vascular risk: rationale and evidence for correcting the lipid imbalance. A1 - Carmena,Rafael, PY - 2004/10/27/received PY - 2005/04/03/accepted PY - 2005/11/18/pubmed PY - 2005/12/31/medline PY - 2005/11/18/entrez SP - 859 EP - 70 JF - American heart journal JO - Am Heart J VL - 150 IS - 5 N2 - Type 2 diabetes is an important cardiovascular risk factor. A significant component of the risk associated with type 2 diabetes is thought to be because of its characteristic lipid "triad" profile of raised small dense low-density lipoprotein levels, lowered high-density lipoprotein, and elevated triglycerides (TGs). Trials of statins and fibrates have included substantial numbers of patients with diabetes and indicate that lipid lowering reduces cardiovascular event rates in these patients. However, statins alone do not always address all the lipid abnormalities of diabetes. Fibrates, which have low affinity for peroxisome proliferator-activated receptor alpha (PPARalpha), improve most aspects of the atherogenic dyslipidemia of diabetes. Chronic elevations of free fatty acids (FFA) induce insulin resistance and contribute to the lipid triad of diabetes. Therefore, reducing their levels is likely to ameliorate insulin resistance and improve the lipid triad of diabetes. PPARs are intimately involved in the regulation of FFA: PPARalpha modulation increases FFA catabolism and PPARgamma agonism (eg, by thiazolidinediones) increases TG lipolysis, FFA transport, conversion of FFA to TGs, and safe storage of FFA. Integrating potent PPARalpha and PPARgamma activity may deliver greater improvement of the diabetic dyslipidemic profile and its attendant risks than selective PPAR activation. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/16290951/Type_2_diabetes_dyslipidemia_and_vascular_risk:_rationale_and_evidence_for_correcting_the_lipid_imbalance_ DB - PRIME DP - Unbound Medicine ER -