Lecithin:cholesterol acyltransferase activity and high-density lipoprotein subfraction composition in type 1 diabetic patients with improving metabolic control

Weight, M.J.; Coetzee, H.S.; Smuts, C.M.; Marais, M.P.; Maritz, J.S.; Hough, F.S.; Benadé, A.J.; Taljaard, J.J.

Acta Diabetologica 30(3): 159-165

1993


ISSN/ISBN: 0940-5429
PMID: 8111077
DOI: 10.1007/bf00572861
Accession: 008949417

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Abstract
On initial diagnosis or when metabolic control is poor, subjects with type 1 (insulin-dependent) diabetes mellitus often exhibit decreased high density lipoprotein (HDL) cholesterol levels, which have been associated in numerous studies in non-diabetic subjects with atherosclerosis and coronary artery disease. We measured the activities of plasma lecithin: cholesterol acyltransferase (LCAT), post-heparin lipoprotein lipase, and the composition of the HDL subfractions HDL, and HDL-3, in ten poorly controlled type 1 diabetic patients admitted to a metabolic ward (six women and four men, aged 18-37 years). The measurements were repeated after metabolic control had been optimized and again a week after discharge. The results were compared with those of ten healthy normolipidaemic subjects matched for age, sex and body mass. LCAT activity increased significantly (P lt 0.05) with improved metabolic control in the diabetic patients, and showed positive within person correlation with HDL-2 cholesterol ester (r = 0.67; P lt 0.01), HDL, free cholesterol (r = 0.67; P lt 0.01), phosphatidylcholine (r = 0.49; P lt 0.05), total phospholipids (r = 0.50; P lt 0.01) and apolipoprotein A-1 (apo A-1: r = 0.72; P lt 0.01). With improving metabolic control HDL-2 lipid levels increased more than twofold and the compositional changes in HDL-2 were reflected by an increased apo A-I:apo A-II ratio (P lt 0.05) and a decreased triglyceride: apo A-I ratio (P lt 0.05). Changes in HDL-3 levels and composition were minor. The results of this study indicate that an increase in LCAT activity increases the concentration and changes the composition of HDL-2 in type 1 diabetic patients with improved metabolic control.

Lecithin:cholesterol acyltransferase activity and high-density lipoprotein subfraction composition in type 1 diabetic patients with improving metabolic control