My observation is that Diabetes patients often time have more Triglyceride and HDL derangement than LDL, most studies and even the ADA standard of care use LDL as outcome of care. Explanation will be appreciated because I see DM patients with more of Triglyceride and HDL abnormality that LDL. Response needed.
Good metabolic control often means good cardiovascular outcomes due to lowered LDL levels.
Triglycerides have a lower impact on cardiovascular mortality,
LDLand/or HDL have a good correlation with cardiovascular mortality. But LDL is a better marker for diabetic metabolic control.
LDL is used because of the sheer number of clinical trials showing LDL reduction linked to reductions in CVD/mortality. Evidence is not so strong for TGs.
High HDL has correlated with better CVD outcome but so far clinical trails have failed to show a benefit of therapeutically raising HDL... still an ongoing area of research.
Good question though, LDL is used because it has the strongest evidence of being a good therapeutic target.
You guys are in the right track. The only two parameter in the lipid profile that has been correlated with future cardiovascular events are, (A) Non-HDL cholesterol (total cholesterol - HDL level); sing this indices is more precise and physiologically relevant than using LDL, which is only part of the bad lipids, and (B) Triglycerides.
I think triglycerides depends on omega-3 deficiency if you will give fish oil these patients, triglycerides can be decreased. But diabetic patients with normal triglycerides you can find diminished omega-6 levels because of delta 6 desaturase enzyme deficiency.
Having low HDL and elevated triglycerides are genetic traits, where diet has very little effect. To-date, there are no drug available safely increase the HDL level. Thus, the piratical option is to using as describe above omega- (fish oil) and use of statins to decrease non-HDL cholesterol. Of course together with life style changes including increasing physical activities and diet changes.
Agreed , @sunil
HDL comes in subtypes
And here's the thing, HDL-3 increase is the best for reducing CV risk- increased by exercise.
HDL-2 next best increased by moderate alcohol intake, and fish oils.
HDL 1, average for reducing CV risk, increased by olive oil and avocado.
- Badges
- Science topic
- Similar topics
- Biological Science
- Biochemistry
- Biomolecules
- Peptides