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Lipoproteins and lipoprotein lipid composition are associated with stages of dysglycemia and subclinical coronary atherosclerosis

Gigante, Bruna ; Chen, Qiaosen ; Björkbacka, Harry LU orcid ; Björnson, Elias ; Brinck, Jonas ; Chorell, Elin ; Djekic, Demir ; Edsfeldt, Andreas LU orcid ; Engström, Gunnar LU and Eriksson, Jan W. , et al. (2025) In International Journal of Cardiology 419.
Abstract

Background: Dyslipidaemia in patients with diabetes contributes to the risk of atherosclerotic cardiovascular disease. We aimed to identify a dyslipidemic profile associated with both dysglycemia and subclinical coronary atherosclerosis. Methods: Study participants (n = 5050) were classified in three groups: normoglycemia, pre-diabetes, and diabetes. A coronary artery calcium score (CACS) > 0 defined subclinical coronary atherosclerosis. Two independent methods were used to identify, among 225 lipid biomarkers, those that were associated with pre-diabetes and diabetes and were further tested for association by zero inflated Poisson regression with CACS and with CACS burden in study participants with CACS>0. Estimates were adjusted... (More)

Background: Dyslipidaemia in patients with diabetes contributes to the risk of atherosclerotic cardiovascular disease. We aimed to identify a dyslipidemic profile associated with both dysglycemia and subclinical coronary atherosclerosis. Methods: Study participants (n = 5050) were classified in three groups: normoglycemia, pre-diabetes, and diabetes. A coronary artery calcium score (CACS) > 0 defined subclinical coronary atherosclerosis. Two independent methods were used to identify, among 225 lipid biomarkers, those that were associated with pre-diabetes and diabetes and were further tested for association by zero inflated Poisson regression with CACS and with CACS burden in study participants with CACS>0. Estimates were adjusted for cardiovascular risk factors with an interaction term for dispensed lipid lowering drugs. Results: Thirty-two biomarkers associated with prediabetes and diabetes were further investigated for association with CACS. HDL diameter [multi-adjusted OR of 0.85 and 95 %CI (0.78–0.92)] as well as free cholesterol, phospholipids and total lipids in extra large HDL were inversely associated with CACS. There was a borderline significant interaction between small HDL and dispensed lipid lowering drugs on the presence of CACS, with and multi-adjusted OR of 0.53 and 95 %CI (0.36–0.77). None of the 32 glycemic profile-related lipid biomarkers associated with the relative increase of CACS in those with CACS>0. No consistent association was observed between non-HDL lipoproteins and CACS. Conclusions: Changes in composition and relative concentration of HDL associated with both dysglycemia and subclinical coronary atherosclerosis. Treatment with lipid lowering drugs may contribute to reduce the risk associated with high circulating levels of small HDL.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Coronary artery calcium score, Cross sectional study, Diabetes mellitus, Lipoproteins, Metabolomics, Subclinical atherosclerosis
in
International Journal of Cardiology
volume
419
article number
132698
publisher
Elsevier
external identifiers
  • scopus:85208371068
  • pmid:39500476
ISSN
0167-5273
DOI
10.1016/j.ijcard.2024.132698
language
English
LU publication?
yes
id
06cc037a-c357-411b-b25a-b037174ec920
date added to LUP
2025-02-20 13:13:25
date last changed
2025-06-12 22:05:14
@article{06cc037a-c357-411b-b25a-b037174ec920,
  abstract     = {{<p>Background: Dyslipidaemia in patients with diabetes contributes to the risk of atherosclerotic cardiovascular disease. We aimed to identify a dyslipidemic profile associated with both dysglycemia and subclinical coronary atherosclerosis. Methods: Study participants (n = 5050) were classified in three groups: normoglycemia, pre-diabetes, and diabetes. A coronary artery calcium score (CACS) &gt; 0 defined subclinical coronary atherosclerosis. Two independent methods were used to identify, among 225 lipid biomarkers, those that were associated with pre-diabetes and diabetes and were further tested for association by zero inflated Poisson regression with CACS and with CACS burden in study participants with CACS&gt;0. Estimates were adjusted for cardiovascular risk factors with an interaction term for dispensed lipid lowering drugs. Results: Thirty-two biomarkers associated with prediabetes and diabetes were further investigated for association with CACS. HDL diameter [multi-adjusted OR of 0.85 and 95 %CI (0.78–0.92)] as well as free cholesterol, phospholipids and total lipids in extra large HDL were inversely associated with CACS. There was a borderline significant interaction between small HDL and dispensed lipid lowering drugs on the presence of CACS, with and multi-adjusted OR of 0.53 and 95 %CI (0.36–0.77). None of the 32 glycemic profile-related lipid biomarkers associated with the relative increase of CACS in those with CACS&gt;0. No consistent association was observed between non-HDL lipoproteins and CACS. Conclusions: Changes in composition and relative concentration of HDL associated with both dysglycemia and subclinical coronary atherosclerosis. Treatment with lipid lowering drugs may contribute to reduce the risk associated with high circulating levels of small HDL.</p>}},
  author       = {{Gigante, Bruna and Chen, Qiaosen and Björkbacka, Harry and Björnson, Elias and Brinck, Jonas and Chorell, Elin and Djekic, Demir and Edsfeldt, Andreas and Engström, Gunnar and Eriksson, Jan W. and Gottsäter, Anders and Gummesson, Anders and Hagström, Emil and Hedin, Ulf and Jernberg, Tomas and Johnston, Nina and Nilsson, Lennart and Nyström, Fredrik and Otten, Julia and Rosengren, Annika and Söderberg, Stefan and Haglöw, Jenny Theorell and Östgren, Carl Johan}},
  issn         = {{0167-5273}},
  keywords     = {{Coronary artery calcium score; Cross sectional study; Diabetes mellitus; Lipoproteins; Metabolomics; Subclinical atherosclerosis}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{International Journal of Cardiology}},
  title        = {{Lipoproteins and lipoprotein lipid composition are associated with stages of dysglycemia and subclinical coronary atherosclerosis}},
  url          = {{http://dx.doi.org/10.1016/j.ijcard.2024.132698}},
  doi          = {{10.1016/j.ijcard.2024.132698}},
  volume       = {{419}},
  year         = {{2025}},
}