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Triglycerides (mmol/L)

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1 Triglycerides (mmol/L)
Analysis Of The Composition And Functional Characteristics Of HDL Subfractions From Patients With Type 2 Diabetes With And Without Obstructive Coronary Artery Disease.  ANTONIO CASELLA-FILHO, LIA BAETA CASELLA, LARISSA ALMEIDA DOURADO, PAULO MAGNO MARTINS DOURADO; MARILIA CO SPRANDEL, RAUL C MARANHAO; WHADY A HUEB Heart Institute (InCor) HCFMUSP - University of Sao Paulo Medical School, Sao Paulo, Brazil Background Results Results Studies indicate a strong relationship between disorders of cholesterol efflux capacity with CHD risk1, and researches in cultured cells revealed that the subfraction HDL2 was shown to be more relevant than the subfraction HDL3 in the cholesterol efflux process2. Disturbances in the metabolic status of the high density lipoprotein (HDL) in type 2 diabetes mellitus (T2DM), leading to coronary artery disease (CAD), is suggested by recent studies.T2DM may affect lipid metabolism by altering the protein lipid transfer and compromising the formation and the metabolism of HDL, especially the reverse cholesterol transport (RCT) However, surprisingly, there are some patients with T2DM whose angiographic study is not able to identify any obstructive change inside the coronary vessels. . Serum triglycerides and HDL-C were similar between the two T2DM groups. LDL-C was higher in T2DM2+CAD than T2DM-CAD. Triglycerides transfer to HDL3 of T2DM+CAD patients was slightly higher than in T2DM-CAD patients. Phospholipid transfers are similar between the groups. HDL3- Transfer of triglycerides HDL3- Transfer of phospholips Parameters T2DM - CAD T2DM + CAD D P value Triglycerides (mmol/L) 1.72 ± 0.78 1.91 ± 0.81 NS Cholesterol (mmol/L) Total 4.99 ± 0.93 5.63 ± 1.24 <0.001 LDL 3.20 ± 0.85 3.80 ± 1.13 HDL 1.06 ± 0.23 0.98 ± 0.20 % transfer / ml plasma . T2DM-CAD T2DM+CAD T2DM-CAD T2DM+CAD Conclusions Data are expressed as mean ± SD. NS = nonstatistically significant, HDL= high density lipoprotein, LDL = low density lipoprotein In this study there was significant differences in the HDL subfractions functionality of the T2DM patients. The cholesterol-ester and cholesterol-free transfers of the T2DM+CAD patients are lower than the T2DM-CAD patients. This strongly indicates HDL2 particles disorders in patients with CAD, promoting considerable instability of these particles and reducing efficiency of RTC. Consequently, there is more propensity to atherosclerotic processes, what would explain the presence or not of CAD in patients with T2DM These data highlight the important role of functional analysis of HDL subfractions of these patients   Objective We aim to distinguish possible compositional and functional differences in HDL subfractions in patients, with similar T2DM evolution, with and without obstructive CAD The transfer of cholesterol – free and cholesterol – ester to HDL2 of T2DM+CAD was lower than in T2DM-CAD patients. Methods We studied 155 patients with T2DM undergoing angiography (79 had obstructive CAD) from MASS study4. Serum biochemical concentrations, separation and isolation of HDL subfractions were proceeded and analyzed. The functionality of the particles was determined by analysing the ability of HDL subfractions to receive lipids, a crucial step in the RCT, obtained by quantifying the transfer of lipids to HDL by an in vitro assay using an artificial nanoemulsion used as donor of radioactive lipids, and subsequent HDL fractionation. The data were compared to healthy controls HDL2- Transfer of cholesterol-free HDL2- Transfer of cholesterol-ester References 1- Rothblat G. et al. Cholesterol efflux capacity, high-density lipoprotein function, and atherosclerosis. N.Engl.J.Med. 2011; 364(2): 2- Yancey PG. et al. High Density Lipoprotein Phospholipid Composition Is a Major Determinant of the Bi-directional Flux and Net Movement of Cellular Free Cholesterol Mediated by Scavenger Receptor BI. J.Biol.Chem. 2000; 275: 3- Sprandel, M C O ; Hueb, W A ; Segre, A ; Ramires, JA F ; Kalil-Filho, R ; Maranhão, R C . Alterations in lipid transfers to HDL associated with the presence of coronary artery disease in patients with type 2 diabetes mellitus. Cardiovascular Diabetology , 2015 v. 14, p. 107. 4- Hueb A W. et al. Ten-Year Follow-Up Survival of the Medicine, Angioplasty, or Surgery Study (MASS II): a randomized, controlled clinical trial of three therapeutic strategies for multivessel coronary artery disease. Circulation, 2010,Volume 122, Issue 10, p % transfer / ml plasma Disclosures T2DM-CAD T2DM+CAD T2DM-CAD T2DM+CAD None

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