- Email: [email protected]
The lipid profile of non-diabetic and diabetic elderly
$52
Poster session abstracts / Atherosclerosis 115 ( SuppL ) (199J) $45-S129 P2 Diabetes
187
189
THE LIPID PROFILE OF NON-DIABETIC AND DIABETIC ELDERLY St. Pagoni, Sp. Paximadas, E. Chatzikonstantino, El. Vervesou, S. Giannakidis, Z Demesticha Unit Lipid, Hospital "ELPIS" Athens, Greece
THE EFFECT OF BENZAFIBRATE OR LOVASTATIN ON THE HEMOSTATIC SYSTEM. DYSLIPIDEMIA AND DIABETES CONTROL IN TYPE-2 DIABETES G. Schernthaner I. Bauer, T. Vukovich, P. Hopmeier Dept. Med. I Rudolfstiftung and University of Vienna, Austria
Purpose: To study the lipid levels in nondiabetic and diabetic elderly and their possible role in longevity. Material-Methods: A total of 156 elderly individuals aged 76 and older were studied. Group A consisted of 53 elderly diabetics, mean age 815:4 yrs, 16 males and 30 females. Group B consisted of 125 nondiabetics, mean age 81 ± 4 yrs, 42 males and 67 females. AI were ambulatory and came to the outpatient clinic for a check-up. None were taking an medication known to affect serum lipids. Diabetics were under diet with or without medical therapy.
Dyslipidemia - associated with abnormalities in the haemostatic system - is believed to play an important role in the development of vascular complications. In a randomized controlled study we compared the effect of Bezafibrate (400 mg/d) vs. Lovastatin (20 mg/dl) in 33 patients with type 2 diabetes. Under Bezafibrate (B) a decrease of total cholesterol (247 vs 240 mg/dl; NS), LDL-cholesterol (163 vs 148 mg/dl; NS) and triglycerides (385 vs 247 mg/dl; p < 0 , 0 l ) was noted. Under Lovastatin (L) total cholesterol (267 vs 215 mg/dl; p < 0 , 0 1 ) , LDL-cholesterol (157 vs 119 mg/dl; p < 0 , 0 1 ) and triglycerides (262 to 241 mg/dl; NS) decreased. HDL-cholesterol remained unchanged under L, but increased slightly under B (47 vs 49mg/dl; p < 0 , 0 5 ) . ApoA1, ApoA2 and Lp(a) remained unchanged in both groups. ApoB decreased under L (152 vs 131 mg/dl; p < 0 , 0 5 ) . The atherogenic index (LDL/HDL) fell similarly (B: 3,9 vs 3,2; p < 0 , 0 5 ; L: 3,3 vs 2,7 p < 0 , 0 5 ) . Fibrinogen decreased under B (313 vs 274 mg/dl; p < 0 , 0 5 ) . Factor VII, tissue-plasminogen-activator and plasminogen-activator inhibitor remained unchanged under B and L, despite the decrease of lipid levels. HbA~ and insulin levels remained also unchanged. In conclusion, the atherogenic index of lipid metabolism was similarly improved by both Bezafibrate and Lovastatin. Parameters of diabetes control and of the haemostatic system remained unchanged in both groups with the exception of a 10% fall of fibrinogen under Bezafibrate.
Results: Group A TC(mg/dL) 185+_43 TG(mg/dL) 1345:76 HDL-C(mg/dL) 33.15:5.2 41.5+9.4 LDL-C(mg/dL) 1115:12 132_+44 NS Lipoprotein Electrophoresis ( ' p < 0.01, N S = Not Significant)
Group B 1965-47 NS 117_+53 NS
NS
Conclusion: The lipid profile of elderly diabetics and non-diabetics in a random population study were not significantly different, except for HDL-C that was significantly increased in non-diabetics. Longevity in both groups is associated with normal lipid parameters.
188
190
CHILDREN WITH DIABETES MELLITUS: LIPID PROFILE ACCORDING TO THE NUMBERS OF GLICATED HAEMOGLOBIN P.N. Kherkheulidze L.V. Jawashvili Tbilisi State Medical University, Georgia
QUALITATIVE DIABETIC LIPOPROTEIN CHANGE: PRANDIAL PROFILE & BEZAFIBRATE THERAPY C. Harris. G. Stirling, J. Lloyd J.P.D. Reckless Postgraduate Medicine, Bath University, UK
In order to know the influence of glicated haemoglobin (HbAlc) levels on lipid and lipoprotein metabolism parameters, 112 children (mean age 9.65-2.4 years) with type 1 diabetes mellitus (IDDM) were investigated according to HbAlc levels (1 group -74 children having HbAIc IO.0%, II group -38 children with HbAIc 5.6%). Standard methods were used for cholesterol (TC), triglycerids (TG), major lipoprotein (VLDL,LDL, HDL) and apoprotein (AI, All, B) classes evaluation. Significantly increased numbers of TC and LDL-C and decreased levels of HDL, apoAI, All with almost 4 fold elevation of atherogenic index were characteristic to children with IDDM. Reduction of anti-atherogenic HDL was parallel to the duration of the disease. Atherogenic changes of lipid profile reached their maximum in children with poor controled diabetes (1 group), while children with good control (II group) were not significantly different from the healthy children. Prevention of atherosclerosis needs high control of carbohydrate metabolism in children with type 1 insulin-dependent diabetes mellitus.
POST-
Coronary disease increases x3 in diabetes, with raised triglycerides, partly linked to control, and exacerbated after food. Lipoprotein subfractions were examined for postprandial (1000 Cal 50g fat, mixed meal) qualitative changes in 18 NIDDM subjects (fructosamine = mean+4SD, cholesterol (C) 5.5-8.0 , triglyceride (T) 1.5-4.0raM), pre & 6 weeks post placebo or bezafibrate (400mg/dl). No placebo changes occurred, but fibrate lowered fasting T (2.92(2.44,3.58):2.05 (1.63,2.56)mM; p=0.059) (mean(x-SE,x+SE)), VLDL-T (1.04(0.77,1.4l):0.46(0.34,0.61); p = O . 0 2 ) and VLDL-C (by 34%; p=0.023). Postprandial areas under lipid curves (AUC) also fell. for O-12hAUC-T (56.2(49.2,64.3): 35.2(30.0,41.4)mM; p=0.014), AUC-VLDL-T (24.6(17.9,34.9):11.2 (9.8,12.9)mM; p=0.022), AUC-VLDL-C (12.7+-1.1:7.86+-0.73mM; p=O.OOl), and AUC-apoB (1703+-73:1245+120mg/dl; p=O.OOl). Chylomicron mass (m:O-8hAUCmg/dl) fell (487±53:217+-34;p=0.004), as did AUC-VLDLIm (1389_+247:702+-133;p=O.005), AUC-VLDL2m (424+63:227+79; p=O.Ol) but not AUC-VLDL3m (p=0.08). LDL3 (% total LDL) fell with bezafibrate at Oh (37.7:31.0%; p=0.007), 3h and 8 h Qualitative pro-atherogenic lipoprotein changes decreased, particularly in large T-rich particles in lipid-treated N1DDM.
Poster session abstracts / Atherosclerosis 115 ( SuppL ) (199J) $45-S129 P2 Diabetes
187
189
THE LIPID PROFILE OF NON-DIABETIC AND DIABETIC ELDERLY St. Pagoni, Sp. Paximadas, E. Chatzikonstantino, El. Vervesou, S. Giannakidis, Z Demesticha Unit Lipid, Hospital "ELPIS" Athens, Greece
THE EFFECT OF BENZAFIBRATE OR LOVASTATIN ON THE HEMOSTATIC SYSTEM. DYSLIPIDEMIA AND DIABETES CONTROL IN TYPE-2 DIABETES G. Schernthaner I. Bauer, T. Vukovich, P. Hopmeier Dept. Med. I Rudolfstiftung and University of Vienna, Austria
Purpose: To study the lipid levels in nondiabetic and diabetic elderly and their possible role in longevity. Material-Methods: A total of 156 elderly individuals aged 76 and older were studied. Group A consisted of 53 elderly diabetics, mean age 815:4 yrs, 16 males and 30 females. Group B consisted of 125 nondiabetics, mean age 81 ± 4 yrs, 42 males and 67 females. AI were ambulatory and came to the outpatient clinic for a check-up. None were taking an medication known to affect serum lipids. Diabetics were under diet with or without medical therapy.
Dyslipidemia - associated with abnormalities in the haemostatic system - is believed to play an important role in the development of vascular complications. In a randomized controlled study we compared the effect of Bezafibrate (400 mg/d) vs. Lovastatin (20 mg/dl) in 33 patients with type 2 diabetes. Under Bezafibrate (B) a decrease of total cholesterol (247 vs 240 mg/dl; NS), LDL-cholesterol (163 vs 148 mg/dl; NS) and triglycerides (385 vs 247 mg/dl; p < 0 , 0 l ) was noted. Under Lovastatin (L) total cholesterol (267 vs 215 mg/dl; p < 0 , 0 1 ) , LDL-cholesterol (157 vs 119 mg/dl; p < 0 , 0 1 ) and triglycerides (262 to 241 mg/dl; NS) decreased. HDL-cholesterol remained unchanged under L, but increased slightly under B (47 vs 49mg/dl; p < 0 , 0 5 ) . ApoA1, ApoA2 and Lp(a) remained unchanged in both groups. ApoB decreased under L (152 vs 131 mg/dl; p < 0 , 0 5 ) . The atherogenic index (LDL/HDL) fell similarly (B: 3,9 vs 3,2; p < 0 , 0 5 ; L: 3,3 vs 2,7 p < 0 , 0 5 ) . Fibrinogen decreased under B (313 vs 274 mg/dl; p < 0 , 0 5 ) . Factor VII, tissue-plasminogen-activator and plasminogen-activator inhibitor remained unchanged under B and L, despite the decrease of lipid levels. HbA~ and insulin levels remained also unchanged. In conclusion, the atherogenic index of lipid metabolism was similarly improved by both Bezafibrate and Lovastatin. Parameters of diabetes control and of the haemostatic system remained unchanged in both groups with the exception of a 10% fall of fibrinogen under Bezafibrate.
Results: Group A TC(mg/dL) 185+_43 TG(mg/dL) 1345:76 HDL-C(mg/dL) 33.15:5.2 41.5+9.4 LDL-C(mg/dL) 1115:12 132_+44 NS Lipoprotein Electrophoresis ( ' p < 0.01, N S = Not Significant)
Group B 1965-47 NS 117_+53 NS
NS
Conclusion: The lipid profile of elderly diabetics and non-diabetics in a random population study were not significantly different, except for HDL-C that was significantly increased in non-diabetics. Longevity in both groups is associated with normal lipid parameters.
188
190
CHILDREN WITH DIABETES MELLITUS: LIPID PROFILE ACCORDING TO THE NUMBERS OF GLICATED HAEMOGLOBIN P.N. Kherkheulidze L.V. Jawashvili Tbilisi State Medical University, Georgia
QUALITATIVE DIABETIC LIPOPROTEIN CHANGE: PRANDIAL PROFILE & BEZAFIBRATE THERAPY C. Harris. G. Stirling, J. Lloyd J.P.D. Reckless Postgraduate Medicine, Bath University, UK
In order to know the influence of glicated haemoglobin (HbAlc) levels on lipid and lipoprotein metabolism parameters, 112 children (mean age 9.65-2.4 years) with type 1 diabetes mellitus (IDDM) were investigated according to HbAlc levels (1 group -74 children having HbAIc IO.0%, II group -38 children with HbAIc 5.6%). Standard methods were used for cholesterol (TC), triglycerids (TG), major lipoprotein (VLDL,LDL, HDL) and apoprotein (AI, All, B) classes evaluation. Significantly increased numbers of TC and LDL-C and decreased levels of HDL, apoAI, All with almost 4 fold elevation of atherogenic index were characteristic to children with IDDM. Reduction of anti-atherogenic HDL was parallel to the duration of the disease. Atherogenic changes of lipid profile reached their maximum in children with poor controled diabetes (1 group), while children with good control (II group) were not significantly different from the healthy children. Prevention of atherosclerosis needs high control of carbohydrate metabolism in children with type 1 insulin-dependent diabetes mellitus.
POST-
Coronary disease increases x3 in diabetes, with raised triglycerides, partly linked to control, and exacerbated after food. Lipoprotein subfractions were examined for postprandial (1000 Cal 50g fat, mixed meal) qualitative changes in 18 NIDDM subjects (fructosamine = mean+4SD, cholesterol (C) 5.5-8.0 , triglyceride (T) 1.5-4.0raM), pre & 6 weeks post placebo or bezafibrate (400mg/dl). No placebo changes occurred, but fibrate lowered fasting T (2.92(2.44,3.58):2.05 (1.63,2.56)mM; p=0.059) (mean(x-SE,x+SE)), VLDL-T (1.04(0.77,1.4l):0.46(0.34,0.61); p = O . 0 2 ) and VLDL-C (by 34%; p=0.023). Postprandial areas under lipid curves (AUC) also fell. for O-12hAUC-T (56.2(49.2,64.3): 35.2(30.0,41.4)mM; p=0.014), AUC-VLDL-T (24.6(17.9,34.9):11.2 (9.8,12.9)mM; p=0.022), AUC-VLDL-C (12.7+-1.1:7.86+-0.73mM; p=O.OOl), and AUC-apoB (1703+-73:1245+120mg/dl; p=O.OOl). Chylomicron mass (m:O-8hAUCmg/dl) fell (487±53:217+-34;p=0.004), as did AUC-VLDLIm (1389_+247:702+-133;p=O.005), AUC-VLDL2m (424+63:227+79; p=O.Ol) but not AUC-VLDL3m (p=0.08). LDL3 (% total LDL) fell with bezafibrate at Oh (37.7:31.0%; p=0.007), 3h and 8 h Qualitative pro-atherogenic lipoprotein changes decreased, particularly in large T-rich particles in lipid-treated N1DDM.