ASSOCIATION BETWEEN BLOOD LIPID PROFILE AND BLOOD GLUCOSE LEVELS IN MEN WITH CORONARY HEART DISEASE, METABOLIC SYNDROME, AND TYPE 2 DIABETES MELLITUS

Aim. To study the associations between blood lipid profile and blood glucose levels in men with coronary heart disease (CHD), stable effort angina (SEA), metabolic syndrome (MS), and Type 2 diabetes mellitus (DM-2).

Material and methods. The study included 82 men (mean age 50,5±0,9 years) with CHD, Functional Class I–III SEA, MS, and DM-2. The following lipid profile parameters were assessed: total cholesterol (TCH), triglycerides (TG), low-density lipoprotein cholesterol (LDL–CH), very low-density lipoprotein cholesterol (VLDL–CH), high-density lipoprotein cholesterol (HDL–CH), atherogenic index (AI), and triglyceride index (TGI), together with fasting blood glucose.

Results. There were positive (direct) associations between higher levels (>90th percentile) of lipid profile parameters (TCH, TG, LDL–CH, VLDL– CH, HDL–CH, AI, TGI) and blood glucose, as well as between lower levels (≤10th percentile) of lipid profile parameters (TCH, TG, LDL–CH, VLDL– CH, AI, TGI) and blood glucose. At the same time, there were negative (inverse) associations between lower lipid levels (≤10th percentile of TCH, TG, LDL–CH, VLDL–CH, HDL–CH, AI, TGI) and higher glucose levels (>90th percentile), as well as between higher lipid levels (>90th percentile of TCH, TG, LDL–CH, VLDL–CH, HDL–CH, AI, TGI) and lower glucose levels (≤10th percentile).

Conclusion. Dyslipidemia and hyperglycemia demonstrate synergetic proatherogenic effects in patients with CHD, SEA, MS, and DM-2, as suggested by significant heterogeneous (direct and inverse) associations between lipid profile parameters and fasting blood glucose. The results obtained provide an opportunity for the assessment of risk levels, prognosis, and need for pharmacological prevention and treatment in patients with combined cardiovascular pathology. 

1. Gerasimenko NF. Supermortality of the population – the main demographic problem of Russia in a context of the European tendencies of health. Health Сare of the Russian Federation 2009; 3: 10–3. Russian (Гераси- менко Н.Ф. Сверхсмертность населения – главная демографическая проблема России в контексте европейских тенденций здоровья. Здравоохранение Российской Федерации 2009; 3: 10–3).

2. Son IM, Leonov SA, Ogrysko EV. Modern features of incidence of adult population. Health Care of the Russian Federation 2010; 1: 3–6. Russian (Сон И.М., Леонов С.А., Огрызка Е.В. Современные особенности заболеваемости взрослого населения. Здравоохранение Российской Федерации 2010; 1: 3–6).

3. Oganov RG, Maslennikova GYa. Demographic trends in the Russian Federation: the contribution of cardiovascular diseases. Cardiovascular Therapy and Prevention 2012; 11 (1): 5–10. Russian (Оганов Р.Г., Масле нникова Г.Я. Демографические тенденции в Российской Федерации: вклад болезней системы кровообращения. Кардиоваскулярная терапия и профилактика 2012; 11 (1): 5–10).

4. Rotar O.P, Либис R. A., Isaeva E. N., et al. Metabolic syndrome prevalence in Russian cities. Russian journal of cardiology, 2012; 2 (94): 55-62. Russian (Ротарь О. П., Либис Р. А., Исаева Е. Н., и др. Распространенность метаболического синдрома в разных городах РФ. Российский кардиологический журнал 2012, 2 (94): 55-62).

5. Diagnostics and treatment of a metabolic syndrome: Russian recommendations. M, 2009. Cardiovascular Therapy and Prevention 2009; 8 (6), appendix 2. Russian (Диагностика и лечение метаболического синдрома: российские рекомендации. М., 2009. Кардиоваскулярная терапия и профилактика 2009; 8 (6), приложение 2).

6. Lakka HM, Laaksonen DE, Lakka TA, et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 2002; 288 (21): 2709–16.

7. Standl E. An etiology and consequences of the metabolic syndrome. Eur Heart J 2005; 7 (D): 10–3.

8. Isomaa B, Lahti K, Almgren P, et al. Cardiovascular morbidity and mortality associated with metabolic syndrome. Diabetes Care 2001; 24 (4): 683–9.

9. King H, Aubert RE, Herman WH. Global burden of diabetes, 1995–2025: prevalence, numerical estimates and projections. Diabetes Care 1998; 21: 1414–31.

10. International Diabetes Federation. The IDF consensus worldwide definition of the metabolic syndrome. < http://www.idf.org/webdata/docs/ MetSyndrome_FINAL.pdf> (Version current at March 3, 2006).

11. Kuzmin AG, Bolotsky LL, Yarek-Martynova IR. The 47th Annual congress of the European Association on Studying of Diabetes (EASD), on September 12–16, 2011, Lisbon. Diabetes Mellitus 2011; 3: 123–5. Russian (Кузьмин А.Г., Болотская Л.Л., Ярек-Мартынова И.Р. 47-й Ежегодный конгресс Европейской Ассоциации по изучению диабета (EASD), 12–16 сентября 2011 г., Лиссабон. Сахарный диабет 2011; 3:123–5).

12. Carr MC, Brunzell JD. Abdominal obesity and dyslipidemia in the metabolic syndrome: importance of type 2 diabetes and familial combined hyperlipidemia in coronary artery disease risk. J Clin Endocrinol Metab 2004; 89 (6): 2601–7.

13. Diagnostics and correction of lipid disorders with the purpose of prophylaxis and treatment of atherosclerosis. Russian Guidelines. V revision. Russian Journal of Cardiology, 2012;4(96):1-32. Suppl. 1; Russian (Диагностика и коррекция нарушений липидного обмена с целью профилактики и лечения атеросклероза. Российские рекомендации, V пересмотр. Российский кардиологический журнал 2012;4(96):1-32, Приложение 1).

14. Cao JJ, Hudson M, Jankowski M, et al. Relation of chronic and acute glycemic control on mortality in acute myocardial infarction with diabetes mellitus. Am J Cardiol 2005; 96: 183–6.

15. Stettler C, Allemann S, Joni P, et al. Glycemic control and macrovascular disease in types 1 and 2 diabetes mellitus: meta-analysis of randomized trials. Am Heart J 2006; 152: 27–38.

16. Klimov AN, Nikulcheva NG. Exchange of lipids and lipoproteins and its disturbances. Peter Press, 1999. Russian (Климов А. Н., Никульчева Н.Г. Обмен липидов и липопротеидов и его нарушения. Питер Пресс, 1999).

17. Mclaughlin T, Abbasi F, Cheal K, et al. Use of metabolic markers to identify overweight individuals who are insulin resistant. Ann Intern Med 2003; 139: 802–9.

18. Berthezene F. Non-insulin-dependent diabetes and reverse cholesterol transport. Atherosclerosis 1996; 124: S39–42.

19. Boden G, Shulman GI. Free fatty acids in obesity and type 2 diabetes: defining their role in the development of insulin resistance and beta-cell dysfunction. Eur J Clin Invest 2002; 32 (3): 14–23.

20. Сardiovascular Prevention. National recommendations. M, 2011. Cardiovascular Therapy and Prevention 2011; 10 (6), appendix 2: 1–64. Russian (Кардиоваскулярная профилактика. Национальные рекомендации. М., 2011. Кардиоваскулярная терапия и профилактика 2011; 10 (6), Приложение 2: 1–64).