The therapeutic efficacy of intensive medical therapy in ameliorating high-density lipoprotein dysfunction in subjects with type two diabetes.

The therapeutic efficacy of intensive medical therapy in ameliorating high-density lipoprotein dysfunction in subjects with type two diabetes.

Kashyap Sangeeta; Kheniser Karim; Li Ling; Bena James; Kasumov Takhar

Lipids in health and disease

2016

2016-08

BACKGROUND: To determine whether 12 months of intensive medical therapy (IMT) improves HDL functionality parameters in subjects with type II diabetes (T2D). METHODS: Retrospective, randomized, and controlled 12-month IMT intervention trial that enrolled 13-subjects with T2D (age 51- years, fasting glucose 147 mg/dL, body mass index [BMI] 36.5 kg/m(2)) and nine healthy control (46-years, fasting glucose 90 mg/dL, BMI 26.5 kg/m2). Subjects with T2D underwent IMT and HDL functionality measures (pro-inflammatory index of high-density lipoprotein (pHDL)), paraoxonase one (PON1), ceruloplasmin (Cp), and myeloperoxidase (MPO) activity were performed on samples at baseline and at 12-months following IMT. RESULTS: At baseline, pHDL index was significantly higher in subjects with T2D (p \textless 0.001) and apolipoprotein A-1 levels were significantly lower (p = 0.013) vs. CONTROLS: After 12-months, there was a trend for improved pHDL activity (p = 0.083), as indicated by intent-to-treat analysis, but when the non-adherent subject was omitted (per-protocol), significant attenuations in pHDL activity (p = 0.040) were noted; Delta pHDL activity at 12-months was associated with Delta weight (r = 0.62, p = 0.032) and Delta fasting glucose (r = 0.65, p = 0.022). Moreover, PON1 activity significantly improved (p \textless 0.001). The aforementioned occurred in association with improvements in inflammatory markers (i.e.,

*Diet; *Exercise Therapy; *Intensive medical therapy; *Myeloperoxidase; *Paraoxonase one; *Pro-inflammatory high-density lipoproteins; Adult; Apolipoprotein A-I/blood/drug effects; Biguanides/pharmacology/therapeutic use; Combined Modality Therapy; Diabetes Mellitus; Diabetic; Female; HDL/blood/*drug effects; Humans; Hypoalphalipoproteinemias/complications/diet therapy/drug therapy/therapy; Hypoglycemic Agents/*pharmacology/therapeutic use; Insulin/analogs & derivatives/pharmacology/therapeutic use; Lipoproteins; Male; Middle Aged; Retrospective Studies; Treatment Outcome; Type 2/blood/complications/*therapy

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