Diabetes and Metabolism Journal

Korean Diabetes Association (대한당뇨병학회)
권호 표지

The Association of Plasma HDL-Cholesterol Level with Cardiovascular Disease Related Factors in Korean Type 2 Diabetic Patients

제2형 당뇨병환자에서 혈장 HDL-콜레스테롤 수준과 심혈관계질환 위험요인 분석

Hong, Hye-Sook;Park, Jong-Suk;Ryu, Han-Kyoung;Kim, Wha-Young
홍혜숙;박종숙;유한경;김화영

  • Published : 2008.06.01
⟨ Previous Next ⟩

Abstract

Background: Cardiovascular disease(CVD) is the major cause of death in type 2 diabetic patients. The purpose of this study was to investigate the characteristics of Korean type 2 diabetes mellitus(DM) patients according to plasma high density lipoprotein(HDL) cholesterol level and to document the effect of diet on HDL-cholesterol. Methods: The subjects were 252(male: 134, female: 118) Korean type 2 DM patients recruited from a general hospital's DM clinic and divided into low HDL-cholesterol group(male < 40 mg/dL, female < 50 mg/dL) and control group(male ≥ 40 mg/dL, female ≥ 50 mg/dL). Anthropometric and hematological variables and dietary intake were assessed by the groups. Results: The subject's mean age was 60.2 ± 1.1 years and duration of diabetes was 9.5 ± 1.0 years. Anthropometric measurements(body fat mass, % body fat, WHR, fat free mass, and muscle mass) and BMI were not significantly different between two groups. The male subjects with low HDL-cholesterolemia showed higher Atherogenic Index(AI, P < 0.001) and higher % carbohydrate from energy than control group(P < 0.01). The female subjects with low HDL-cholesterolemia showed higher AI(P < 0.001) and a tendency of higher triglyceride level and lower intake of energy, protein, lipid, vitamin B1 and vitamin E(P < 0.05) than control group.Conclusion: The subject with low HDL-cholesterolemia showed significantly higher AI. Male subject with low HDL-cholesterolemia consumed higher carbohydrate and female subject with low HDL-cholesterolemia showed lower intakes of many nutrients. This result suggests the importance of an adequate and balanced diet to manage type 2 DM patients to prevent CVD complications.(KOREAN DIABETES J 32:215-223, 2008)

연구배경: 이상지혈증은 심혈관질환의 주요한 위험 요인으로 특히 HDL-콜레스테롤의 농도를 정상수준으로 유지하는 것이 중요하다. 본 연구에서는 제2형 당뇨병환자에게서 혈장 HDL-콜레스테롤 농도에 따른 특성을 비교하여 보았다. 방법: 제2형 당뇨병환자 252명(남자: 134명, 여자: 118명)을 대상으로 신체계측과 생화학적 검사, 식품섭취빈도 조사를 통한 식이조사를 통해 평가하였다. 결과: 대상자의 평균 연령은 60.2 ± 1.1세로 남녀 대상자 모두에게서 HDL-콜레스테롤 농도가 낮은 군과 정상군 간에 키, 체중, WHR, 체지방량, 체지방률, 제지방량, 근육량, 체질량지수에서 유의한 차이가 없었다. 남녀 모두 HDL-콜레스테롤이 낮은 군이 대조군보다 동맥경화지수가 유의적으로 높게 나타났다(P < 0.001). 식이에서는 남자 대상자의 경우 HDL-콜레스테롤이 낮은 군에서 탄수화물 에너지 섭취비율이 대조군보다 유의적으로 높게 나타났고(P < 0.05) 여자 대상자의 경우는 HDL-콜레스테롤이 낮은 군에서 항산화 영양소인 비타민 B1, 비타민 E의 섭취가 낮은 것으로 나타났다(P < 0.05).

Keywords

References

  1. Choi DS, Kim DK, Kim DM, Kim SY, Nam MS, Park YS, Shon HS, Ahan CW, Lee KW, Lee KU, Lee MK, Chung CH, Cha BH and 83 investigators: Efficacy evaluation of atorvastatin in Korean hyperlipidemic patients with Type 2 diabetes Mellitus. J Kor Diabetes Assoc 30:292-302, 2006 https://doi.org/10.4093/jkda.2006.30.4.292
  2. Yun KE, Park MJ, Park HS: Lack of management of cardiovascular risk factors in type 2 diabetic patients. Int J Clin Pract 61:39-44, 2007 https://doi.org/10.1111/j.1742-1241.2006.01154.x
  3. Hobbs FD: Type-2 diabetes mellitus related cardiovascular risk:New options for interventions to reduce risk and treatment goals. Atherosclerosis Supplements 7:29-32, 2006
  4. Cui R, Iso H, Toyoshima H, Date C, Yamamoto A, Kikuchi S, Kondo T, Watanabe Y, Koizumi A, Inaba Y, Tamakoshi A: JACC Study Group. Serum total cholesterol levels and risk of mortality from stroke and coronary heart disease in Japanese: the JACC study. Atherosclerosis 194:415-20, 2007 https://doi.org/10.1016/j.atherosclerosis.2006.08.022
  5. Lozano JV, Pallares V, Cea-Calvo L, Llisterri JL, Fernandez-Perez C, Marti-Canales JC, Aznar J, Gil-Guillen V, Redon J: Investigators of the PREV-ICTUS Study: Serum lipid profiles and their relationship to cardiovascular disease in the elderly : the PREV-ICTUS study. Curr Med Res Opin. 24:659-70, 2008 https://doi.org/10.1185/030079908X273372
  6. Cho HK: High density lipoprotein cholesterol comes of ages. Kor Circulation J 37:187-90, 2007 https://doi.org/10.4070/kcj.2007.37.5.187
  7. Simons LD: Interelations of lipids-lipoproteins with coronary artery disease mortality in 19 countries. AM J Cardiol 27:20-106, 1986 https://doi.org/10.1016/0002-9149(71)90078-6
  8. Castelli WP: Cholesterol and lipids in the risk of coronary heart disease:the Framingham Heart Study. Can J Cardiol 4:5A-10A, 1988
  9. Assmann G, Schulte H: Relation of high-density lipoprotein cholesterol and triglycerides to incidence of atherosclerotic coronary disease (the PROCAM experience). AM J Cardiol 70:733-7, 1992 https://doi.org/10.1016/0002-9149(92)90550-I
  10. Multiple risk factor intervention trial. Risk factor changes and mortality results. Multiple Risk Factor Intervention Trial Research Group. JAMA 248:1465-77, 1982 https://doi.org/10.1001/jama.248.12.1465
  11. Gordon DJ, Knoke J, Probstifield JL, et al: Highdensity lipoprotein cholesterol and coronary heart disease in hypercholesterolemic men. The Lipid Research Clinics Coronary Prevention Trial. Circulation 74;1217-25, 1986 https://doi.org/10.1161/01.CIR.74.6.1217
  12. Gordon DJ, Ekelund LG, Karon JM, et al: Predictive value of exercise test for mortality in North American men: the Lipid Research Clinics Mortality Follow-up study. Circulation 74:252-61, 1986 https://doi.org/10.1161/01.CIR.74.2.252
  13. Forti N, Diament J: High-density lipoproteins: Metabolic, clinical, epidemiological and therapeutic intervention aspects. An update for clinicians. Arq Bras Cardiol 87:671-9, 2006 https://doi.org/10.1590/S0066-782X2006001800019
  14. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults: Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 285:2486-97, 2001 https://doi.org/10.1001/jama.285.19.2486
  15. Friedewald WT, Levy RI, Fredrickson DS: Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clim Chem 18:499-502, 1972
  16. Lauer RM, Lee J, Clarke WP: Factors affecting the relationship between childhood and adult cholesterol levels. The Muscatine study. Pediatrics 82:309-18, 1988
  17. Oh SY, Kim EM, Shin MH, Lee SH, Kim JE, Lee HS, Jo JS, Kim WY: Development & validity of food frequency questionnaire for adults. The Korean society of health promotion, annual spring conference, 2007
  18. Kopp W: The atherogenic potential of dietary carbohydrate. Prev Med 42:336-42, 2006 https://doi.org/10.1016/j.ypmed.2006.02.003
  19. Farvid M S, Jalali M, Siassi F, Hosseini M : Comparison of the effects of vitamins and/or mineral supplementation on glomerular and tubular dysfunction in type 2 diabetes.Diabetes care 28:2458-64, 2005 https://doi.org/10.2337/diacare.28.10.2458
  20. Afkhami-Ardekani M, Shojaoddiny-Ardekani A: Effect of vitamin C on blood glucose, serum lipids & serum insulin in type 2 diabetes patients. Indian J Med Res 126:471-4, 2007
  21. Kim WY, Kim JE, Choi YJ, Huh KB: Nutritional risk and metabolic syndrome in Korean Type2 diabetes mellitus. Asia Pac J Cli Nutr 17(Suppl 1):47-51, 2008
  22. Kim MH, Lee HS, Park HJ, Kim WY: Risk factors associated with metabolic syndrome in Korean elderly. Ann Nutr Metab 51:533-40, 2007 https://doi.org/10.1159/000112977
  23. Yang EJ, Kim WY: The Influence of Dietary Factors on the Incidence of Non-Insulin-Dependent Diabetes Mellitus. Korean J Nutr 32:407-18, 1999
  24. Ministry of health and welfare. The Third Korea National Health and Nutrition Examination Survey (KNHANES III) 2005