Plasma lipids and diabetes mellitus in an adult community.

Most previous studies of hyperlipidemia in diabetics are based on patients in specialty clinics or reflect an era when diabetics consumed a high-fat, low-carbohydrate diet. In this paper, data from a defined adult population aged 20-79 years in an upper middle class community in Southern California, 1972-1974, were used to ascertain the relationship of hyperlipidemia to diabetes in a current community-based population. All (n = 358) diabetics as defined by history and/or fasting hyperglycemia (fasting plasma glucose, greater than or equal to 140 mg/dl) were compared with all (n = 4387) nondiabetics defined as euglycemic (fasting plasma glucose, less than 110 mg/dl) with no personal or family history of diabetes. In both men and women 50 years of age and older, the mean cholesterol level and the prevelance of categorical hypercholesterolemia were not significantly different in diabetics vs. nondiabetics, whereas the mean triglyceride level and the prevalence of categorical hypertriglyceridemia were significantly higher in diabetics vs. nondiabetics. Case-control comparisons of 356 diabetics matched for age and obesity with 356 nondiabetics confirmed the significantly higher triglyceride levels in diabetes. Conversely, hypertriglyceridemia was associated with diabetes in 29 per cent of nonobese men and 25 per cent of obese men, and in 10 per cent of non-obese women and 21 per cent of obese women. The biologic mechanism of hypertriglyceridemia in diabetics is discussed.