Lipids and lipoproteins as risk factors for coronary heart disease in non-insulin-dependent diabetes mellitus.

Dyslipidaemia is frequent in non-insulin-dependent diabetes mellitus (NIDDM). Lipid and lipoprotein abnormalities include particularly elevated levels of total and very-low-density lipoprotein (VLDL) triglycerides and reduced levels of high-density lipoprotein (HDL) cholesterol. The worsening of glycaemic control further deteriorates lipid and lipoprotein abnormalities and furthermore, total and low-density lipoprotein (LDL) cholesterol levels are often elevated in poor glycaemic control. Epidemiological data show that total cholesterol is as powerful risk factor for coronary heart disease (CHD) in NIDDM patients as in nondiabetic subjects. High total triglycerides and low HDL cholesterol may be even stronger risk factors for CHD in NIDDM patients than in nondiabetic individuals, but more prospective studies are needed to substantiate this view. Compositional changes in LDL and VLDL particles may further increase the risk of CHD but epidemiological data are missing to support this notion.