Plasma Lipids and Lipoprotein Cholesterol in Undernourished Diabetic Subjects and Adults with Protein Energy Malnutrition

Estimation of triglycerides (Tg), total cholesterol (Tc), HDLs, LDLc, and VLDLc was carried out in 46 undernourished diabetic subjects (UND); 21 untreated and 25 on insulin; 44 well-nourished diabetic subjects (WND); 22 untreated and 22 on insulin; together with 25 patients with protein energy malnutrition (PEM) and 25 healthy controls <50 yr of age. Compared with controls, in the untreated diabetic subjects Tg, Tc, LDLc, and VLDLc were significantly higher in both classes, while HDLc was lower only in WND. Among the treated diabetic subjects, Tg were higher in WND, LDLc lower in UND, and VLDLc higher in both. With regard to relative distribution of cholesterol in the untreated patients, HDLc/Tc was lower in WND, but this was not so in UND. HDLc/Tc was higher in treated UND. Between undernourished and well-nourished groups of diabetic subjects in the untreated patients, HDLc was significantly higher and LDLc lower in the former. Both Tc and LDLc were lower in UND on insulin compared with WND. HDLc/Tc was higher and LDLc/Tc lower in both untreated and treated UND. In adults with PEM, mean values of Tg, Tc, and LDLc were much lower than in controls, as well as in both groups of UND. On the other hand, values of HDLc/Tc were higher and LDLc/Tc lower in PEM compared with controls, but this was not so for treated UND. It is evident from the results of this study that the undernourished have lower levels of plasma lipids and a favorable distribution of cholesterol among the lipid fractions from the point of view of vulnerability to development of atherosclerosis.