Prevalence of Lipid Abnormalities in Progressive Stages of Diabetes Mellitus

Prediabetes (PD) often exists in patients with coronary artery disease (CAD). This cross-sectional study aimed to uncover a link between measures of fat metabolism and lipid profiles with increasing stages of glucose intolerance which could promote premature CAD in PD.

Methods: Subjects from NHANES 2005-2012 without history of DM, dyslipidemia or medication for these disorders were matched by age and gender and categorized into normal group (HbA1c<5.7 and fasting plasma glucose<100mg/dl), PD group (6.5>HbA1c≥5.7 or 125mg/dl>fasting plasma glucose≥100mg/dl) and DM group (HbA1c≥6.5 or fasting plasma glucose≥125mg/dl). Body mass measures, plasma insulin level, lipid panel and hepatic steatosis were compared among 3 groups, using Chi-square and Wilcoxon rank sum test.

Results: From 29314 subjects in NHANES: 128 normal, 132 PD and 130 DM subjects were selected. Weight, BMI, waist circumference significantly increased within groups (all P<0.001) in parallel with hepatosteatosis, and consistent with increasing lipogenesis. LDL changes were distinctive being highest in PD group (P=0.0003).

Conclusions: Insulin values and progressive dyslipidemia correlated with increasing diabetes as expected, but the disparity between hepatic steatosis and LDL suggests an imbalance between lipogenesis and lipoprotein clearance resulting in higher LDL in PD; and a mechanism for early onset of diabetic induced atherogenesis.