Introduction: Type 1 diabetes (T1DM) is characterized by high serum HDL, which does not translate into a better cardiovascular (CVD) prognosis. It is probably related to the impaired function of HDL particles. One of the main functions of HDL is the anti-atherosclerotic role related to reverse cholesterol transport from macrophages in arterial walls (cholesterol efflux capacity-CEC). CEC is a proven CVD risk factor. The dysfunction of HDL particles may be the result of glycation. Metabolic memory phenomena revealed that glycation status at the onset of T1DM may be crucial for future prognosis. Objective: To evaluate the influence of advanced glycation end products (AGE) at the onset of T1DM on HDL CEC in adults with newly diagnosed T1DM.
Methods: The analysis comprised 164 patients (110 men, 67%) with newly diagnosed T1DM confirmed by the presence of autoantibodies, recruited to the Insulin Therapy and Lipoproteins' Profile in Type 1 Diabetes (InLipoDiab1) study. CEC was assessed by measuring the efflux of radiolabelled cholesterol from murine J774 macrophages to apolipoprotein B-depleted serum. AGE in the skin was measured by autofluorescence using an AGE Reader. The endpoint was the assessment of CEC at one year after diagnosis.
Results: After one year of observation, a significant negative correlation was demonstrated between AGE at onset and CEC at one year (Rs=-0.33, p<0.001). Moreover, the multiple linear regression revealed an independent relationship between AGE at onset and HDL function at one year (beta=-0.25, p=0.02), adjusted for age, BMI, and smoking.
Conclusions: The higher glycation expressed as AGE at the onset, the worse CEC, a key anti-atherosclerotic HDL function in adults with T1DM, after a year of T1DM duration. These results support the need for early T1DM diagnosis, preferably before the glycation process develops, to improve the future CVD prognosis of people with T1DM.
A. Uruska: Other Relationship; Ascensia Diabetes Care, Novo Nordisk, Lilly Diabetes, Boehringer-Ingelheim, AstraZeneca. A. Grzelka-Wozniak: Consultant; Novo Nordisk. Other Relationship; Boehringer-Ingelheim, Novo Nordisk, AstraZeneca, Roche Diabetes Care, Sanofi. A. Rohatgi: Research Support; CSL Behring, Quest Diagnostics. Consultant; Johnson & Johnson Medical Devices Companies, Raydel. J. Flotynska: None. D. Zozulinska-Ziolkiewicz: Advisory Panel; Abbott, BIOTON. Speaker's Bureau; Boehringer-Ingelheim, Eli Lilly and Company, Ascensia Diabetes Care, Novo Nordisk, Medtronic, Sanofi, Servier Laboratories. Advisory Panel; Eli Lilly and Company.
Kosciuszko Foundation, National Agency Academic Exchange (NAWA)
