Although several studies have shown that increased levels of both VLDL and LDL particles are predictive of cardiovascular disease, their association with specific patterns of body fat distribution is not well established, especially in patients with type 2 diabetes. In this regard, Sam et al. performed a cross-sectional study in 382 subjects with type 2 diabetes who underwent computed tomography to measure accumulation of intra-abdominal (visceral) and subcutaneous adipose tissue. VLDL and LDL particle number as well as VLDL and LDL particle size were measured with proton nuclear magnetic resonance spectroscopy. Intra-abdominal adipose tissue positively correlated with VLDL particle number (r=0.34, p<0.001) and LDL particle number (r=0.15, p<0.001) as well as with VLDL size (r=0.25, p<0.001) and negatively with LDL size (r=-0.34, p<0.001). Intra-abdominal fat also negatively correlated with HDL size (r=-0.30, p<0.001). Those associations were not observed with subcutaneous adipose tissue accumulation or with body mass index (BMI). Interestingly, a multivariable-adjusted linear regression model showed that these relationships between intra-abdominal fat accumulation and the specific indices of the lipoprotein-lipid profile were independent of BMI and the homeostasis model assessment of insulin resistance. These results suggest that intra-abdominal adipose tissue is associated with an adverse lipoprotein-lipid profile in men and women with type 2 diabetes. Based on the results, the authors suggested that the increased free fatty acid flux and the adipokine release from intra-abdominal fat are likely to have a negative impact on these markers of an atherogenic lipoprotein-lipid profile.
Documentation centre