Assessment of Remnant Lipoprotein Cholesterol (RLP-C) Levels and its Correlation with Carotid Intima Media Thickness in Insulin Resistant Type 2 Diabetes Mellitus Patients

摘要

Remnant lipoproteins are Triglyceride (TG) rich lipoproteins products of partially metabolised chylomicrons and Very Low Density Lipoproteins (VLDL). Remnant Lipoprotein Cholesterol (RLP-C) levels are related to the risk of ischaemic heart disease. It has been hypothesized that Carotid Intima Media Thickness (CIMT) measurements could aid in the prediction of Cardiovascular Disease (CVD).Aim: To evaluate the levels of RLP-C in Insulin Resistant (IR) Type-2 Diabetes Mellitus (T2DM) patients and correlate the levels of RLP-C with CIMT, IR, TG and High Density Lipoprotein (HDL).Materials and Methods: The present cross-sectional study was conducted in the Department of Internal Medicine, SRM Medical College and Research Centre, Tamil Nadu, India. A total of 80 (aged 30 to 65 years) T2DM, men and women, aged 30-65 years, were included in the study. Serum lipids (Total Cholesterol (TC), TG, HDL-C and LDL-C), and serum insulin were measured. Insulin Resistance (IR) was estimated by the Homeostatic Model Assessment-Insulin Resistance (HOMA-IR). Based on HOMA-IR values, the individuals with HOMA-IR >2.5 were categorised as IR and HOMA-IR<2.5 as Insulin sensitive. RLP-C was calculated by using the formula: RLP-C=TC-(HDL-C+LDL-C). CIMT was measured in patients who had IR by using B Mode Ultrasonography (USG). Statistical analysis was done using Student?s t-test and Pearson correlation analysis.Results: Among the insulin resistant diabetic patients, a positive correlation was observed between IR and serum TG (r=0.0448). In these subjects, RLP-C was positively correlated with serum TG (r=0.5191) and negatively correlated with HDL-C (r=-0.0542). A positive correlation was also observed between RLP-C and CIMT (r=0.513) in these patients with IR.Conclusion: Type 2 diabetic patients with IR are characterised by high RLP-C and TG levels and low HDL-C levels. Estimation of RLP-C may help to identify individuals at high risk of atherosclerosis. The calculation of RLP-C can be easily done from the already existing conventional lipid profile at no additional cost.