Two interventions reduces LDL and increases HDL reduces heart disease risk
The dyslipidemia of diabetes can occur in those with prediabetes and increases atherosclerosis risk in these individuals.
Dr. , Ronald Goldberg, MD, Professor of Medicine, Biochemistry, and Molecular Biology in the Division of Endocrinology, Diabetes and Metabolism at the University of Miami Miller School of Medicine, Associate Director of Medical Affairs of the Diabetes Research Institute, and Director of the Lipid Disorders Unit and colleagues investigated the effect that making intensive lifestyle changes or taking the medication metformin (used to treat people with type 2 diabetes) had on cholesterol and triglyceride levels. This study is part of the National Institutes of Health’s Diabetes Prevention Program,
This randomized clinical trial included 1,645 people with impaired glucose tolerance. Researchers took blood samples at the start of the study.
The participants were randomly assigned to one of three intervention groups; one group taking metformin at 850mg twice daily, second group taking a placebo twice daily and the third group underwent an intensive lifestyle modification program (ILS) that was aimed at a 7% weight loss using a low-fat diet with increased physical activity, for a one year period.
Researchers compared blood samples taken at the start of study to samples taken one year later to examine the effects of the interventions. Lipoprotein subfraction size, density, and concentration measured by magnetic resonance and density gradient ultracentrifugation.
The results showed the participants in the intensive lifestyle program had lower levels of triglycerides, a type of fat (lipid) found in your blood. Both the metformin and lifestyle intervention group were associated to decreased LDL particles. LDL or low-density lipoprotein is the bad cholesterol which collects in the walls of blood vessels, causing the blockages of atherosclerosis. They also showed increases in HDL or high-density lipoproteins known as the good cholesterol that lowers the risk of developing heart disease.
In their conclusion the team writes “Since ILS significantly lowered VLDL and LDL particle numbers, with MET having milder but parallel effects, and both interventions altered lipoprotein size distribution in apparently favorable directions, these changes constitute treatment effects that could have benefit for the vascular complications of diabetes.”
Dr. Goldberg comments “Cardiovascular disease is the most significant cause of death and disability in people with diabetes. Our findings demonstrate that the same therapies used to slow the onset of diabetes also may help allay the risk of heart disease.”
“Preventing or slowing the development of diabetes with these treatments also improves the cholesterol and triglyceride profile of a person’s blood.” “Thanks to the added benefits of existing diabetes interventions, we stand a better chance of lowering the risk of heart disease in this patient population,” said Goldberg.
This study appears in in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM) and the journal Circulation.