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A drop in A1c has a corresponding rise in HDL. Glycemic optimization should be used as a therapeutic tool for improving diabetic dyslipidemia. That from a presentation at last weeks AACE.
The researchers set about to quantify the predictive value of reducing hemoglobin A1c (HbA1c) levels on lipid and lipoprotein concentrations in patients with type 2 diabetes.
“These patients are at higher risk of developing cardiovascular disease, particularly coronary disease,” explained Alberto de Leiva, MD, PhD, chief of the department of endocrinology, Hospital de Sant Pau, and professor of medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
The study group consisted of 73 patients with type 2 diabetes, 44% of them women. Mean age was 60.9 years. Measurements of total triglycerides and cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), apolipoprotein 1 (apo 1), and apolipoprotein B (apo B) were taken at baseline and follow-up.
After a median follow-up of 3 months, the mean HbA1c decreased to 6.7% (range: 3.8 to 8.0%) from a baseline level of 9.9% (range, 6.2 to 16.0%).
The study found that, after correcting for potential confounding variables such as body mass index, age, and gender, for each percentage-point reduction in HbA1c, there was an increase in HDL cholesterol and its carrier protein apo A-1 (0.007 mmol/L and 0.087 g/L, respectively).
HDL (r=-03.58, P=0.01) and apo A-1 (r=-0.355, P=0.003) were the only lipid factors that correlated significantly with the decrease in HbA1c level. “Quantitative estimation of those variables allows a prediction of the potential benefit of improving glycemic control on lipids,” Dr. de Leiva noted.
“Our study supports previous work showing a favorable effect of improving glycemic control on lipid and lipoprotein concentrations both in type 1 and type 2 diabetic patients,” Dr. de Leiva concluded.
[Study title: Quantitative Effect of Improving Glycemic Control on Lipids and Lipoproteins in Type 2 Diabetes Mellitus: Is it Predictable? Abstract 68]
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