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Insulin resistance predicts atherogenic lipoprotein profile in non-diabetic subjects


Atherogenic diabetes is associated with increased cardiovascular risk and mortality in diabetic individuals, however, the impact of insulin resistance (IR) in lipid metabolism in pre-clinical stages is generally under reported. The aim of this study was to evaluate the capacity of IR to predict an atherogenic lipid subfractions profile. This cross-sectional study included 181 of subjects. Complete clinical evaluation and biochemical analysis (lipid, glucose profile, LDL and HDL subfractions and LDL phenotype and size) were performed. The impact of IR as predictor of atherogenic lipoproteins was tested by logistic regression analysis in raw and adjusted models. HDL-C and Apo AI were significantly lower in individuals without IR. Lipoprotein subfractions analysis showed that individuals with IR had a higher percentage of small HDL particles, lower percentage in the larger ones and reduced frequency of phenotype A (IR=62%; non-IR=83%). IR individuals had reduced probability to have large HDL (OR=0.213; CI=0.999-0.457) and had twice more chances to show increased small HDL (OR=2.486; CI=1.341-7.051). IR was a significant predictor of small LDL (OR=3.075: CI=1.341-7.051) and atherogenic phenotype (OR=3.176; CI=1.469-6.867). IR, previous diabetes mellitus diagnosis, is a strong predictor of quantitative and qualitative features of lipoproteins directly associated an increased atherogenic risk. (AU)

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