Department of Medical Biotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Vascular Medicine, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands.
Atherosclerosis. 2017 Dec;267:99-109. doi: 10.1016/j.atherosclerosis.2017.10.018. Epub 2017 Oct 21.
Type 1 diabetes (T1D) is a chronic autoimmune disease characterized by absence of insulin secretion due to destruction of the pancreatic beta-cells. Patients with T1D exhibit an increased risk for cardiovascular disease (CVD) compared with non-diabetic subjects. It has been established that low concentration of high-density lipoprotein cholesterol (HDL-C), an independent risk marker of CVD, coincides with a reduced protective capacity against oxidative stress. However, conflicting results have been reported on the prevalence of low HDL-C levels in T1D. Interestingly, changes in composition and function of HDL particles (abnormal ratio of cholesteryl ester-to-triglyceride, reduction in the phospholipid content, reduced capacity to promote cholesterol efflux from macrophages, impaired anti-inflammatory and anti-oxidant activities) have been described in patients with T1D. Hence, exploring HDL function, even in the presence of normal HDL-C levels, might provide additional insight into the underlying pathophysiology associated with increased CV risk in T1D. In the current review, we will provide a detailed overview of the current evidence for a role of HDL function as independent risk factor for the development of CVD in T1D.
1 型糖尿病（T1D）是一种慢性自身免疫性疾病，其特征是由于胰腺β细胞破坏导致胰岛素分泌不足。与非糖尿病患者相比，T1D 患者患心血管疾病（CVD）的风险增加。已经确定，高密度脂蛋白胆固醇（HDL-C）浓度低是 CVD 的独立风险标志物，与抗氧化应激的保护能力降低有关。然而，关于 T1D 患者低 HDL-C 水平的患病率，已有相互矛盾的报道。有趣的是，在 T1D 患者中已经描述了 HDL 颗粒的组成和功能的变化（胆固醇酯与甘油三酯的比例异常、磷脂含量降低、促进巨噬细胞胆固醇流出的能力降低、抗炎和抗氧化活性受损）。因此，即使在 HDL-C 水平正常的情况下，探索 HDL 功能也可能提供更多关于与 T1D 中 CV 风险增加相关的潜在病理生理学的见解。在当前的综述中，我们将详细概述 HDL 功能作为 T1D 发生 CVD 的独立风险因素的现有证据。
