Lipid Levels and Glucose Intolerance

Dyslipidemia is one of the major risk factors for Cardiovascular Disease (CVD) that coexists with diabetes. It plays an important role in the development and progress of atherosclerosis, the underlying pathogenesis of CVD. Hyperglycemia is associated with adverse lipid profiles. An atherogenic lipid profile, consisting of high Triglycerides (TG) and small dense Low-Density Lipoprotein Cholesterol (LDL-C) and low High-Density Lipoprotein Cholesterol (HDL-C), is common not only in patients with overt diabetes but also in individuals with prediabetes. The impact of dyslipidemia on risk of CVD in patients with hyperglycemia has been extensively studied. Reduced HDL-C is well documented as an independent predictor of CVD events, the role of TG as an independent risk factor for CVD is, however, controversial. Recently, the interest to use novel parameters such as total cholesterol (TC) to HDL ratio (TC/HDL-C), non- HDL-cholesterol (non-HDL-C), apolipoprotein B (apoB) and apolipoprotein A (apoA) to assess CVD risk has increased. This chapter provides a comprehensive review of the physiology, pathophysiology, prognosis and management of dyslipidemia in individuals with different glycemic levels. The ethnic differences in occurrence of dyslipidemia are also addressed.

Keywords: Lipid, glucose levels, cardiovascular mortality and mobidity, ethnicity.