Vascular Disease and Serum Lipids in Diabetes Mellitus

Abstract

Over the past 3 decades, serum lipid analyses were conducted for 139 diabetics without acute illness or other disease which might influence serum lipids. These observations have been correlated with the presence of vascular complications. The latter were divided into small vessel disease almost specific for diabetes (e.g. diabetic retinitis) and non-specific atherosclerosis of large vessels (e.g. coronary artery disease). The mean triglyceride concentration increased significantly (p = 0.02) from 5.7meq/l in 1931-35 to 8.2 meq/l in 1951-61, while large vessel disease increased from 10% to 56%. A relationship between serum triglycerides and atherosclerosis was further supported by the observation that the average triglyceride concentration of patients with large vessel disease was 8.9 meq/l, significantly greater than the mean concentration 5.7 meq/l for patients without large vessel disease (p = 0.02). Mild diabetes of brief duration characterized patients with elevated serum triglycerides and atherosclerotic disease. Small artery disease increased slightly from 13% in 1931-35 to 23% in 1951-61, perhaps related to the slightly longer duration of diabetes in the later group. The ages for the two groups were similar. Small vessel diseases was unrelated to triglyceride concentration. The mean serum cholesterol, slightly higher than that of non-diabetics, was the same for the two periods. Cholesterol concentration was not correlated with either type of vascular complication. Available dietary data suggested an inverse relationship between fat intake and triglyceride concentration. Decreased fat intake and possibly increased carbohydrate intake may account for the observed rise in serum triglycerides and in large artery disease since the 1930''s.