Effects of Diabetes Mellitus on Cholesterol Metabolism in Man

Abstract

In view of the reported excess prevalence of atherosclerosis and cholelithiasis in diabetes, we investigated several aspects of cholesterol metabolism under metabolic ward conditions in six Pima Indians with maturity-onset diabetes mellitus. Cholesterol balance (13.5 versus 11.0 mg per kilogram per day, P<0.05), fecal bile acid excretion (415 versus 261 mg per day, P<0.05), bile acid pool size (3150 versus 1950 mg, P<0.05), fasting plasma cholesterol (193 versus 160 mg per deciliter, P<0.05) and plasma triglycerides (251 versus 150 mg per deciliter, P<0.05) were higher during uncontrolled hyperglycemia than during relative euglycemia on insulin. The increased plasma lipid levels and total cholesterol synthesis during hyperglycemia may contribute to the acceleration of atherosclerosis in diabetes mellitus.