Diabetes Metab J.  2015 Oct;39(5):353-362. 10.4093/dmj.2015.39.5.353.

Interaction between Glucose and Lipid Metabolism: More than Diabetic Dyslipidemia

Affiliations
  • 1Department of Medicine 2-Grosshadern, University of Munich, Munich, Germany. klaus.parhofer@med.uni-muenchen.de

Abstract

Glucose and lipid metabolism are linked to each other in many ways. The most important clinical manifestation of this interaction is diabetic dyslipidemia, characterized by elevated triglycerides, low high density lipoprotein cholesterol (HDL-C), and predominance of small-dense LDL particles. However, in the last decade we have learned that the interaction is much more complex. Hypertriglyceridemia and low HDL-C cannot only be the consequence but also the cause of a disturbed glucose metabolism. Furthermore, it is now well established that statins are associated with a small but significant increase in the risk for new onset diabetes. The underlying mechanisms are not completely understood but modulation of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG CoA)-reductase may play a central role as genetic data indicate that mutations resulting in lower HMG CoA-reductase activity are also associated with obesity, higher glucose concentrations and diabetes. Very interestingly, this statin induced increased risk for new onset type 2 diabetes is not detectable in subjects with familial hypercholesterolemia. Furthermore, patients with familial hypercholesterolemia seem to have a lower risk for type 2 diabetes, a phenomenon which seems to be dose-dependent (the higher the low density lipoprotein cholesterol, the lower the risk). Whether there is also an interaction between lipoprotein(a) and diabetes is still a matter of debate.

Keyword

Diabetes mellitus; Diabetic dyslipidemia; Hyperlipoproteinemia type II; Hyperlipoproteinemias; Statin

MeSH Terms

Cholesterol, HDL
Cholesterol, LDL
Diabetes Mellitus
Dyslipidemias*
Glucose*
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Hyperlipoproteinemia Type II
Hyperlipoproteinemias
Hypertriglyceridemia
Lipid Metabolism*
Lipoprotein(a)
Metabolism
Obesity
Triglycerides
Cholesterol, HDL
Cholesterol, LDL
Glucose
Lipoprotein(a)
Triglycerides
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