Lipid-lowering therapy is guided by Low-density-lipoprotein cholesterol (LDL-c) levels, although the cardiovascular disease (CVD) risk could be better reflected by other lipid parameters. This study aimed at comparing a comprehensive lipid profile between patients with type 2 diabetes mellitus (T2DM) with LDL-c concentration within and above target. A comprehensive lipid profile was characterized in 96 T2DM patients. The European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) 2016 and 2019 Guidelines for the Management of Dyslipidemias were used to define LDL-c targets. In this population, only 28.1 and 16.7% of patients had mean LDL-c levels within target, as defined by the 2016 and 2019 guidelines, respectively. Applying the 2016 guidelines criteria, in patients with LDL-c within target, 22, 25 and 44% presented non-high-density lipoprotein cholesterol (non-HDL-c), Apolipoprotein B (ApoB) and oxidized LDL-c levels above the recommended range, respectively, whereas according to the 2019 guidelines criteria, 50, 39 and 44% of the patients with LDL-c within target had elevated high-density lipoprotein cholesterol (HDL-c), ApoB and oxidized LDL-c levels, respectively. LDL-c was strongly correlated with non-HDL-c (r = 0.850), ApoB (r = 0.656) and oxidized LDL-c (r = 0.508). Similarly, there was a strong correlation between non-HDL-c with both ApoB (r = 0.808) and oxidized LDL-c (r = 0.588). These findings emphasize the limitations of only considering LDL-c concentration for cardiovascular (CV) risk assessment. Targeting only LDL-c could result in missed opportunities for CV risk reduction in T2DM patients. These data suggest that non-HDL-c, ApoB and oxidized LDL-c levels could be considered as an important part of these patients’ evaluation allowing for a more accurate estimation of CV risk and hopefully better management of these high-risk patients.

中文翻译：

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载脂蛋白B和非高密度脂蛋白胆固醇在患有2型糖尿病和控制性低密度脂蛋白胆固醇的个体中显示出很高的动脉粥样硬化性。

尽管低密度脂蛋白胆固醇（LDL-c）水平可以指导降脂治疗，但其他脂质参数可以更好地反映心血管疾病（CVD）的风险。这项研究旨在比较LDL-c浓度在目标范围内和之上的2型糖尿病（T2DM）患者之间的综合脂质分布。在96名T2DM患者中表征了全面的脂质分布。欧洲心脏病学会/欧洲动脉粥样硬化学会（ESC / EAS）2016年和2019年血脂异常管理指南用于定义LDL-c目标。在该人群中，分别有28.1％和16.7％的患者平均LDL-c水平在目标范围内，分别由2016年和2019年指南定义。根据2016年指南标准，LDL-c在目标范围内的患者22 25％和44％的患者分别显示非高密度脂蛋白胆固醇（non-HDL-c），载脂蛋白B（ApoB）和氧化的LDL-c水平高于建议范围，而根据2019年指南标准，分别为50、39和在目标范围内的LDL-c患者中，分别有44％的高密度脂蛋白胆固醇（HDL-c），ApoB和氧化LDL-c水平升高。LDL-c与非HDL-c（r = 0.850），ApoB（r = 0.656）和氧化的LDL-c（r = 0.508）密切相关。同样，非HDL-c与ApoB（r = 0.808）和氧化的LDL-c（r = 0.588）之间也有很强的相关性。这些发现强调了仅将LDL-c浓度用于心血管（CV）风险评估的局限性。仅针对LDL-c可能会导致T2DM患者错过降低CV风险的机会。