Pathophysiology of Diabetic Dyslipidaemia

Background: Patients with diabetes usually exhibit diabetic dyslipidaemia. Aim: The aim of the review is to present the quantitative and qualitative alterations of lipids and lipoproteins and the associated mechanisms in patients with diabetic dyslipidaemia. Results: The main quantitative changes observed in patients with diabetic dyslipidaemia are increased triglycerides and decreased high-density lipoprotein (HDL) cholesterol levels. Qualitative abnormalities mainly include increased small dense low-density lipoprotein (LDL) particles (despite similar serum LDL cholesterol levels as non-diabetic subjects) and alterations in the apolipoprotein content of HDL particles. Alterations in the activities of enzymes involved in lipoprotein metabolism, such as cholesteryl ester transfer protein, and the lipoprotein content of lipid particles, along with their glycation and oxidation, play a role in the pathogenesis of diabetic dyslipidaemia. Conclusion: Diabetic dyslipidaemia is associated with quantitative and qualitative alterations of lipids and lipoproteins, which are associated with increased cardiovascular risk.