Influence of various therapies on hyperlipidemia in diabetes mellitus.
The relationship between diabetes mellitus and the factors involved in its treatment, and plasma lipoprotein concentrations, is far from clear. The prognostic value of plasma HDL cholesterol measurements is also unclear, as none of the published data relating to this are concerned with diabetes mellitus. The plasma concentration of HDL at any particular time is the result of a combination of factors. The production of nascent HDL particles by the liver and intestine, and small HDL particles from unknown sources (which may include triglyceride-rich particles undergoing catabolism in the circulation), and the production of HDL esterified cholesterol by LCAT, are balanced by the still poorly understood mechanisms of HDL catabolism outlined above. Until these mechanisms are better understood, we are unlikely to understand the implications of plasma HDL and HDL cholesterol concentrations in diabetes mellitus, and the effects of treatment of diabetes.