Effects of cardiac rehabilitation on lipoprotein abnormalities in patients with Type 2 diabetes mellitus and metabolic syndrome

Type 2 diabetes mellitus (DM) and the related metabolic syndrome are highly prevalent clinical entities. The Adult Treatment Panel III guidelines have called specific attention to the importance of targeting cardiovascular risk factors in metabolic syndrome and Type 2 DM as a method of risk-reduction therapy. One of the cornerstones of treatment and prevention for both of these conditions is individualized, systematic and intensive lifestyle interventions in addition to traditional pharmacological therapy. The goals of cardiac rehabilitation and secondary prevention programs are to prevent disability resulting from cardiovascular disease, improve cardiac risk profile, and prevent subsequent cardiovascular events, hospitalizations and death from cardiac causes. The benefit seen with cardiac rehabilitation in patients with Type 2 DM and metabolic syndrome is likely related to the impact these programs have on the common pathophysiological background of atherosclerosis shared in Type 2 DM and metabolic syndrome. Lipoprotein abnormalities are a major contributor to accelerated atherosclerosis in Type 2 DM and metabolic syndrome. This review focuses on the effect of cardiac rehabilitation on lipids in these high-risk patients.