Plasma lipoprotein composition and cholesteryl ester transfer from high density lipoproteins to very low density and low density lipoproteins in patients with non-insulin-dependent diabetes mellitus

We have examined cholesteryl ester transfer (GET) from HDL to low density and very low density lipoproteins (LDL and VLDL) and lecithin:cholesterol acyl transferase (LCAT) activity in plasma from 28 men with non-insulin-dependent diabetes mellitus (NIDDM) treated with diet alone or diet and sulphonylurea drugs and in 27 healthy non-diabetic controls. Patients and healthy subjects had similar LCAT activity, but CET was significantly higher in NIDDM 26.1 +/- 11.5 mu mol l(-1) h(-1)) than in healthy men (17.8 +/- 6.5 mu mol l(-1) h(-1)) (p = 0.001). Diabetic men also had higher CET compared to 15 healthy non-diabetic men (18.7 +/- 5.6 mu mol l(-1) h(-1)) (p = 0.001) with similar serum lipids. CET activity was similar in patients treated with diet alone (24.8 +/- mu mol l(-1) h(-1)) or with sulphonylureas (27.7 +/- 15.8 mu mol l(-1) h(-1)). The Sf 0-12 fraction was significantly enriched with total cholesterol (p = 0.0001) and free cholesterol (p = 0.006) in diabetic subjects whether treated with diet alone or on sulphonylureas compared to the 15 non-diabetic controls matched for serum triglycerides. The free cholesterol/phospholipid, the free cholesterol/total protein and the free cholesterol/mass ratios were increased in the Sf 0-12 fraction in diabetic subjects (p < 0.01). These findings indicate that CET is accelerated in patients with NIDDM and that this may be due to the altered composition of acceptor lipoproteins.