Low serum LDL cholesterol in patients with type 2 diabetes: an analysis on two different patient populations

Int J Cardiol. 2010 Oct 29;144(3):394-8. doi: 10.1016/j.ijcard.2009.04.048. Epub 2009 May 27.


Background: Patients with type 2 diabetes (T2DM) typically exhibit a pattern of dyslipidemia with high triglycerides, low HDL cholesterol, and small LDL particles. We aimed at investigating whether also LDL cholesterol levels are altered in diabetic patients.

Methods: Lipid panels were obtained in a consecutive series of angiographied coronary patients (n=750), and in a large sample of hypertensive outpatients (n=5949).

Results: T2DM patients in the cohort of coronary patients (n=164; 21.9%) had significantly higher triglycerides (203±138 vs. 153±91 mg/dl; p<0.001), lower HDL cholesterol (44±14 vs. 50±14 mg/dl; p<0.001), lower apolipoprotein A1 (140±28 vs. 148±28 mg/dl; p=0.002), lower total cholesterol (211±48 vs. 220±42 mg/dl; p=0.006) and, importantly, lower LDL cholesterol (122±38 vs. 134±35 mg/dl; p<0.001) than non-diabetic subjects. Whereas apolipoprotein B was similar in T2DM patients as in non-diabetic subjects (113±26 vs. 114±25 mg/dl; p=0.648), the LDL cholesterol/apolipoprotein B ratio was significantly lower (1.08±0.24 vs. 1.18±0.21; p<0.001) and LDL particles were significantly smaller (257±7 vs. 259±6 Å; p<0.001) in T2DM patients. Also among the hypertensive subjects, diabetic patients (n=1632; 27.3%) besides higher triglycerides (173±70 vs. 151±65 mg/dl; p<0.001) and lower HDL cholesterol (53±17 vs. 57±19 mg/dl; p<0.001) exhibited lower total cholesterol (216±44 vs. 222±41 mg/dl; p<0.001) and lower LDL cholesterol (127±40 vs. 136±37 mg/dl; p<0.001) than non-diabetic subjects.

Conclusions: Both among angiographied coronary patients and hypertensive outpatients, LDL cholesterol is significantly lower in T2DM patients than in non-diabetic individuals.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Algorithms
  • Apolipoproteins / blood
  • Austria
  • Biomarkers / blood
  • Cholesterol / blood
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood*
  • Cohort Studies
  • Coronary Angiography
  • Coronary Artery Disease / blood
  • Coronary Artery Disease / diagnostic imaging
  • Diabetes Mellitus, Type 2 / blood*
  • Female
  • Humans
  • Hypertension / blood
  • Male
  • Middle Aged
  • Risk Factors
  • Triglycerides / blood


  • Apolipoproteins
  • Biomarkers
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Triglycerides
  • Cholesterol