Low LDL particle levels associate with coronary arteries free from atherosclerosis in long-term type 1 diabetes: the Dialong study

Abstract Background The risk of developing coronary artery disease (CAD) is increased in type 1 diabetes, due to accelerated atherosclerosis. The molecular mechanisms are yet to be unraveled, but potential functional and quantitative abnormalities in lipoproteins are suggested to be involved. Some i...

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Main Authors: Marte Narum, Jacob Juel Christensen, Kirsten B. Holven, Tore Julsrud Berg, Kari Anne Sveen
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Cardiovascular Diabetology
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Online Access:https://doi.org/10.1186/s12933-025-02844-z
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author Marte Narum
Jacob Juel Christensen
Kirsten B. Holven
Tore Julsrud Berg
Kari Anne Sveen
author_facet Marte Narum
Jacob Juel Christensen
Kirsten B. Holven
Tore Julsrud Berg
Kari Anne Sveen
author_sort Marte Narum
collection DOAJ
description Abstract Background The risk of developing coronary artery disease (CAD) is increased in type 1 diabetes, due to accelerated atherosclerosis. The molecular mechanisms are yet to be unraveled, but potential functional and quantitative abnormalities in lipoproteins are suggested to be involved. Some individuals have coronary arteries free from atherosclerosis even after living with type 1 diabetes for many decades. We therefore aimed to investigate the associations between a set of lipoproteins and metabolites and the presence of coronary arteries free from atherosclerosis in individuals with long-term type 1 diabetes. Methods Cross-sectional, controlled study of 102 participants with type 1 diabetes and 61 control subjects. We used a high-throughput nuclear magnetic resonance (NMR) spectroscopy platform to quantify circulating lipids and metabolites in serum. In participants without previously established coronary heart disease (CHD) we performed computed tomography coronary angiography (CTCA). Results In the diabetes group, mean age was 62 (7) [mean (standard deviation, SD)] year and diabetes duration 50.6 (4.9) years. Lower particle concentration of all LDL subclass particles associated significantly with higher odds of having coronary arteries free from atherosclerosis (p < 0.05). Low particle concentration of all LDL subclasses also associated significantly with normal Coronary Artery Calcium (CAC) score (p < 0.05 for all), after adjustment for age, sex, BMI, eGFR and statin treatment. The whole diabetes group, independent of presence of CAD, had significantly lower particle concentration of IDL and all LDL and VLDL subclass particles compared to the control group (p < 0.05 for all). Conclusions In this cohort of long-term survivors of type 1 diabetes, lower levels of all types of LDL particles associated significantly with higher odds of having coronary arteries free from atherosclerosis, after adjustment for statin treatment. These results emphasize the importance of early treatment start and lipid management in the development of CAD in type 1 diabetes and suggest a subgroup of long-term survivors of type 1 diabetes to may hold environmental or genetic protective beneficial traits, independent of statin use. More research on the role of lipoproteins in the development of atherosclerosis in patients with type 1 diabetes is needed.
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spelling doaj-art-bae332fd124748e6bc65d4ce467aba942025-08-20T03:42:26ZengBMCCardiovascular Diabetology1475-28402025-07-0124111110.1186/s12933-025-02844-zLow LDL particle levels associate with coronary arteries free from atherosclerosis in long-term type 1 diabetes: the Dialong studyMarte Narum0Jacob Juel Christensen1Kirsten B. Holven2Tore Julsrud Berg3Kari Anne Sveen4Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University HospitalDepartment of Nutrition, University of OsloDepartment of Nutrition, University of OsloDepartment of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University HospitalDepartment of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University HospitalAbstract Background The risk of developing coronary artery disease (CAD) is increased in type 1 diabetes, due to accelerated atherosclerosis. The molecular mechanisms are yet to be unraveled, but potential functional and quantitative abnormalities in lipoproteins are suggested to be involved. Some individuals have coronary arteries free from atherosclerosis even after living with type 1 diabetes for many decades. We therefore aimed to investigate the associations between a set of lipoproteins and metabolites and the presence of coronary arteries free from atherosclerosis in individuals with long-term type 1 diabetes. Methods Cross-sectional, controlled study of 102 participants with type 1 diabetes and 61 control subjects. We used a high-throughput nuclear magnetic resonance (NMR) spectroscopy platform to quantify circulating lipids and metabolites in serum. In participants without previously established coronary heart disease (CHD) we performed computed tomography coronary angiography (CTCA). Results In the diabetes group, mean age was 62 (7) [mean (standard deviation, SD)] year and diabetes duration 50.6 (4.9) years. Lower particle concentration of all LDL subclass particles associated significantly with higher odds of having coronary arteries free from atherosclerosis (p < 0.05). Low particle concentration of all LDL subclasses also associated significantly with normal Coronary Artery Calcium (CAC) score (p < 0.05 for all), after adjustment for age, sex, BMI, eGFR and statin treatment. The whole diabetes group, independent of presence of CAD, had significantly lower particle concentration of IDL and all LDL and VLDL subclass particles compared to the control group (p < 0.05 for all). Conclusions In this cohort of long-term survivors of type 1 diabetes, lower levels of all types of LDL particles associated significantly with higher odds of having coronary arteries free from atherosclerosis, after adjustment for statin treatment. These results emphasize the importance of early treatment start and lipid management in the development of CAD in type 1 diabetes and suggest a subgroup of long-term survivors of type 1 diabetes to may hold environmental or genetic protective beneficial traits, independent of statin use. More research on the role of lipoproteins in the development of atherosclerosis in patients with type 1 diabetes is needed.https://doi.org/10.1186/s12933-025-02844-zType 1 diabetesCoronary artery diseaseLDL-cholesterolLipoprotein profile
spellingShingle Marte Narum
Jacob Juel Christensen
Kirsten B. Holven
Tore Julsrud Berg
Kari Anne Sveen
Low LDL particle levels associate with coronary arteries free from atherosclerosis in long-term type 1 diabetes: the Dialong study
Cardiovascular Diabetology
Type 1 diabetes
Coronary artery disease
LDL-cholesterol
Lipoprotein profile
title Low LDL particle levels associate with coronary arteries free from atherosclerosis in long-term type 1 diabetes: the Dialong study
title_full Low LDL particle levels associate with coronary arteries free from atherosclerosis in long-term type 1 diabetes: the Dialong study
title_fullStr Low LDL particle levels associate with coronary arteries free from atherosclerosis in long-term type 1 diabetes: the Dialong study
title_full_unstemmed Low LDL particle levels associate with coronary arteries free from atherosclerosis in long-term type 1 diabetes: the Dialong study
title_short Low LDL particle levels associate with coronary arteries free from atherosclerosis in long-term type 1 diabetes: the Dialong study
title_sort low ldl particle levels associate with coronary arteries free from atherosclerosis in long term type 1 diabetes the dialong study
topic Type 1 diabetes
Coronary artery disease
LDL-cholesterol
Lipoprotein profile
url https://doi.org/10.1186/s12933-025-02844-z
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