Atherogenic Dyslipidemia: An Important Risk Factor for Cardiovascular Disease in Metabolic Syndrome and Type 2 Diabetes Mellitus Patients

Both metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM) are increased risk of cardiovascular disease (CVD) and coronary heart events. Lipid abnormalities in MetS and T2DM patients are the major role in atherogenesis development. These lipid disorders include both quantitative and qualitative abnormalities of lipoproteins the potentially atherogenic. Hypertriglyceridemia is the main quantitative abnormalities, correlated with hepatic VLDL over production and the reduction of both VLDL and IDL catabolism in circulation, and accelerated HDL catabolism to cause decreased HDL-Cholesterol levels. Increased triglyceride content in VLDL particles cause VLDL1 (large VLDL) and also increase in triglyceride content of LDL and HDL particle, small dense LDL particles, easy to cause LDL oxidation and apolipoproteins glycation. Although the LDL-cholesterol level in circulation is usually normal in MetS and T2DM patients, but these types of LDL particles show easy oxidized and reduced turn-over, which is potentially harmful. However, insulin resistance and the insulin deficiency are occurred in MetS and T2DM patients, may play the important role of dyslipidemia. Insulin has the important function and regulation in lipid metabolism. In addition with adipokine, both in the pro-inflammatory and anti-pro-inflammatory adipokines, it could play the important role in the pathophysiology of dyslipidemia.