Changes in HOMA2 during follow-up were not different between patients with increased or stable HDL-cholesterol, triglyceride or triglyceride/HDL-C ratio. LDL Temsirolimus purchase particle size distribution and levels of adiponectin / resistin Serum levels of adiponectin and resistin were assessed at both visits (table 3). In the whole cohort, resistin levels increased (p=0.001) and were closely correlated with the number of sdLDL particles at the first (p=0.02) and second (p<0.001) visit. In patients showing an increase in the proportion of sdLDL particles, resistin concentrations also increased (p<0.001), which was not the case in those patients whose sdLDL particle number did not rise during follow-up (Figure 2b); the increase in resistin directly correlated with the increase in sdLDL particle number (R2=0.

149, p=0.01). On the other hand, serum adiponectin increased only in patients without increasing sdLDL particles (p=0.006), but not in those with more sdLDL particles at follow-up. To assess relevant effects of possible subclinical inflammation on resistin levels, measures of C-reactive protein (CRP) were included in the analysis in a subset of 16 patients at the first and / or second visit. Resistin levels still correlated with sdLDL particles (p=0.03), but not with logCRP levels (p=0.55) when this parameter was included using multiple linear regression. No deaths and only one major cardiovascular event (stroke) occurred during follow-up. Discussion This prospective cohort study demonstrates the value of LDL particle size measurements in the prediction of changes in metabolic status and cardiovascular disease in patients with diabetes or prediabetes.

The fraction of small LDL particles at baseline predicted changes in intima-media thickness that occurred during the following two years, with a larger fraction of sdLDL particles being associated with a larger increase in IMT. Whereas a correlation of IMT with actual LDL particle size was demonstrated by many earlier studies including our own data [7,26], the predictive value of LDL size with regard to IMT in dysglycemic patients has not been investigated in prospective long-term studies. Of interest, other parameters as HbA1c, BMI, or systolic blood pressure were not associated with the extent of IMT increase in the present study.

This might be partly due to the inclusion criteria of the study, which narrowed the spread of these parameters within the cohort and thereby limited the possibility to determine their predictive value. Further, the superiority of LDL particle size in comparison to other conventional risk factors may also be due GSK-3 to its comprehensive character �C as the number of small LDL particles is influenced by age, weight, body composition and also metabolic control and may therefore provide more precise information.