Non-HDL cholesterol level is reliable to be an early predictor for vascular inflammation in type 2 diabetes mellitus

Although LDL is the primary target for lipid-lowering therapy and non-HDL cholesterol is a secondary target in patients with elevated triglyceride (TG) levels, non-HDL cholesterol is still an early, reliable, and practical predictor for vascular inflammation. However, in comparison with LDL, further evidence for superiority in non-HDL cholesterol as the primary therapeutic target is required. A total of 189 type 2 diabetic patients (88 men and 101 women; mean age 58.4±4.0 years; duration of diabetes 9.8±4.2 years) who had not used anti-inflammatory agents in the past two years were enrolled in this study. Levels of various lipid fractions and C-reactive protein (CRP) and the cholesterol retention fraction (CRF) were measured. Lipid levels and CRF in samples with CRP levels below or above different cutoffs were compared. Statistically significant differences were seen at all CRP cutoffs in the levels of TG, HDL, and non-HDL cholesterol and the CRF, but no differences were seen in total cholesterol and LDL cholesterol levels. CRP levels correlated with non-HDL cholesterol levels (r = 0.16, P = 0.0236) and the CRF (r = 0.18, P = 0.014), but not with levels of HDL or TG Besides, non-HDL levels showed a marked correlation with CRF (r = 0.68, P < 0.0001). On the basis of CRP levels, non-HDL levels are reliable in predicting vascular inflammation, and CRF could be another important predictor for cardiovascular events. Our results suggest that the emphasis placed on non-HDL cholesterol should be reevaluated in comparison with that placed on LDL cholesterol.