High-density lipoprotein subclasses in diabetes.

This cross-sectional study evaluated high-density lipoprotein subclasses measured by a precipitation technique before and after treatment in men and women with types I and II diabetes. Total high-density lipoprotein cholesterol was lower in subjects of both sexes with untreated type I and type II diabetes, the change occurring primarily in subclass 2. Insulin therapy raised total and subclass 2 high-density lipoprotein levels in men and women with type I and type II diabetes, the predominant rise occurring in subclass 2. The improvement was unrelated to metabolic control. Normalization of total and subclass 2 high-density lipoprotein was not achieved in women with type II disease who had higher body weights and triglyceride levels. Treatment with oral hypoglycemic agents did not lower total high-density lipoprotein or subclass 2 levels. It is concluded that therapies affecting high-density lipoprotein produce the preponderant change in subclass 2, insulin therapy increases total and subclass 2 high-density lipoprotein but may not restore levels to normal in the presence of elevated body weight and lipid levels, there is no relation between control of diabetes and changes in total and subclass 2 high-density lipoprotein levels, and treatment with oral hypoglycemic agents does not adversely affect high-density lipoprotein levels.