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Accelerated cholesteryl ester transfer in patients with insulin‐dependent diabetes mellitus

Abstract. Abnormalities in cholesteryl ester transfer (CET) may play a role in the development of diabetic arterial vascular complications. To assess this important step systematically in reverse cholesterol transport, we have studied 20 treated, clinically stable, normolipidaemic patients. Contrary to the impairment in CET described previously in NIDDM, the mass of CE transferred from HDL to VLDL+LDL was significantly greater in IDDM patients than in controls at 1,2, and 4 h (P<0.001). When the d<1.063 plasma fractions from IDDM subjects were combined with controls d<1.063 fractions, an accelerated CET response was observed which was identical to that found in intact IDDM plasma. This finding, which indicates that this disturbance in CET was associated with the acceptor lipoproteins, was confirmed when we found that it was reproduced by the addition of IDDM VLDL and not LDL to control d>1.063 fractions.