11 Mar Familial Hypercholesterolemia Linked To Lower Type2 Diabetes Risk

MedicalResearch.com Interview with:
Joost Besseling PhD-student
Academic Medical Center
Dept. of Vascular Medicine
Amsterdam

Medical Research: What is the background for this study? What are the main findings?

Response: Statins are associated with an increased risk for type 2 diabetes mellitus (DM). The exact mechanism for this adverse event is largely unknown, although the upregulation of the low-density lipoprotein receptor (LDLR) has been suggested to play a role. In familial hypercholesterolemia (FH) the uptake of LDL-cholesterol via the LDLR is decreased due to a genetic defect. We found that the prevalence of type 2 DM is 50% lower in relative terms in patients with familial hypercholesterolemia. Moreover, there was a dose-response relationship: the more severe the genetic defect that causes familial hypercholesterolemia, the lower the prevalence of type 2 DM.

Medical Research: What should clinicians and patients take away from your report?

Response: Although the high relative reduction of type 2 diabetes mellitus prevalence in familial hypercholesterolemia patients, this probably has no consequences for patients and clinicians. Since the prevalence of type 2 DM is quite low (3% in unaffected persons in our study), the absolute difference in prevalence is modest. Our findings primarily contribute to our understanding of the pathogenesis of type 2 diabetes mellitus and suggest a role for cellular cholesterol metabolism in the pathogenesis of type 2 diabetes mellitus.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Our study was cross-sectional and our results should be confirmed using a longitudinal study design. Furthermore, the role of cellular cholesterol metabolism in the pathogenesis of type 2 diabetes mellitus can be explored more in depth, so that we might eventually be able to target it in order to prevent and treat type 2 diabetes mellitus.

Citation:

Besseling J, Kastelein JP, Defesche JC, Hutten BA, Hovingh G. Association Between Familial Hypercholesterolemia and Prevalence of Type 2 Diabetes Mellitus. JAMA. 2015;313(10):1029-1036. doi:10.1001/jama.2015.1206.

Joost Besseling PhD-student, Academic Medical Center, Dept. of Vascular Medicine, Amsterdam (2015). Familial Hypercholesterolemia Linked To Lower Type2 Diabetes Risk 

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Last Updated on March 11, 2015 by Marie Benz MD FAAD