P 14: Hypertriglyceridemic waist phenotype in type 2 diabetes: association with higher hs-CRP and lower antioxidative enzyme activity

BACKGROUND AND AIM: It was previously suggested that hypertriglyceridemic waist (HTgW) phenotype (waist girth ≥90cm in men and ≥85cm in women, and triglyceride (Tg) levels ≥2.0mmol/l) could identify visceral obesity and higher risk for atherosclerosis, but the relationship between HTgW phenotype and different atherosclerosis risk factors has not yet been elucidated. The aim of this study was to analize (a) hs-CRP levels, (b) lipid levels and (c) antioxidant enzyme glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) activities in the following groups of subjects: 30 patients with type 2 diabetes (T2D) and HTgW (group A), 24 T2D patients with abdominal obesity (higher waist) and normal Tg (group B) and 20 non obese T2D patients without HTgW (group C). METHODS: CRP levels were detected by Elisa method, GSH-Px and SOD activity were detected by spectrophotometry, total cholesterol (Ch), HDL-Ch, LDL-Ch and Tg levels by enzymatic methods and the insulin resistance (IR) was assessed by using HOMA-IR (calculated from basal insulin levels determined by RIA and fasting glucose levels determined by glucosooxidase method). RESULTS: We found significantly higher hs-CRP level in group A compared to group B (6,97+/-2,01 vs 4,72+/-2,01mg/l; p<0.05), being also higher in group A vs group C (C:0,98± 0,21mg/l; p<0.05). Simultaneously, total Ch was significantly higher in group A vs B (6,36 ±0,22 vs 5,44±0,26; p<0,01) while we could not significant differences in LDL-Ch levels between groups A and B. However, HDL-Ch level was significantly lower in group A vs B (1,05± 0,4 vs 1,22±0,08, p<0,05),being the highest in group C (1,45±0,08, p<0,001 vs groups A and B). Also, Tg/HDL ratio was significantly higher in group A (3,06±0,21) in comparison to group B (1,22±0,09) and C (0,85±0,12); p<0,001 vs p<0,05). On the other hand, we found significantly lower SOD values in group A vs B (913,68±34,33 vs 992,06±49,83; p<0,05), and also when we compared groups A and C (1023,40±29,39, p<0,05), but we could not find any differences in GPX values amoung groups. At the same time, we found that HOMA-IR was significantly higher in group A vs group B (9,80±1,79 vs 7,72±1,10, p<0,05) and in group C (7,39±2,10, p<0,05), while we could not find differences in HOMA-IR between groups B and C. CONCLUSIONS: Our results signify that presence of HTgW phenotype in T2D, as a marker of visceral obesity, is strongly associated with marked atherosclerosis risk profile, especially at the level of inflammation, reverse cholesterol metabolism and antioxidative enzyme activity. The results also suggest that in this phenotype detected higher IR might be exerting its atherogenic effect partly on the level of the changes in antioxidative defence.