Insulin Resistance Predicts Atherogenic Lipoprotein Profile in Nondiabetic Subjects

BACKGROUND: Atherogenic diabetes is associated with an increased cardiovascular risk and mortality in diabetic individuals; however, the impact of insulin resistance (IR) in lipid metabolism in preclinical stages is generally underreported. For that, we evaluated the capacity of IR to predict an atherogenic lipid subfraction profile. METHODS: Complete clinical evaluation and biochemical analysis (lipid, glucose profile, LDL, and HDL subfractions and LDL phenotype and size) were performed in 181 patients. The impact of IR as a predictor of atherogenic lipoproteins was tested by logistic regression analysis in raw and adjusted models. RESULTS: HDL-C and Apo AI were significantly lower in individuals with IR. Individuals with IR had a higher percentage of small HDL particles, lower percentage in the larger ones, and reduced frequency of phenotype A (IR = 62%; non-IR = 83%). IR individuals had reduced probability to have large HDL (OR = 0.213; CI = 0.999–0.457) and had twice more chances to show increased small HDL (OR = 2.486; CI = 1.341–7.051). IR was a significant predictor of small LDL (OR = 3.075; CI = 1.341–7.051) and atherogenic phenotype (OR = 3.176; CI = 1.469–6.867). CONCLUSION: IR, previously DM2 diagnosis, is a strong predictor of quantitative and qualitative features of lipoproteins directly associated with an increased atherogenic risk.