HDL functionality in type 1 diabetes: enhancement of cholesterol efflux capacity in relationship with decreased HDL carbamylation after improvement of glycemic control

Damien Denimal, Serge Monier, Isabelle Simoneau, Laurence Duvillard, Bruno Vergès, Benjamin Bouillet, Damien Denimal, Serge Monier, Isabelle Simoneau, Laurence Duvillard, Bruno Vergès, Benjamin Bouillet

Abstract

Background: Reduced cholesterol efflux capacity (CEC) of HDLs is likely to increase cardiovascular risk in type 1 diabetes (T1D). We aimed to assess whether improvement of glycemic control in T1D patients is associated with changes in CEC in relation with changes in carbamylation of HDLs.

Methods: In this open-label trial, 27 uncontrolled T1D patients were given a three-month standard medical intervention to improve glycemic control. HDL fraction was isolated from plasma, and CEC was measured on THP-1 macrophages. Carbamylation of HDLs was evaluated by an immunoassay. Control HDLs from healthy subjects were carbamylated in vitro with potassium cyanate.

Results: HbA1c decreased from 11.4% [10.2-12.9] (median [1st-3rd quartiles]) at baseline to 8.1% [6.6-9.0] after the three-month intervention (P < 0.00001). The CEC of HDLs increased after intervention in 19 (70%) patients (P = 0.038). At the same time, the carbamylation of HDLs decreased in 22 (82%) patients after intervention (P = 0.014). The increase in CEC significantly correlated with the decrease in carbamylated HDLs (r = -0.411, P = 0.034), even after adjustment for the change in HbA1c (β = -0.527, P = 0.003). In vitro carbamylation of control HDLs decreased CEC by 13% (P = 0.041) and 23% (P = 0.021) using 1 and 10 mmol/L of potassium cyanate, respectively.

Conclusions: The improvement of CEC in relation to a decrease in the carbamylation of HDLs may likely contribute to the beneficial cardiovascular effect of glycemic control in T1D patients.

Trial registration: NCT02816099 ClinicalTrials.gov.

Keywords: Carbamylation; Cholesterol efflux; HDL; Type 1 diabetes.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Changes in cholesterol efflux capacity after intervention
Fig. 2
Fig. 2
Changes in carbamylated HDL levels after intervention
Fig. 3
Fig. 3
Correlation between changes in cholesterol efflux capacity and in carbamylated HDL levels after intervention
Fig. 4
Fig. 4
Effect of in vitro HDL carbamylation on cholesterol efflux capacity. Data are presented as means ± SD. Data are obtained from 9 replicates obtained in three independent experiments. KCN: potassium cyanate

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Source: PubMed

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