Atherogenic Dyslipidaemia in Diabetes: Burden and Challenges

Authors

  • Ketut Suastika Department of Internal Medicine, Faculty of Medicine, Mahasaraswati University, Denpasar, Indonesia

Keywords:

Type 2 Diabetes Mellitus, atherogenic dyslipidemia, cardiovascular risk

Abstract

Atherogenic dyslipidemia is a lipid disorder characterized by high triglyceride (triglyceride-rich lipoprotein) levels, reduced HDL-C levels, and an abundance of small dense LDL (sdLDL) particles. This condition is frequently associated with diseases or states that involve insulin resistance and inflammation, such as obesity, metabolic syndrome, and type 2 diabetes. Atherogenic dyslipidemia/lipoprotein is linked to a heightened risk of cardiovascular disease. The presence of numerous sdLDL particles and remnant lipoproteins are critical in the development and buildup of plaque in atherosclerosis. Elevated triglyceride levels can also promote inflammation and thrombosis within the arterial walls. In addition to lifestyle modifications, cholesterol-lowering drugs—whether used alone or in combination—are often prescribed for the prevention or management of atherosclerotic cardiovascular disease (ASCVD), including statins, ezetimibe, bempedoic acid, and PCSK9 inhibitors.

References

International Diabetes Federation. IDF Diabetes Atlas. 11th Edition 2025. diabetesatlas.org. ISBN: 978-2-930229-96-6.

Lorenzatti A, Toth PP. New perspectives on atherogenic dyslipidaemia and cardiovascular disease. Eur Cardiol Rev 2020;15:e04. DOI: https://doi.org/10.15420/ecr.2019.06.

Soewondo P, Soegondo S, Suastika K, Pranoto A, Soeatmadji DW, Tjokroprawiro A. The DiabCare Asia 2008 study – Outcomes on control and complications of type 2 diabetic patients in Indonesia. Med J Indones. 2010;19:235-44. https://doi.org/10.13181/mji.v19i4.412.

Suastika K, Semadi IMS, Dwipayana IMP, Saraswati MR, Gotera W, Budhiarta AAG, Matsumoto K, Kajiwara N, Taniguchi T. Dyslipidemia in diabetes: a population-based study in Bali. Internat J General Med 2019:12;313–21. http://doi.org/10.2147/IJGM.S215548.

Hirano T. Pathophysiology of diabetic dyslipidemia. J Atheroscler Thromb. 2018;25:771-82. http://doi.org/10.5551/jat.RV17023.

Tomlinson B, Chan P, Lam CWK. Postprandial hyperlipidemia as a risk factor in patients with type 2 diabetes. Expert Rev Endocrinol Metab. 2020. DOI: 10.1080/17446651.2020.1750949.

Giraldo-Gonzalez GC, Roman-Gonzalez A, Cañas F, Garcia A. Molecular mechanisms of type 2 diabetes-related heart disease and therapeutic insights. Int. J. Mol. Sci. 2025;26:4548. https://doi.org/ 10.3390/ijms26104548.

Kazibwe R, Jehopio J. Schaich CL, Rikhi R, Mirzai S, Chevli PA, Namutebi JH, Chebrolu S, O’Connor S, Yeboah J, Shapiro MD. Atherogenic dyslipidemia and incident cardiovascular events in high-risk hypertension. Progress Cardiovac 2025. https://doi.org/10.1016/j.pcad.2025.05.006.

Nakashima R, Ikeda S, Shinohara K, Matsumoto S, Yoshida D, Ono Y, Nakashima H, Miyamoto R, Matsushima S, Kishimoto J, Itoh H, Komuro I, Tsutsui H, Abe K. Triglyceride/high density lipoprotein cholesterol index and future cardiovascular events in diabetic patients without known cardiovascular disease. Scientific Reports. 2025; 15:9217. https://doi.org/10.1038/s41598-025-92933-6.

Zhang Y-Y, Yang X-Y, and Wan Q. Association between atherogenic

Index of plasma and type 2 diabetic complications: a cross-sectional study. Front Endocrinol. 2025;16:1537303. Doi: 10.3389/fendo.2025.1537303.

Zhang Y, Chen G, and Jing Y. Correlation between the atherogenic index of plasma and risk of diabetic retinopathy. Front Med. 2025;12:1565414. Doi: 10.3389/fmed.2025.1565414.

Gaita L, Timar B, Timar R, Fras Z, Gaita D, Banach M. Lipid disorders management strategies (2024) in prediabetic and diabetic patients. Pharmaceuticals. 2024;17:219. https://doi.org/10.3390/ph17020219.

American Diabetes Association. Cardiovascular disease and risk management: Standards of care in diabetes—2025. Diabetes Care 2025;48 (Suppl 1): S207–S238. https://doi.org/10.2337/dc25-S010.

Patel SB, Wyne KL, Alfreen S, Belalcazar LM, Bird MD, Coles S, Marrs JC, Peng CCH, Pulipati VP, Sultan S, Zilbermint M. American Association of Clinical Endocrinology Clinical Practice Guideline on Pharmacologic Management of Adults with Dyslipidemia. Endocrine Pract 2025; 31: 236-262. http://doi.org/10.1016/j.eprac.2024.09.016.

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Published

2025-10-03

How to Cite

Suastika, K. (2025). Atherogenic Dyslipidaemia in Diabetes: Burden and Challenges. Acta Medica Indonesiana, 57(3), 293. Retrieved from http://actamedindones.org/index.php/ijim/article/view/3154