Lipid and lipoprotein particle profiles in patients with type 2 diabetes mellitus: A comparative study between highlanders and lowlanders

The lipid profiles of highlanders and lowlanders differ. However, studies of the lipid profiles of patients with type 2 diabetes mellitus (T2DM) living at high altitudes are limited. This study aimed to compare lipid profiles and lipoprotein particles in individuals with T2DM permanently residing in the Tibetan Plateau and those residing in the lowlands. This cross-sectional study included 117 individuals with T2DM from the lowlands (n = 78) and highlands (n = 39). Demographic information, clinical features, blood biochemical indices, and standard lipid concentrations were recorded and evaluated. Low-density lipoprotein particles (LDL-Ps) and LDL subfractions were compared between the groups. Additionally, the risk for atherosclerotic cardiovascular disease (ASCVD) was assessed. The standard lipid profile and nuclear magnetic resonance-measured lipid panel showed no significant differences in terms of triglyceride, total cholesterol, and high-density lipoprotein cholesterol levels. However, highlanders exhibited a higher mean level of LDL cholesterol (LDL-C) than lowlanders. The LDL-P mean level was significantly higher in highlanders than in lowlanders. Small-density LDL (sdLDL) showed no distinct difference between the two groups. Furthermore, the 10-year risks of ASCVD were slightly higher in highlanders than in lowlanders, although the difference was not statistically significant. Individuals with T2DM living at highland altitudes have higher LDL-C and LDL-P levels than those living in lowlands. No difference was observed in the sdLDL levels between the two populations. These discrepancies may carry profound implications for the clinical management of T2DM and the prevention of cardiovascular diseases in high-altitude areas.