Weight Gain, Serum Lipids, and Vascular Disease in Diabetics

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Abstract
One hundred and twenty diabetics were studied with regard to age, sex, duration, family history, somatic index, weight gain, treatment, and triglyceride and cholesterol concentration in relation to the two distinguished vascular complications, specific diabetic microangiopathy (small-vessel disease) and nonspecific atherosclerosis (large-vessel disease). Weight gain, when maintained, was markedly associated with large-vessel disease, to a lesser extent with small-vessel disease, and to some extent with triglyceride elevation, less with cholesterol levels. When weight gain was followed by weight loss, large-vessel complications were much less frequent than when the excess weight was maintained. Patients with fasting blood sugar-concentrations above 150 mg/100 ml compared to those with concentrations less than 150 mg/100 ml had a significantly higher mean triglyceride concentration, 6.3 mEq/liter compared to 5.1 mEq/liter (P < 0.05). All patients with large-vessel disease had a significantly higher mean triglyceride level (6.5 mEq/liter) than those without atherosclerotic symptoms (5.0 mEq/liter, P < 0.05). Diabetics with microangiopathy only had the highest prevalence of a positive family history of diabetes (40%) and of coronary artery disease (32%); in the group with large-vessel disease the percentages were 15% and 18%, respectively. Correspondingly a positive family history of diabetes (21% of all diabetics) was associated with a higher prevalence of small-vessel complication. A high prevalence of hypertension was noted, especially in the youngest diabetics and in those without other complications. The possibility that hypertension is an early manifestation of small-vessel disease is discussed, as well as genetic and environmental influences on diabetes mellitus and its vascular complications.