The Impacts Of Type2 Diabetes Mellitus On High-density Lipoprotein's Function:A Systematic Review

Background:High-density lipoprotein(HDL)with normal functions is known as functional HDL,however,in conditions of stress response,chronic inflammation and some metabolic diseases,such as type 2 diabetes(T2DM),some pathological decorations including glycosylation will happen to HDL.Subsequently,they change the internal components and functional groups of HDL,which lead to the loss of function of HDL.It is well known that in healthy human body,HDL has anti-inflammatory function.Recently,a growing number of researches suggest that the anti-inflammatory effect of HDL is impaired in condition of T2 DM.Moreover,HDL in T2 DM even becomes pro-inflammatory and injures the vascular endothelial,which called dysfunctional HDL.This is likely to be closely related to cardiovascular disease in patients with T2 DM.Objective: To systematic review the effects of type 2 diabetes on HDL antiinflammatory function.The systematic evaluation of the included literatures was also carried out.Method : According to the search strategy developed by the Cochorane Collaboration,the search for PUBMED,MEDLINE,EMBASE,CENTRAL,China Knowledge Network and Wanfang Database(1966-2018)was conducted through the combination of subject terms,keywords and free words.We investigated the original study of the anti-inflammatory effects of high-density lipoproteins in diabetics or diabetic models and contacted the author if necessary.According to the inclusion criteria and exclusion criteria,the initial screening of the literature,the application of the Cochorane risk bias evaluation system and the CASP list were used to evaluate the quality of the above studies and in-depth screening.Due to the great specificity between the experimental methods and experimental designs included in the study,an effective meta-analysis cannot be made.Therefore,a general descriptive systematic review method is used for follow-up studies.Results:A total of 14 literatures were included,including 15 studies,which showed greater heterogeneity in methodology,study population,and established diabetes models.Overall,the ability of HDL in patients with T2 DM to suppress the inflammatory response and inflammatory mediators is significantly reduced compared with the normal population.However,its mechanism and in vivo effects remain unclear.In the included studies,there were no reports of high-density lipoproteins in other types of diabetic patients.Most studies have a high risk of bias or cannot be assessed.Conclusions:HDL in patients with T2 DM show a decrease in anti-inflammatory capacity,but the mutual causality and mechanism of action between the two are still unknown.In the future,in the goal of treating dyslipidemia in patients with T2 DM,we cannot limit ourselves to increasing the serum level of HDL-C and reducing the serum level of LDL-C.Improvement or protection of HDL function should not be overlooked.In order to further study treatments for protecting the anti-inflammatory function of HDL in patients with T2 DM,future research will focus on the standardized methods for assessing the anti-inflammatory function of HDL and identifying relevant in vivo biomarkers.