A study of patients with type-2 diabetes found that smokers had increased levels of serum TC and triglycerides, lower HDL-C and HDL2-C, and increased hepatic lipase activity – an early sign of atherosclerosis – and it was suggested that accentuation of dyslipidaemia by smoking may be driven by increased hepatic lipase activity.34 It is possible that inflammation of the coronary vessel caused by one of these risk factors exposes the weakened vessel to other risk factor to cause further damage. This evidence concerns the gene LIPC and atherosclerosis.