Bingjie Qu
Remnant cholesterol and cardiovascular mortality in patients with type 2 diabetes and incident diabetic nephropathy
Qu, Bingjie; Zhang, Xiaoxue; Yu, Dahai; Wang, Zheng; Cai, Yamei; Ma, Shuang; Zhao, Zhanzheng; Simmons, David
Authors
Xiaoxue Zhang
Dr. Dahai Yu d.yu@keele.ac.uk
Zheng Wang
Yamei Cai
Shuang Ma
Zhanzheng Zhao
David Simmons
Abstract
Context
The association between remnant cholesterol (remnant-C) and cardiovascular mortality in patients with type 2 diabetes (T2D) and incident diabetic nephropathy remains unclear.
Objective
To examinie the association between remnant-C and cardiovascular mortality in patients with T2D, chronic kidney disease (CKD) stages 3 to 5, and newly diagnosed DN.
Methods
This study determined the baseline lipid profile and searched for deaths with cardiovascular disease (CVD) within 2 years of baseline among 2282 adults enrolled between January 1, 2015 and December 31, 2016, who had T2D, CKD stages 3 to 5, and newly diagnosed DN. Adjusted logistic regression models were used to assess the associations between lipid, especially remnant-C concentration (either as continuous or categorical variables), and risk of cardiovascular mortality.
Results
In multivariable-adjusted analyses, low-density lipoprotein cholesterol (LDL-C) (odds ratio [OR], 1.022; 95% CI, 1.017-1.026, per 10 mg/dL), high-density lipoprotein cholesterol (HDL-C) (OR, 0.929; 95% CI, 0.922-0.936, per 5 mg/dL), non–HDL-C (OR, 1.024; 95% CI, 1.021-1.028, per 10 mg/dL), and remnant-C (OR, 1.115; 95% CI, 1.103-1.127, per 10 mg/dL), but not triglycerides were associated with cardiovascular mortality. Atherogenic dyslipidemia (triglycerides > 150 mg/dL [1.69 mmol/L] and HDL-C < 40 mg/dL in men or < 50 mg/dL in women) was also associated with cardiovascular mortality (OR, 1.073; 95% CI, 1.031-1.116). Remnant-C greater than or equal to 30 mg/dL differentiated patients at a higher risk of cardiovascular mortality from those with lower concentrations, especially with interaction with LDL-C level greater than 100 mg/dL: The highest risk was found in patients with higher levels both of remnant-C and LDL-C (OR, 1.696; 95% CI, 1.613-1.783).
Conclusion
In patients with T2D, CKD stages 3 to 5, and incident DN, remnant-C was associated with a higher risk of death with CVD. Different from the general population, the interaction of remnant-C and LDL-C was associated with the highest risk of cardiovascular mortality.
Citation
Qu, B., Zhang, X., Yu, D., Wang, Z., Cai, Y., Ma, S., …Simmons, D. (2021). Remnant cholesterol and cardiovascular mortality in patients with type 2 diabetes and incident diabetic nephropathy. Journal of Clinical Endocrinology and Metabolism, 3546-3553. https://doi.org/10.1210/clinem/dgab533
Journal Article Type | Article |
---|---|
Acceptance Date | Jul 22, 2021 |
Publication Date | Jul 22, 2021 |
Journal | The Journal of Clinical Endocrinology & Metabolism |
Print ISSN | 0021-972X |
Publisher | Oxford University Press |
Pages | 3546-3553 |
DOI | https://doi.org/10.1210/clinem/dgab533 |
Keywords | Type 2 diabetes, Diabetic nephropathy, Cardiovascular diseases, Mortality, Lipids, Remnant cholesterol |
Publisher URL | https://doi.org/10.1210/clinem/dgab533 |
Files
remanant paper REV2 clean copy final with figures.docx
(5.4 Mb)
Document
Publisher Licence URL
https://creativecommons.org/licenses/by-nc/4.0/
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