Impact of diabetes, high triglycerides and low HDL cholesterol on risk for ischemic cardiovascular disease varies by LDL cholesterol level: A 15-year follow-up of the Chinese Multi-provincial Cohort Study

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• 作者：Jing Liu ; Wei Wang ; Miao Wang ; Jiayi Sun ; Jun Liu ; Yan Li ; Yue Qi ; Zhaosu Wu ; Dong Zhao ; ^{deezhao@vip.sina.com}
• 关键词：Cardiovascular disease ; Prospective cohort study ; Diabetes ; Dyslipidemia
• 刊名：Diabetes Research and Clinical Practice
• 出版年：2012
• 期刊代码：78_01688227
• 类别：med
• 出版时间：May, 2012
• 卷：96
• 期：2
• 页码：217-224
• 文件大小：375 K

摘要

Aims

A large proportion of ischemic cardiovascular disease occur in people without hypercholesterolemia. We aimed to investigate whether risk factors other than low-density lipoprotein cholesterol (LDL-C) have different impacts on cardiovascular risk in people with low verses high LDL-C levels.

Methods

A total of 30,378 participants (35-64 years) were followed for 15 years in the Chinese Multi-provincial Cohort Study. Associations of coronary heart disease (CHD) and ischemic stroke with risk factors other than LDL-C were assessed in participants with low (<130 mg/dL) and high (鈮?30 mg/dL) LDL-C levels.

Results

During the follow-up, 65.5%of CHD and 70.2%of ischemic stroke events occurred in participants with low LDL-C. High triglycerides predicted CHD (HR = 1.74, 95%CI 1.25-2.42, P = 0.001), and low HDL-C predicted ischemic stroke (HR = 1.54, 95%CI 1.18-2.03, P = 0.002) only in participants with low LDL-C. Diabetes predicted CHD in participants with high LDL-C (HR = 2.38, 95%CI 1.31-4.34, P = 0.005), but not in those with low LDL-C. Older age, male, hypertension, central obesity, and smoking had similar effects on the risk in both groups.

Conclusions

Triglycerides and low HDL-C should be addressed in the management of dyslipidemia in people with low LDL-C. When LDL-C is high, tighter management of glycemia and LDL-C is warranted.