Total/high density lipoprotein cholesterol and cardiovascular disease (re)hospitalization nadir in type 2 diabetes

Dahai Yu, Yamei Cai, Rui Qin, Jonathan Graffy, Daniel Holman, Zhanzheng Zhao, David Simmons

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

Total cholesterol to HDL cholesterol ratio (TC/ HDL) is an important prognostic factor for CVD. This study used restricted cubic spline modeling to investigate the dose-response associations between TC/HDL and both CVD hospitalization and CVD rehospitalization in two independent prospective cohorts. The East Cambridgeshire and Fenland cohort includes 4,704 patients with T2D from 18 general practices in Cambridgeshire. The Randomized controlled trial of Peer Support In type 2 Diabetes cohort comprises 1,121 patients with T2D with posttrial follow-up data. TC/HDL and other demographic and clinical measurements were measured at baseline. Outcomes were CVD hospitalization over 2 years and CVD rehospitalization after 90 days of the prior CVD hospitalization. Modeling showed nonlinear relationships between TC/HDL and risks of CVD hospitalization and rehospitalization consistently in both cohorts (all P < 0.001 for linear tests). The lowest risks of CVD hospitalization and rehospitalization were consistently found for TC/HDL at 2.8 (95% CI: 2.6-3.0) in both cohorts and both overall and by gender. This is lower than the current lipid control target, 4.0 of TC/HDL. Reducing the TC/HDL target to 2.8 would include a further 33-44% patients with TC/HDL in the 2.8-4.0 range. Studies are required to assess the effectiveness and cost-effectiveness of the earlier introduction of, and more intensive, lipid-lowering treatment needed to achieve this new lower TC/HDL target.
Original languageEnglish
Pages (from-to)1745-1750
Number of pages6
JournalJournal of Lipid Research
Volume59
Issue number9
DOIs
Publication statusPublished - 2018

Keywords

  • cardiovascular system
  • cholesterol
  • diseases
  • high density lipoproteins
  • hospitalization
  • non-insulin-dependent diabetes

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