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Joint role of non-HDL cholesterol and glycated haemoglobin in predicting future coronary heart disease events among women with type 2 diabetes.
Diabetologia 2004; 47(12):2129-36D

Abstract

AIMS/HYPOTHESIS

Non-HDL cholesterol (the sum of LDL, VLDL and IDL cholesterol) is considered to be particularly valuable in the management of dyslipidaemia in type 2 diabetes. However, it remains uncertain whether the association between non-HDL cholesterol and cardiovascular risk in type 2 diabetes depends on the status of hyperglycaemia. We aimed to determine whether non-HDL cholesterol predicts CHD events among diabetic women independently of currently established risk factors and the status of glycaemic control.

METHODS

We prospectively followed 921 diabetic women in the Nurses' Health Study, who were free of cardiovascular disease at the time that blood was drawn in 1989/90. During 10 years of follow-up, we identified 122 incident CHD cases.

RESULTS

After adjustment for age, BMI, smoking, alcohol consumption, and other lifestyle risk factors, the multivariate relative risks (RRs) of CHD for extreme quartiles were 1.97 (95% CI: 1.14-3.43) for non-HDL cholesterol, 1.78 (1.02-3.11) for apolipoprotein B-100, and 1.93 (1.15-3.22) for LDL cholesterol. However, the association between non-HDL cholesterol and CHD risk was only apparent among women with elevated fasting triglycerides (RR for extreme quartiles: 3.80; p=0.045). HbA(1)c was strongly associated with increased CHD risk (RR for increase by 1 unit: 1.24; 95% CI: 1.13-1.35), and both non-HDL cholesterol and HbA(1)c additively predicted CHD risk (RR for the combination of high non-HDL cholesterol and high HbA(1)c [tertiles]: 4.59).

CONCLUSIONS/INTERPRETATION

Our study suggests that non-HDL cholesterol and HbA(1)c are potent predictors of CHD risk in diabetic women. Therapies to lower CHD risk in diabetic patients should emphasise both glycaemic control and lipid lowering.

Authors+Show Affiliations

Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15662553

Citation

Schulze, M B., et al. "Joint Role of non-HDL Cholesterol and Glycated Haemoglobin in Predicting Future Coronary Heart Disease Events Among Women With Type 2 Diabetes." Diabetologia, vol. 47, no. 12, 2004, pp. 2129-36.
Schulze MB, Shai I, Manson JE, et al. Joint role of non-HDL cholesterol and glycated haemoglobin in predicting future coronary heart disease events among women with type 2 diabetes. Diabetologia. 2004;47(12):2129-36.
Schulze, M. B., Shai, I., Manson, J. E., Li, T., Rifai, N., Jiang, R., & Hu, F. B. (2004). Joint role of non-HDL cholesterol and glycated haemoglobin in predicting future coronary heart disease events among women with type 2 diabetes. Diabetologia, 47(12), pp. 2129-36.
Schulze MB, et al. Joint Role of non-HDL Cholesterol and Glycated Haemoglobin in Predicting Future Coronary Heart Disease Events Among Women With Type 2 Diabetes. Diabetologia. 2004;47(12):2129-36. PubMed PMID: 15662553.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Joint role of non-HDL cholesterol and glycated haemoglobin in predicting future coronary heart disease events among women with type 2 diabetes. AU - Schulze,M B, AU - Shai,I, AU - Manson,J E, AU - Li,T, AU - Rifai,N, AU - Jiang,R, AU - Hu,F B, Y1 - 2004/12/15/ PY - 2004/05/15/received PY - 2004/07/18/accepted PY - 2005/1/22/pubmed PY - 2005/5/27/medline PY - 2005/1/22/entrez SP - 2129 EP - 36 JF - Diabetologia JO - Diabetologia VL - 47 IS - 12 N2 - AIMS/HYPOTHESIS: Non-HDL cholesterol (the sum of LDL, VLDL and IDL cholesterol) is considered to be particularly valuable in the management of dyslipidaemia in type 2 diabetes. However, it remains uncertain whether the association between non-HDL cholesterol and cardiovascular risk in type 2 diabetes depends on the status of hyperglycaemia. We aimed to determine whether non-HDL cholesterol predicts CHD events among diabetic women independently of currently established risk factors and the status of glycaemic control. METHODS: We prospectively followed 921 diabetic women in the Nurses' Health Study, who were free of cardiovascular disease at the time that blood was drawn in 1989/90. During 10 years of follow-up, we identified 122 incident CHD cases. RESULTS: After adjustment for age, BMI, smoking, alcohol consumption, and other lifestyle risk factors, the multivariate relative risks (RRs) of CHD for extreme quartiles were 1.97 (95% CI: 1.14-3.43) for non-HDL cholesterol, 1.78 (1.02-3.11) for apolipoprotein B-100, and 1.93 (1.15-3.22) for LDL cholesterol. However, the association between non-HDL cholesterol and CHD risk was only apparent among women with elevated fasting triglycerides (RR for extreme quartiles: 3.80; p=0.045). HbA(1)c was strongly associated with increased CHD risk (RR for increase by 1 unit: 1.24; 95% CI: 1.13-1.35), and both non-HDL cholesterol and HbA(1)c additively predicted CHD risk (RR for the combination of high non-HDL cholesterol and high HbA(1)c [tertiles]: 4.59). CONCLUSIONS/INTERPRETATION: Our study suggests that non-HDL cholesterol and HbA(1)c are potent predictors of CHD risk in diabetic women. Therapies to lower CHD risk in diabetic patients should emphasise both glycaemic control and lipid lowering. SN - 0012-186X UR - https://www.unboundmedicine.com/medline/citation/15662553/Joint_role_of_non_HDL_cholesterol_and_glycated_haemoglobin_in_predicting_future_coronary_heart_disease_events_among_women_with_type_2_diabetes_ L2 - https://dx.doi.org/10.1007/s00125-004-1593-2 DB - PRIME DP - Unbound Medicine ER -