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The impact of dyslipidaemia on cardiovascular mortality in individuals without a prior history of diabetes in the DECODE Study.
Atherosclerosis. 2009 Sep; 206(1):298-302.A

Abstract

OBJECTIVE

To evaluate the impact of dyslipidaemia on cardiovascular disease (CVD) mortality in relation to fasting (FPG) and 2-h (2hPG) plasma glucose levels in individuals without a prior history of diabetes.

METHODS

Data from 14 European population-based prospective studies of 9132 men and 8631 women aged 25-89 years were jointly analysed. A total of 871 CVD deaths occurred during the average 10 years of follow-up. Subjects were classified into normoglycaemia, isolated fasting hyperglycaemia (IFH, FPG> or =6.10 mmol/l and 2hPG<7.80 mmol/l), isolated post-load hyperglycaemia (IPH, FPG<6.10 mmol/l and 2hPG> or =7.80 mmol/l) and combined fasting and post-load hyperglycaemia (CH, FPG> or =6.10 mmol/l and 2hPG> or =7.80 mmol/l). Multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD mortality were estimated using Cox proportional hazard analysis.

RESULTS

Multivariate-adjusted HRs (95% CIs) for high-density lipoprotein cholesterol (HDL-C) were 0.84 (0.75-0.94), 0.66 (0.48-0.92), 1.03 (0.84-1.27) and 0.67 (0.51-0.89) in individuals with normoglycaemia, IFH, IPH and CH, respectively. For total cholesterol (TC) to HDL-C ratio they were 1.14 (1.03-1.27), 1.44 (1.13-1.84), 0.94 (0.77-1.15) and 1.26 (1.05-1.50), respectively. HRs for TC and triglycerides (TG) were not significant in most of the glucose categories except for TG in those with CH [HR 1.12 (1.00-1.27)].

CONCLUSIONS

Low HDL-C and high TC/HDL-C increase CVD mortality in either diabetic or non-diabetic individuals defined based on the fasting glucose criteria, but not the 2-h criteria. TG is a significant CVD risk predictor only in the presence of combined hyperglycaemia or diabetes. The difference between fasting and post-load hyperglycaemia with regard to the lipid-CVD relation may suggest a different pathophysiology underlying these two prediabetic states.

Authors+Show Affiliations

Department of Public Health, University of Helsinki, Mannerheimintie 172, Helsinki, Finland. lei.zhang@ktl.fiNo affiliation info availableNo affiliation info availableNo affiliation info availableNo 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

Language

eng

PubMed ID

19303072

Citation

Zhang, Lei, et al. "The Impact of Dyslipidaemia On Cardiovascular Mortality in Individuals Without a Prior History of Diabetes in the DECODE Study." Atherosclerosis, vol. 206, no. 1, 2009, pp. 298-302.
Zhang L, Qiao Q, Tuomilehto J, et al. The impact of dyslipidaemia on cardiovascular mortality in individuals without a prior history of diabetes in the DECODE Study. Atherosclerosis. 2009;206(1):298-302.
Zhang, L., Qiao, Q., Tuomilehto, J., Hammar, N., Ruotolo, G., Stehouwer, C. D., Heine, R. J., Eliasson, M., & Zethelius, B. (2009). The impact of dyslipidaemia on cardiovascular mortality in individuals without a prior history of diabetes in the DECODE Study. Atherosclerosis, 206(1), 298-302. https://doi.org/10.1016/j.atherosclerosis.2008.12.043
Zhang L, et al. The Impact of Dyslipidaemia On Cardiovascular Mortality in Individuals Without a Prior History of Diabetes in the DECODE Study. Atherosclerosis. 2009;206(1):298-302. PubMed PMID: 19303072.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact of dyslipidaemia on cardiovascular mortality in individuals without a prior history of diabetes in the DECODE Study. AU - Zhang,Lei, AU - Qiao,Qing, AU - Tuomilehto,Jaakko, AU - Hammar,Niklas, AU - Ruotolo,Giacomo, AU - Stehouwer,Coen D A, AU - Heine,Robert J, AU - Eliasson,Mats, AU - Zethelius,Björn, AU - ,, Y1 - 2009/02/23/ PY - 2008/09/17/received PY - 2008/11/10/revised PY - 2008/12/02/accepted PY - 2009/3/24/entrez PY - 2009/3/24/pubmed PY - 2009/12/16/medline SP - 298 EP - 302 JF - Atherosclerosis JO - Atherosclerosis VL - 206 IS - 1 N2 - OBJECTIVE: To evaluate the impact of dyslipidaemia on cardiovascular disease (CVD) mortality in relation to fasting (FPG) and 2-h (2hPG) plasma glucose levels in individuals without a prior history of diabetes. METHODS: Data from 14 European population-based prospective studies of 9132 men and 8631 women aged 25-89 years were jointly analysed. A total of 871 CVD deaths occurred during the average 10 years of follow-up. Subjects were classified into normoglycaemia, isolated fasting hyperglycaemia (IFH, FPG> or =6.10 mmol/l and 2hPG<7.80 mmol/l), isolated post-load hyperglycaemia (IPH, FPG<6.10 mmol/l and 2hPG> or =7.80 mmol/l) and combined fasting and post-load hyperglycaemia (CH, FPG> or =6.10 mmol/l and 2hPG> or =7.80 mmol/l). Multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD mortality were estimated using Cox proportional hazard analysis. RESULTS: Multivariate-adjusted HRs (95% CIs) for high-density lipoprotein cholesterol (HDL-C) were 0.84 (0.75-0.94), 0.66 (0.48-0.92), 1.03 (0.84-1.27) and 0.67 (0.51-0.89) in individuals with normoglycaemia, IFH, IPH and CH, respectively. For total cholesterol (TC) to HDL-C ratio they were 1.14 (1.03-1.27), 1.44 (1.13-1.84), 0.94 (0.77-1.15) and 1.26 (1.05-1.50), respectively. HRs for TC and triglycerides (TG) were not significant in most of the glucose categories except for TG in those with CH [HR 1.12 (1.00-1.27)]. CONCLUSIONS: Low HDL-C and high TC/HDL-C increase CVD mortality in either diabetic or non-diabetic individuals defined based on the fasting glucose criteria, but not the 2-h criteria. TG is a significant CVD risk predictor only in the presence of combined hyperglycaemia or diabetes. The difference between fasting and post-load hyperglycaemia with regard to the lipid-CVD relation may suggest a different pathophysiology underlying these two prediabetic states. SN - 1879-1484 UR - https://www.unboundmedicine.com/medline/citation/19303072/The_impact_of_dyslipidaemia_on_cardiovascular_mortality_in_individuals_without_a_prior_history_of_diabetes_in_the_DECODE_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0021-9150(09)00142-7 DB - PRIME DP - Unbound Medicine ER -