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Low HDL cholesterol and the risk of diabetic nephropathy and retinopathy: results of the ADVANCE study.
Diabetes Care. 2012 Nov; 35(11):2201-6.DC

Abstract

OBJECTIVE

Although low HDL cholesterol (HDL-C) is an established risk factor for atherosclerosis, data on HDL-C and the risk of microvascular disease are limited. We tested the association between HDL-C and microvascular disease in a cohort of patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS

A total of 11,140 patients with type 2 diabetes and at least one additional vascular risk factor were followed a median of 5 years. Cox proportional hazards models were used to assess the association between baseline HDL-C and the development of new or worsening microvascular disease, defined prospectively as a composite of renal and retinal events.

RESULTS

The mean baseline HDL-C level was 1.3 mmol/L (SD 0.45 mmol/L [range 0.1-4.0]). During follow-up, 32% of patients developed new or worsening microvascular disease, with 28% experiencing a renal event and 6% a retinal event. Compared with patients in the highest third, those in the lowest third had a 17% higher risk of microvascular disease (adjusted hazard ratio 1.17 [95% CI 1.06-1.28], P = 0.001) after adjustment for potential confounders and regression dilution. This was driven by a 19% higher risk of renal events (1.19 [1.08-1.32], P = 0.0005). There was no association between thirds of HDL-C and retinal events (1.01 [0.82-1.25], P = 0.9).

CONCLUSIONS

In patients with type 2 diabetes, HDL-C level is an independent risk factor for the development of microvascular disease affecting the kidney but not the retina.

Authors+Show Affiliations

The Heart Research Institute, Sydney, New South Wales, Australia.No 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 availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22891258

Citation

Morton, Jamie, et al. "Low HDL Cholesterol and the Risk of Diabetic Nephropathy and Retinopathy: Results of the ADVANCE Study." Diabetes Care, vol. 35, no. 11, 2012, pp. 2201-6.
Morton J, Zoungas S, Li Q, et al. Low HDL cholesterol and the risk of diabetic nephropathy and retinopathy: results of the ADVANCE study. Diabetes Care. 2012;35(11):2201-6.
Morton, J., Zoungas, S., Li, Q., Patel, A. A., Chalmers, J., Woodward, M., Celermajer, D. S., Beulens, J. W., Stolk, R. P., Glasziou, P., & Ng, M. K. (2012). Low HDL cholesterol and the risk of diabetic nephropathy and retinopathy: results of the ADVANCE study. Diabetes Care, 35(11), 2201-6. https://doi.org/10.2337/dc12-0306
Morton J, et al. Low HDL Cholesterol and the Risk of Diabetic Nephropathy and Retinopathy: Results of the ADVANCE Study. Diabetes Care. 2012;35(11):2201-6. PubMed PMID: 22891258.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low HDL cholesterol and the risk of diabetic nephropathy and retinopathy: results of the ADVANCE study. AU - Morton,Jamie, AU - Zoungas,Sophia, AU - Li,Qiang, AU - Patel,Anushka A, AU - Chalmers,John, AU - Woodward,Mark, AU - Celermajer,David S, AU - Beulens,Joline W J, AU - Stolk,Ronald P, AU - Glasziou,Paul, AU - Ng,Martin K C, AU - ,, Y1 - 2012/08/13/ PY - 2012/8/15/entrez PY - 2012/8/15/pubmed PY - 2013/4/18/medline SP - 2201 EP - 6 JF - Diabetes care JO - Diabetes Care VL - 35 IS - 11 N2 - OBJECTIVE: Although low HDL cholesterol (HDL-C) is an established risk factor for atherosclerosis, data on HDL-C and the risk of microvascular disease are limited. We tested the association between HDL-C and microvascular disease in a cohort of patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: A total of 11,140 patients with type 2 diabetes and at least one additional vascular risk factor were followed a median of 5 years. Cox proportional hazards models were used to assess the association between baseline HDL-C and the development of new or worsening microvascular disease, defined prospectively as a composite of renal and retinal events. RESULTS: The mean baseline HDL-C level was 1.3 mmol/L (SD 0.45 mmol/L [range 0.1-4.0]). During follow-up, 32% of patients developed new or worsening microvascular disease, with 28% experiencing a renal event and 6% a retinal event. Compared with patients in the highest third, those in the lowest third had a 17% higher risk of microvascular disease (adjusted hazard ratio 1.17 [95% CI 1.06-1.28], P = 0.001) after adjustment for potential confounders and regression dilution. This was driven by a 19% higher risk of renal events (1.19 [1.08-1.32], P = 0.0005). There was no association between thirds of HDL-C and retinal events (1.01 [0.82-1.25], P = 0.9). CONCLUSIONS: In patients with type 2 diabetes, HDL-C level is an independent risk factor for the development of microvascular disease affecting the kidney but not the retina. SN - 1935-5548 UR - https://www.unboundmedicine.com/medline/citation/22891258/Low_HDL_cholesterol_and_the_risk_of_diabetic_nephropathy_and_retinopathy:_results_of_the_ADVANCE_study_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&pmid=22891258 DB - PRIME DP - Unbound Medicine ER -