Yu, D ORCID: https://orcid.org/0000-0002-8449-7725, Wang, Z, Zhang, X, Qu, B, Cai, Y, Ma, S, Zhao, Z and Simmons, D (2021) Remnant cholesterol and cardiovascular mortality in patients with type 2 diabetes and incident diabetic nephropathy. The Journal of Clinical Endocrinology & Metabolism.

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Abstract

This study examined the association between remnant cholesterol (remnant-C) and cardiovascular mortality in patients with type 2 diabetes (T2D), chronic kidney disease (CKD) stages 3-5 and newly diagnosed diabetic nephropathy (DN). This study determined the baseline lipid profile and searched for deaths with cardiovascular disease (CVD) within 2 years of baseline among 2282 adults enrolled between 01/01/2015 and 31/12/2016 who had T2D, CKD stages 3-5 and newly diagnosed DN. Adjusted Logistic regression models were used to assess the associations between lipid, especially remnant-C concentration (either as continuous or categorical variables), and risk of cardiovascular mortality.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>In multivariable-adjusted analyses, low-density lipoprotein cholesterol (LDL-C) (odds ratio [OR]:1.022; 95% confidence interval [CI]: 1.017-1.026, per 10mg/dl), HDL-C (0.929 [0.922-0.936], per 5 mg/dl), Non-HDL-C (1.024 [1.021-1.028], per 10mg/dl), and remnant-C (1.115 [1.103-1.127], per 10mg/dl), but not triglyceride were associated with cardiovascular mortality. Atherogenic dyslipidemia (triglycerides &amp;gt;150 mg/dl [1.69 mmol/l] and HDL-C &amp;lt;40 mg/dl in men or &amp;lt;50 mg/dl in women) was also associated with cardiovascular mortality (1.073[1.031-1.116]). Remnant-C ≥30 mg/dl differentiated patients at a higher risk of cardiovascular mortality compared with those with lower concentrations, especially with interaction with LDL-C level &amp;gt;100 mg/dl: the highest risk was found in patients with higher levels of both remnant-C and LDL-C (1.696 [1.613-1.783]). In patients with T2D, CKD stages 3-5 and incident DN, remnant-C was associated with higher risk of death with CVD. Different from the general population, the interaction of remnant-C and LDL-C was associated with the highest risk of cardiovascular mortality.

Item Type: Article
Additional Information: The final version of this accepted manuscript is available from the publishers at https://academic.oup.com/jcem/advance-article-abstract/doi/10.1210/clinem/dgab533/6325383?redirectedFrom=fulltext
Uncontrolled Keywords: Type 2 diabetes, Diabetic nephropathy, Cardiovascular diseases, Mortality, Lipids, Remnant cholesterol
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
Divisions: Faculty of Medicine and Health Sciences > School of Medicine
Depositing User: Symplectic
Date Deposited: 17 Aug 2021 09:39
Last Modified: 17 Aug 2021 09:39
URI: https://eprints.keele.ac.uk/id/eprint/9877

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