Low HDL Cholesterol Is Associated With the Risk of Stroke in Elderly Diabetic Individuals: Changes in the risk for atherosclerotic diseases at various ages

OBJECTIVE: To clarify the relationship between lipid levels and ischemic heart disease (IHD) and cerebrovascular disease (CVD) in diabetic individuals. RESEARCH DESIGN AND METHODS: The Japan Cholesterol and Diabetes Mellitus Study is a prospective cohort study of 4,014 type 2 diabetic patients (1,936 women; mean ± SD age 67.4 ± 9.5 years). Lipid and glucose levels and other factors were investigated in relation to occurrence of IHD or CVD. RESULTS: IHD and CVD occurred in 1.59 and 1.43% of participants, respectively, over a 2-year period. The relation of lower HDL or higher LDL cholesterol to occurrence of IHD in subjects <65 years old was significant. Lower HDL cholesterol was also significantly related to CVD in subjects ≥65 years old and especially in those >75 years old (n = 1,016; odds ratio 0.511 [95% CI 0.239–0.918]; P < 0.05). Stepwise multiple regression analysis with onset of CVD as a dependent variable showed the same result. CONCLUSIONS: Lower HDL cholesterol is an important risk factor for not only IHD but also CVD, especially in diabetic elderly individuals.