Cargando…

Remnant cholesterol and the risk of cardiovascular disease in type 2 diabetes: a nationwide longitudinal cohort study

BACKGROUND: Elevated remnant cholesterol (remnant-C) is considered a risk factor for cardiovascular disease (CVD); however, whether this notion applies to the East Asian population with type 2 diabetes (T2D) has not been established. This study investigated the association between remnant-C concentr...

Descripción completa

Detalles Bibliográficos
Autores principales: Huh, Ji Hye, Han, Kyung-do, Cho, Yun Kyung, Roh, Eun, Kang, Jun Goo, Lee, Seong Jin, Ihm, Sung-Hee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9632127/
https://www.ncbi.nlm.nih.gov/pubmed/36324177
http://dx.doi.org/10.1186/s12933-022-01667-6
_version_ 1784823964417130496
author Huh, Ji Hye
Han, Kyung-do
Cho, Yun Kyung
Roh, Eun
Kang, Jun Goo
Lee, Seong Jin
Ihm, Sung-Hee
author_facet Huh, Ji Hye
Han, Kyung-do
Cho, Yun Kyung
Roh, Eun
Kang, Jun Goo
Lee, Seong Jin
Ihm, Sung-Hee
author_sort Huh, Ji Hye
collection PubMed
description BACKGROUND: Elevated remnant cholesterol (remnant-C) is considered a risk factor for cardiovascular disease (CVD); however, whether this notion applies to the East Asian population with type 2 diabetes (T2D) has not been established. This study investigated the association between remnant-C concentrations and the risk of CVD in Korean patients with T2D. METHODS: By using the Korean National Health Insurance Service database, 1,956,452 patients with T2D and without atherosclerotic CVD who underwent regular health checks between 2009 and 2012 were included. Cox regression analyses were conducted to assess the association between remnant-C concentrations and incident CVD comprising myocardial infarction (MI) and ischemic stroke. RESULTS: In total, 50,120 (2.56%) cases of MI and 73,231 (3.74%) cases of ischemic strokes occurred during a median follow-up of 8.1 years. The adjusted hazard ratios for MI and stroke in the highest remnant-C quartile were 1.281 (95% confidence interval [CIs], 1.249–1.314) for MI and 1.22 (1.195–1.247) for ischemic stroke, compared to those in the lowest quartiles. The results were similar, based on stratified analysis by age, sex, use of statin or fibrate, and levels of other cholesterol. The increased risk of CVD in the highest remnant-C quartile was profound in patients who had a longer T2D duration. A remnant-C concentration ≥ 30 mg/dL differentiated patients who were at a higher risk of CVD, compared to patients with a lower concentrations, regardless of whether LDL-C levels were or were not on target at ≤ 100 mg/dL. CONCLUSION: In Korean patients with T2D, remnant-C was associated with CVD, independent of the LDL-C level or other conventional CVD risk factors. Our finding confirmed evidence of the causal role of remnant-C on CVD, as a residual risk of CVD, in East Asian patients with T2D. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12933-022-01667-6.
format Online
Article
Text
id pubmed-9632127
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-96321272022-11-04 Remnant cholesterol and the risk of cardiovascular disease in type 2 diabetes: a nationwide longitudinal cohort study Huh, Ji Hye Han, Kyung-do Cho, Yun Kyung Roh, Eun Kang, Jun Goo Lee, Seong Jin Ihm, Sung-Hee Cardiovasc Diabetol Research BACKGROUND: Elevated remnant cholesterol (remnant-C) is considered a risk factor for cardiovascular disease (CVD); however, whether this notion applies to the East Asian population with type 2 diabetes (T2D) has not been established. This study investigated the association between remnant-C concentrations and the risk of CVD in Korean patients with T2D. METHODS: By using the Korean National Health Insurance Service database, 1,956,452 patients with T2D and without atherosclerotic CVD who underwent regular health checks between 2009 and 2012 were included. Cox regression analyses were conducted to assess the association between remnant-C concentrations and incident CVD comprising myocardial infarction (MI) and ischemic stroke. RESULTS: In total, 50,120 (2.56%) cases of MI and 73,231 (3.74%) cases of ischemic strokes occurred during a median follow-up of 8.1 years. The adjusted hazard ratios for MI and stroke in the highest remnant-C quartile were 1.281 (95% confidence interval [CIs], 1.249–1.314) for MI and 1.22 (1.195–1.247) for ischemic stroke, compared to those in the lowest quartiles. The results were similar, based on stratified analysis by age, sex, use of statin or fibrate, and levels of other cholesterol. The increased risk of CVD in the highest remnant-C quartile was profound in patients who had a longer T2D duration. A remnant-C concentration ≥ 30 mg/dL differentiated patients who were at a higher risk of CVD, compared to patients with a lower concentrations, regardless of whether LDL-C levels were or were not on target at ≤ 100 mg/dL. CONCLUSION: In Korean patients with T2D, remnant-C was associated with CVD, independent of the LDL-C level or other conventional CVD risk factors. Our finding confirmed evidence of the causal role of remnant-C on CVD, as a residual risk of CVD, in East Asian patients with T2D. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12933-022-01667-6. BioMed Central 2022-11-02 /pmc/articles/PMC9632127/ /pubmed/36324177 http://dx.doi.org/10.1186/s12933-022-01667-6 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Huh, Ji Hye
Han, Kyung-do
Cho, Yun Kyung
Roh, Eun
Kang, Jun Goo
Lee, Seong Jin
Ihm, Sung-Hee
Remnant cholesterol and the risk of cardiovascular disease in type 2 diabetes: a nationwide longitudinal cohort study
title Remnant cholesterol and the risk of cardiovascular disease in type 2 diabetes: a nationwide longitudinal cohort study
title_full Remnant cholesterol and the risk of cardiovascular disease in type 2 diabetes: a nationwide longitudinal cohort study
title_fullStr Remnant cholesterol and the risk of cardiovascular disease in type 2 diabetes: a nationwide longitudinal cohort study
title_full_unstemmed Remnant cholesterol and the risk of cardiovascular disease in type 2 diabetes: a nationwide longitudinal cohort study
title_short Remnant cholesterol and the risk of cardiovascular disease in type 2 diabetes: a nationwide longitudinal cohort study
title_sort remnant cholesterol and the risk of cardiovascular disease in type 2 diabetes: a nationwide longitudinal cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9632127/
https://www.ncbi.nlm.nih.gov/pubmed/36324177
http://dx.doi.org/10.1186/s12933-022-01667-6
work_keys_str_mv AT huhjihye remnantcholesterolandtheriskofcardiovasculardiseaseintype2diabetesanationwidelongitudinalcohortstudy
AT hankyungdo remnantcholesterolandtheriskofcardiovasculardiseaseintype2diabetesanationwidelongitudinalcohortstudy
AT choyunkyung remnantcholesterolandtheriskofcardiovasculardiseaseintype2diabetesanationwidelongitudinalcohortstudy
AT roheun remnantcholesterolandtheriskofcardiovasculardiseaseintype2diabetesanationwidelongitudinalcohortstudy
AT kangjungoo remnantcholesterolandtheriskofcardiovasculardiseaseintype2diabetesanationwidelongitudinalcohortstudy
AT leeseongjin remnantcholesterolandtheriskofcardiovasculardiseaseintype2diabetesanationwidelongitudinalcohortstudy
AT ihmsunghee remnantcholesterolandtheriskofcardiovasculardiseaseintype2diabetesanationwidelongitudinalcohortstudy