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Comparison of the effects of triglyceride variability and exposure estimate on clinical prognosis in diabetic patients

BACKGROUND: Hypertriglyceridemia is an important feature of dyslipidemia in type 1 and type 2 diabetic patients and associated with the development of atherosclerotic cardiovascular disease. Recently, variability of lipid profile has been suggested as a residual risk factor for cardiovascular diseas...

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Autores principales: Koh, Sung Min, Chung, Se Hwa, Yum, Yun Jin, Park, Se Jun, Joo, Hyung Joon, Kim, Yong-Hyun, Kim, Eung Ju
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9667663/
https://www.ncbi.nlm.nih.gov/pubmed/36380325
http://dx.doi.org/10.1186/s12933-022-01681-8
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author Koh, Sung Min
Chung, Se Hwa
Yum, Yun Jin
Park, Se Jun
Joo, Hyung Joon
Kim, Yong-Hyun
Kim, Eung Ju
author_facet Koh, Sung Min
Chung, Se Hwa
Yum, Yun Jin
Park, Se Jun
Joo, Hyung Joon
Kim, Yong-Hyun
Kim, Eung Ju
author_sort Koh, Sung Min
collection PubMed
description BACKGROUND: Hypertriglyceridemia is an important feature of dyslipidemia in type 1 and type 2 diabetic patients and associated with the development of atherosclerotic cardiovascular disease. Recently, variability of lipid profile has been suggested as a residual risk factor for cardiovascular disease. This study compared the clinical impact of serum triglyceride variability, and their cumulative exposure estimates on cardiovascular prognosis in diabetic patients. METHODS: A total of 25,933 diabetic patients who had serum triglyceride levels measured at least 3 times and did not have underlying malignancy, myocardial infarction (MI), and stroke during the initial 3 years (modeling phase) were selected from three tertiary hospitals. They were divided into a high/low group depending on their coefficient of variation (CV) and cumulative exposure estimate (CEE). Incidence of major adverse event (MAE), a composite of all-cause death, MI, and stroke during the following 5 years were compared between groups by multivariable analysis after propensity score matching. RESULTS: Although there was a slight difference, both the high CV group and the high CEE group had a higher cardiovascular risk profile including male-dominance, smoking, alcohol, dyslipidemia, and chronic kidney disease compared to the low groups. After the propensity score matching, the high CV group showed higher MAE incidence compared to the low CV group (9.1% vs 7.7%, p = 0.01). In contrast, there was no significant difference of MAE incidence between the high CEE group and the low CEE group (8.6% vs 9.1%, p = 0.44). After the multivariable analysis with further adjustment for potential residual confounding factors, the high CV was suggested as an independent risk predictor for MAE (HR 1.19 [95% CI 1.03–1.37]). CONCLUSION: Visit-to-visit variability of triglyceride rather than their cumulative exposure is more strongly related to the incidence of MAE in diabetic patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12933-022-01681-8.
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spelling pubmed-96676632022-11-17 Comparison of the effects of triglyceride variability and exposure estimate on clinical prognosis in diabetic patients Koh, Sung Min Chung, Se Hwa Yum, Yun Jin Park, Se Jun Joo, Hyung Joon Kim, Yong-Hyun Kim, Eung Ju Cardiovasc Diabetol Research BACKGROUND: Hypertriglyceridemia is an important feature of dyslipidemia in type 1 and type 2 diabetic patients and associated with the development of atherosclerotic cardiovascular disease. Recently, variability of lipid profile has been suggested as a residual risk factor for cardiovascular disease. This study compared the clinical impact of serum triglyceride variability, and their cumulative exposure estimates on cardiovascular prognosis in diabetic patients. METHODS: A total of 25,933 diabetic patients who had serum triglyceride levels measured at least 3 times and did not have underlying malignancy, myocardial infarction (MI), and stroke during the initial 3 years (modeling phase) were selected from three tertiary hospitals. They were divided into a high/low group depending on their coefficient of variation (CV) and cumulative exposure estimate (CEE). Incidence of major adverse event (MAE), a composite of all-cause death, MI, and stroke during the following 5 years were compared between groups by multivariable analysis after propensity score matching. RESULTS: Although there was a slight difference, both the high CV group and the high CEE group had a higher cardiovascular risk profile including male-dominance, smoking, alcohol, dyslipidemia, and chronic kidney disease compared to the low groups. After the propensity score matching, the high CV group showed higher MAE incidence compared to the low CV group (9.1% vs 7.7%, p = 0.01). In contrast, there was no significant difference of MAE incidence between the high CEE group and the low CEE group (8.6% vs 9.1%, p = 0.44). After the multivariable analysis with further adjustment for potential residual confounding factors, the high CV was suggested as an independent risk predictor for MAE (HR 1.19 [95% CI 1.03–1.37]). CONCLUSION: Visit-to-visit variability of triglyceride rather than their cumulative exposure is more strongly related to the incidence of MAE in diabetic patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12933-022-01681-8. BioMed Central 2022-11-15 /pmc/articles/PMC9667663/ /pubmed/36380325 http://dx.doi.org/10.1186/s12933-022-01681-8 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
Koh, Sung Min
Chung, Se Hwa
Yum, Yun Jin
Park, Se Jun
Joo, Hyung Joon
Kim, Yong-Hyun
Kim, Eung Ju
Comparison of the effects of triglyceride variability and exposure estimate on clinical prognosis in diabetic patients
title Comparison of the effects of triglyceride variability and exposure estimate on clinical prognosis in diabetic patients
title_full Comparison of the effects of triglyceride variability and exposure estimate on clinical prognosis in diabetic patients
title_fullStr Comparison of the effects of triglyceride variability and exposure estimate on clinical prognosis in diabetic patients
title_full_unstemmed Comparison of the effects of triglyceride variability and exposure estimate on clinical prognosis in diabetic patients
title_short Comparison of the effects of triglyceride variability and exposure estimate on clinical prognosis in diabetic patients
title_sort comparison of the effects of triglyceride variability and exposure estimate on clinical prognosis in diabetic patients
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9667663/
https://www.ncbi.nlm.nih.gov/pubmed/36380325
http://dx.doi.org/10.1186/s12933-022-01681-8
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