CHD, Stroke Risk Markedly Increased in Diabetics With Both High TG, Low HDL-C

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Patients with diabetes and both high triglycerides and low HDL-C have increased risks of incident coronary heart disease and stroke.
Patients with diabetes and both high triglycerides and low HDL-C have increased risks of incident coronary heart disease and stroke.

HealthDay News – A high fasting triglyceride (TG) level combined with a low high-density lipoprotein cholesterol (HDL-C) level is associated with increased risks of incident coronary heart disease (CHD) and ischemic stroke, especially for patients with diabetes or a low-density lipoprotein cholesterol (LDL-C) level of ≥130 mg/dL, independent of other atherosclerotic cardiovascular disease risk factors, according to a study published online in Diabetes Care.

Jennifer S. Lee, MD, from the Stanford University Medical Center in California, and colleagues studied 3216 American Indians (41% with diabetes) who were free from cardiovascular disease at baseline in a prospective cohort (median follow-up, 17.7 years). 

The authors estimated hazard ratios (HRs) for incident ischemic stroke and CHD in relation to combined TG and HDL-C status (fasting TG level ≥150 mg/dL was high; fasting HDL-C level <40 mg/dL [for men] was low).

The researchers found that, compared with those with normal TG and HDL levels, participants with high TG and low HDL levels had a 1.32-fold elevated HR for CHD. In participants with, but not those without, diabetes, high TG plus low HDL levels correlated with a 1.54- and 2.13-fold increased HR for CHD and stroke, respectively (P for interaction =.003 and .060, respectively). 

In participants with LDL-C levels of ≥130 mg/dL, high TG and low HDL correlated with CHD risk; this was not seen in participants with lower LDL-C levels. The correlations were not modified by sex.

"Adults with both high TG and low HDL-C, particularly those with diabetes, have increased risks of incident CHD and stroke," the authors wrote. "Recognition of these patterns may help to enhance lipid-targeted strategies to prevent CHD and ischemic stroke."

Reference

Lee JS, Chang P-Y, Zhang Y, Kizer JR, Best LG, Howard BV. Triglyceride and HDL-C dyslipidemia and risks of coronary heart disease and ischemic stroke by glycemic dysregulation status: the Strong Heart Study [published online January 24, 2017]. Diabetes Care. doi:10.2337/dc16-1958


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