Higher HDL Cholesterol Associated With Cardiac Risk in Type 2 Diabetes With Low LDL Cholesterol

Share this content:
Higher HDL cholesterol levels were linked to increased cardiovascular risk.
Higher HDL cholesterol levels were linked to increased cardiovascular risk.

(HealthDay News) — For patients with type 2 diabetes with LDL cholesterol levels lower than 2.0 mmol/L, higher HDL cholesterol is associated with increased risk for cardiovascular (CV) events and all-cause mortality, according to a study published in Diabetes Care.

Shahnam Sharif, MD, from the University Medical Center Utrecht in the Netherlands, and colleagues performed a prospective cohort study of 1829 patients with type 2 diabetes in the Second Manifestations of ARTerial disease (SMART) cohort. The authors examined the risk of HDL cholesterol on CV events and all-cause mortality. Analyses were performed in strata of LDL colesterol levels and lipid-lowering therapy intensity.

The researchers found that during a median follow-up of 7.0 years there were 335 new CV events and 385 deaths. 

Plasma HDL cholesterol was not related to CV events (hazard ratio [HR], 0.97; 95% CI, 0.93-1.01) or all-cause mortality (HR, 0.99; 95% CI, 0.96-1.03). The effect was modified by plasma LDL cholesterol levels: For patients with LDL cholesterol levels lower than 2.0 mmol/L, higher HDL cholesterol was associated with higher risk for all-cause mortality (HR, 1.14; 95% CI, 1.07-1.21) and higher risk for CV events (HR, 1.10; 95% CI, 1.07-1.21), compared with patients with LDL cholesterol levels between 2.0 mmol/L and 2.5 mmol/L or greater than 2.5 mmol/L.

"Future studies are needed to confirm this finding and investigate the causality," the authors wrote.

Reference

  1. Sharif S, van der Graaf Y, Nathoe HM, de Valk HW, Visseren FLJ, Westerink J; for the SMART Study Group. HDL Cholesterol as a Residual Risk Factor for Vascular Events and All-Cause Mortality in Patients With Type 2 Diabetes. Diabetes Care. 2016. doi:10.2337/dc16-0155.
You must be a registered member of Endocrinology Advisor to post a comment.

Sign Up for Free e-Newsletters

CME Focus