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