Comments on Li et al. HbA1c and all-cause mortality risk among patients with type 2 diabetes. International Journal of Cardiology. 2015; 202:490–496

Abstract Background. Atherogenic dyslipidaemia has been implicated in the residual risk for cardiovascular morbidity and mortality, which remains despite attainment of LDL cholesterol goals especially in individuals with type 2 diabetes. However, its relationship with all-cause death has not been sufficiently explored. This analysis evaluated the independent association of increased triglycerides and triglyceride:HDL cholesterol ratio (TG:HDL) and decreased HDL cholesterol with total mortality and the possible modifying effect of gender in a large cohort of patients with type 2 diabetes.Methods. This observational, prospective study enrolled 15,773 patients in 19 Diabetes Clinics throughout Italy in the years 2006-2008. Triglycerides and total and HDL cholesterol were measured by colorimetric enzymatic methods. Vital status was retrieved on 31 October 2015 for 15,656 patients (99.3%). Participants were stratified by quartiles of triglycerides, HDL cholesterol, and TG:HDL.Results. There were 3,602 deaths over a follow-up 7.42±2.05 years (31.0 x 1,000 person-years). In the unadjusted analyses, the highest TG:HDL (but not triglyceride) and the lowest HDL cholesterol quartile were associated with increased death rate and mortality risk. When sequentially adjusting for confounders, including total, LDL, or non-HDL cholesterol and lipid-lowering treatment, mortality risk was significantly higher in the highest triglyceride (hazard ratio 1.167 [95% confidence interval 1.055-1.291], p=0.003) and TG:HDL (1.192 [1.082-1.314], p<0.0001) and the lowest HDL cholesterol (1.232 [1.117-1.360], p<0.0001) quartile, though the association of triglycerides and HDL cholesterol disappeared after further adjustment for each other. Interaction with gender was significant only for HDL cholesterol (p=0.0009). The relationship with death was stronger for triglycerides in males and HDL cholesterol in females, with these associations remaining significant even after adjustment for HDL cholesterol (1.161 [1.019-1.324], p=0.025, for the highest vs the lowest triglyceride quartile) and triglycerides (1.366 [1.176-1.587], p<0.0001, for the lowest vs the highest HDL cholesterol quartile).Conclusions. In patients with type 2 diabetes, higher triglycerides and TG:HDL and lower HDL cholesterol were independently associated with increased all-cause mortality, with a modifying effect of gender for triglycerides and HDL cholesterol. These data suggest that atherogenic dyslipidaemia, especially TG:HDL, may serve as predictor of all-cause death in these individuals.

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Type 2 Diabetes Genetic Predisposition, Obesity, and All-Cause Mortality Risk in the U.S.: A Multiethnic Analysis

Diabetes Care ◽

10.2337/dc15-2080 ◽

2016 ◽

Vol 39 (4) ◽

pp. 539-546 ◽

Cited By ~ 17

Author(s):

Aaron Leong ◽

Bianca Porneala ◽

Josée Dupuis ◽

Jose C. Florez ◽

James B. Meigs

Keyword(s):

Type 2 Diabetes ◽

Mortality Risk ◽

Genetic Predisposition ◽

All Cause Mortality ◽

The U.S

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Association of smoking cessation after new-onset type 2 diabetes with overall and cause-specific mortality among Korean men: a nationwide population-based cohort study

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001249 ◽

2020 ◽

Vol 8 (1) ◽

pp. e001249

Author(s):

Jae Woo Choi ◽

Euna Han ◽

Tae Hyun Kim

Keyword(s):

Type 2 Diabetes ◽

Smoking Cessation ◽

Mortality Risk ◽

Smoking Status ◽

Onset Type ◽

All Cause Mortality ◽

Never Smokers ◽

New Onset

IntroductionThis study aimed to examine the association between smoking cessation after new-onset type 2 diabetes and overall and cause-specific mortality risks among Korean men.Research design and methodsThe Korean National Health Insurance Service-National Health Screening Cohort database was searched, and 13 377 Korean men aged ≥40 years diagnosed with new-onset type 2 diabetes between 2004 and 2007 were included and followed up until 2013. We defined smoking status changes by comparing participants’ answers in the last survey before diagnosis to those in the first survey after diagnosis. We estimated the adjusted HR (AHR) and 95% CI for mortality risk using multivariable Cox proportional hazards regression models.ResultsWe identified 1014 all-cause mortality events (cancer, n=406 and cardiovascular disease (CVD), n=184) during an average follow-up duration of 7.2 years. After adjustment for all confounding factors, the reduced risk of all-cause mortality was more significant among short-term quitters (AHR 0.78; 95% CI 0.64 to 0.95), long-term quitters (AHR 0.68; 95% CI 0.54 to 0.85), and never smokers (AHR 0.66; 95% CI 0.56 to 0.78) compared with current smokers (p for trend <0.001). The lower risk of mortality from cancer was significant among the short-term quitters (AHR 0.60; 95% CI 0.44 to 0.83), long-term quitters (AHR 0.67; 95% CI 0.46 to 0.90), and never smokers (AHR 0.50; 95% CI 0.39 to 0.65) compared with current smokers (p for trend <0.001). There was no significant association between changes in smoking status and death from CVD. Smoking cessation after diagnosis in non-obese individuals (AHR 0.73; 95% CI 0.58 to 0.92) and exercisers (AHR 0.54; 95% CI 0.38 to 0.76) was significantly associated with reduced mortality risk than current smoking.ConclusionsSmoking cessation after new-onset type 2 diabetes was associated with reduced mortality risk.

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HbA1c and all-cause mortality risk among patients with type 2 diabetes

International Journal of Cardiology ◽

10.1016/j.ijcard.2015.09.070 ◽

2016 ◽

Vol 202 ◽

pp. 490-496 ◽

Cited By ~ 21

Author(s):

Weiqin Li ◽

Peter T. Katzmarzyk ◽

Ronald Horswell ◽

Yujie Wang ◽

Jolene Johnson ◽

...

Keyword(s):

Type 2 Diabetes ◽

Mortality Risk ◽

All Cause Mortality

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Cardiovascular and All-Cause Mortality Risk Associated With Urinary Excretion of 8-oxoGuo, a Biomarker for RNA Oxidation, in Patients With Type 2 Diabetes: A Prospective Cohort Study

Diabetes Care ◽

10.2337/dc17-1150 ◽

2017 ◽

Vol 40 (12) ◽

pp. 1771-1778 ◽

Cited By ~ 21

Author(s):

Laura K. Kjær ◽

Vanja Cejvanovic ◽

Trine Henriksen ◽

Kasper M. Petersen ◽

Torben Hansen ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cohort Study ◽

Urinary Excretion ◽

Prospective Cohort Study ◽

Mortality Risk ◽

Prospective Cohort ◽

Rna Oxidation ◽

All Cause Mortality

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Independent association of atherogenic dyslipidaemia with all‐cause mortality in individuals with type 2 diabetes and modifying effect of gender: a prospective cohort study

Cardiovascular Diabetology ◽

10.1186/s12933-021-01224-7 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Emanuela Orsi ◽

◽

Giuseppe Penno ◽

Anna Solini ◽

Enzo Bonora ◽

...

Keyword(s):

Type 2 Diabetes ◽

Mortality Risk ◽

Hdl Cholesterol ◽

Lipid Lowering ◽

Cardiovascular Morbidity And Mortality ◽

All Cause Mortality ◽

Atherogenic Dyslipidaemia ◽

Modifying Effect ◽

Independent Association

Abstract Background Atherogenic dyslipidaemia has been implicated in the residual risk for cardiovascular morbidity and mortality, which remains despite attainment of LDL cholesterol goals especially in individuals with type 2 diabetes. However, its relationship with all-cause death has not been sufficiently explored. This analysis evaluated the independent association of increased triglycerides and triglyceride:HDL cholesterol ratio (TG:HDL) and decreased HDL cholesterol with total mortality and the possible modifying effect of gender in a large cohort of patients with type 2 diabetes. Methods This observational, prospective study enrolled 15,773 patients in 19 Diabetes Clinics throughout Italy in the years 2006–2008. Triglycerides and total and HDL cholesterol were measured by colorimetric enzymatic methods. Vital status was retrieved on 31 October 2015 for 15,656 patients (99.3%). Participants were stratified by quartiles of triglycerides, HDL cholesterol, and TG:HDL. Results There were 3,602 deaths over a follow-up 7.42 ± 2.05 years (31.0 × 1000 person-years). In the unadjusted analyses, the highest TG:HDL (but not triglyceride) and the lowest HDL cholesterol quartile were associated with increased death rate and mortality risk. When sequentially adjusting for confounders, including total, LDL, or non-HDL cholesterol and lipid-lowering treatment, mortality risk was significantly higher in the highest triglyceride (hazard ratio 1.167 [95% confidence interval 1.055–1.291], p = 0.003) and TG:HDL (1.192 [1.082–1.314], p < 0.0001) and the lowest HDL cholesterol (1.232 [1.117–1.360], p < 0.0001) quartile, though the association of triglycerides and HDL cholesterol disappeared after further adjustment for each other. Interaction with gender was significant only for HDL cholesterol (p = 0.0009). The relationship with death was stronger for triglycerides in males and HDL cholesterol in females, with these associations remaining significant even after adjustment for HDL cholesterol (1.161 [1.019–1.324], p = 0.025, for the highest vs the lowest triglyceride quartile) and triglycerides (1.366 [1.176–1.587], p < 0.0001, for the lowest vs the highest HDL cholesterol quartile). Conclusions In patients with type 2 diabetes, higher triglycerides and TG:HDL and lower HDL cholesterol were independently associated with increased all-cause mortality, with a modifying effect of gender for triglycerides and HDL cholesterol. These data suggest that atherogenic dyslipidaemia, especially TG:HDL, may serve as predictor of all-cause death in these individuals. Trial registration ClinicalTrials.gov, NCT00715481, 15 July, 2008

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Independent association of atherogenic dyslipidaemia with all-cause mortality in individuals with type 2 diabetes and modifying effect of gender: A prospective cohort study

10.21203/rs.3.rs-123775/v1 ◽

2020 ◽

Author(s):

Emanuela Orsi ◽

Giuseppe Penno ◽

Anna Solini ◽

Enzo Bonora ◽

Cecilia Fondelli ◽

...

Keyword(s):

Type 2 Diabetes ◽

Mortality Risk ◽

Ldl Cholesterol ◽

Hdl Cholesterol ◽

All Cause Mortality ◽

Atherogenic Dyslipidaemia ◽

Modifying Effect ◽

Independent Association ◽

The Relationship

Abstract BackgroundIncreased LDL cholesterol is a major risk factor for morbidity and mortality from cardiovascular disease, though this association is attenuated by the widespread use of statins. Moreover, despite attainment of LDL cholesterol goals, a residual cardiovascular risk remains, partly attributed to atherogenic dyslipidaemia, the relationship of which with all-cause death has not been sufficiently explored. This analysis evaluated the independent association of atherogenic dyslipidaemia with total mortality in patients with type 2 diabetes from the Renal Insufficiency And Cardiovascular Events Italian Multicentre Study.MethodsThis observational, prospective study enrolled 15,773 patients in 19 Diabetes Clinics throughout Italy in the years 2006–2008. Triglycerides and total and HDL cholesterol were measured by colorimetric enzymatic methods, whereas LDL cholesterol was estimated using the Friedewald formula. Vital status was retrieved on 31 October 2015 for 15,656 patients (99.3%). Participants were stratified by quartiles of triglycerides, HDL cholesterol, and triglyceride:HDL cholesterol ratio (TG:HDL).ResultsA total of 3,602 deaths occurred over a follow-up 7.42 ± 2.05 years (31.0 × 1,000 person-years). In the unadjusted analyses, the highest TG:HDL (but not triglyceride) and the lowest HDL cholesterol quartile were associated with increased death rate and mortality risk. When sequentially adjusting for confounders, including total or LDL cholesterol and lipid-lowering treatment, mortality risk was significantly higher in the highest triglyceride (hazard ratio 1.167 [95% confidence interval 1.055–1.291], p = 0.003) and TG:HDL (1.192 [1.082–1.314], p < 0.0001) and the lowest HDL cholesterol (1.232 [1.117–1.360], p < 0.0001) quartile, though the association of triglycerides and HDL cholesterol disappeared after further adjustment for each other. Interaction with gender was significant only for HDL cholesterol (p = 0.0009). The relationship with death was stronger for triglycerides in males and HDL cholesterol in females, with the latter remaining even after adjustment for triglycerides (1.366 [1.176–1.587], p < 0.0001, for the lowest vs the highest quartile).ConclusionsIn patients with type 2 diabetes, higher triglycerides and TG:HDL and lower HDL cholesterol were independently associated with increased all-cause mortality, with a modifying effect of gender for triglycerides and HDL cholesterol. These data suggest that atherogenic dyslipidaemia, especially TG:HDL, may serve as predictor of death in these individuals.Trial registrationClinicalTrials.gov, NCT00715481, 15 July, 2008.

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