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

2021 ◽  
Author(s):  
Emanuela Orsi ◽  
Giuseppe Penno ◽  
Anna Solini ◽  
Enzo Bonora ◽  
Cecilia Fondelli ◽  
...  
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 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.

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

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

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

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.

scholarly journals Mortality risk in people with type 2 diabetes: a large prospective population-based cohort study (The Ayrshire Diabetes fOllow-up Cohort (ADOC) study)

2020 ◽  
Author(s):  
Andrew Collier ◽  
Mario Hair ◽  
Lyall Cameron ◽  
Sujoy Ghosh ◽  
James Boyle ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Mortality Risk ◽  
Smoking Status ◽  
Economic Status ◽  
Hdl Cholesterol ◽  
Population Based ◽  
Risk Difference ◽  
All Cause Mortality ◽  
Low Hdl

Abstract BackgroundThe aims of this study were to investigate the effects of age, gender, body mass index (BMI), glycaemic control, socio-economic status, dyslipidaemia, hypertension, ischaemic heart disease (IHD) and smoking status in type 2 diabetes in a population-based analysis. MethodsData were collected from 46 General Practice databases in 2009 and 2014. Cox regressions were run in the non-diabetes population plus type 2 diabetes patients. ResultsPeople with type 2 diabetes (n=16,643) had higher mortality rates than non-diabetes subjects. Ranked in order of Hazard Ratio (HR), increasing age (HR 2.31), smoking (HR 1.79), IHD (HR 1.65), deprivation (HR 1.36), hypertension (HR 1.23) and male gender (HR 1.20) all increased mortality risk (p<0.01). Statin therapy was associated with better outcome (HR 0.65, p<0.01). Abnormal lipid levels whilst not on a statin significantly increased mortality risk for raised total-cholesterol (HR 1.74) and low HDL-cholesterol (HR 1.48) but not for triglycerides (HR 0.67) (all p<0.01). ConclusionsThis large study confirmed that the all-cause mortality risk in people with type 2 diabetes remains elevated. In the study we demonstrated that a man with type 2 diabetes of 5-10 years duration who smoked, had hypertension and IHD plus lived in the most deprived area had a HR of 6.2 compared with a non-smoking, normotensive, non-diabetes subject without IHD living in the least deprived area. . Further research is required to understand the gender risk difference in all-cause mortality in type 1 compared with type 2 diabetes and why obesity plus raised triglycerides appear to be protective.

scholarly journals Response to Comment on Sharif et al. HDL Cholesterol as a Residual Risk Factor for Vascular Events and All-Cause Mortality in Patients With Type 2 Diabetes. Diabetes Care 2016;39:1424–1430

Diabetes Care ◽  
2016 ◽  
Vol 39 (10) ◽  
pp. e190-e191
Author(s):  
Shahnam Sharif ◽  
Yolanda van der Graaf ◽  
Hendrik M. Nathoe ◽  
Harold W. de Valk ◽  
Frank L.J. Visseren ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Risk Factor ◽  
Diabetes Care ◽  
Hdl Cholesterol ◽  
Residual Risk ◽  
Vascular Events ◽  
All Cause Mortality

The relationship between high levels of HDL cholesterol and mortality risk in patients with well-regulated type 2 diabetes

2018 ◽  
Vol 275 ◽  
pp. e168
Author(s):  
T. Athanasopoulou ◽  
I.L. Matsoukis ◽  
K. Kanellopoulou ◽  
A. Ganotopoulou ◽  
N. Zimpounoumi ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Mortality Risk ◽  
Hdl Cholesterol ◽  
The Relationship

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

Diabetes Care ◽  
2016 ◽  
Vol 39 (4) ◽  
pp. 539-546 ◽  
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

scholarly journals A metformin hatása a vérzsírértékekre, illetve a szív és érrendszeri kockázatra sztatinkezelésben nem részesülő 2-es típusú cukorbetegekben

2019 ◽  
Vol 160 (34) ◽  
pp. 1346-1352 ◽  
Author(s):  
Zoltán Kender ◽  
Jan Benedikt Groener ◽  
Péter Reismann ◽  
Stefan Kopf
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Risk ◽  
Hdl Cholesterol ◽  
Lipid Lowering ◽  
Cross Sectional ◽  
Metformin Therapy ◽  
Beneficial Effects ◽  
Cholesterol Levels ◽  
Lipid Parameters

Abstract: Introduction: Some meta-analyses suggested a positive effect of metformin therapy on lipid parameters, but the potential beneficial effect of metformin on cardiovascular risk in type 2 diabetes is not entirely clear. Aim: We investigated the effect of metformin therapy on lipid parameters and cardiovascular risk in patients with type 2 diabetes. Method: In a cross-sectional, monocentric study, 102 patients with type 2 diabetes without lipid-lowering medication were analysed for lipid profile and cardiovascular risk (United Kingdom Prospective Diabetes Study Risk Calculator) depending on metformin therapy. The patients were divided into two subgroups regarding with (n = 52) or without metformin therapy (n = 50). Results: Patients with metformin therapy had significantly lower total cholesterol and LDL cholesterol levels than patients without metformin (p<0.01 and p<0.05). This effect was independent from glucose control. No intrinsic effect of metformin could be found on systolic blood pressure, HDL cholesterol, triglycerides, and long-term cardiovascular risk using a multivariable risk assessment score. Conclusion: Metformin therapy has beneficial effects on cholesterol levels without improving cardiovascular risk in patients with type 2 diabetes. Orv Hetil. 2019; 160(34): 1346–1352.

scholarly journals 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

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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