Document Detail


Discordance between non-HDL cholesterol and LDL cholesterol levels in patients with diabetes without previous cardiovascular events.
MedLine Citation:
PMID:  20537932     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Despite achieving desirable LDL cholesterol levels, the residual cardiovascular (CV) risk remains high among patients with diabetes. This is partly due to the increased number of atherogenic LDL particles and apoB levels, despite optimal LDL levels. As correlation studies have shown that non-HDL cholesterol is an acceptable surrogate marker for apoB, this study aimed to determine the concordance between non-HDL and LDL cholesterol in diabetic patients with different triglyceride and HbA(1c) levels and metabolic syndrome (MS) status. METHODS AND RESULTS: Data from 11,005 diabetes patients from a large UK primary-care electronic database, with no previous CV events and not taking lipid-lowering therapy, were analyzed. Of the patients with LDL cholesterol <1.8 mmol/L, only 58.6% had correspondingly low levels of non-HDL cholesterol (< 2.6 mmol/L). Concordance between very low LDL and very low non-HDL values was significantly less among patients with high triglycerides (25.5%) compared with those with low triglycerides (76.2%) (Pearson's χ(2) test=177.6; P<0.001). However, greater concordance between very low LDL and very low non-HDL cholesterol levels was seen in patients without (77.9%), compared with those with (50.3%), the MS (Pearson's χ(2) test=59.7; P<0.001). This persisted even after adjusting for hypertriglyceridaemia. Concordance was similar at different levels of glycaemia. CONCLUSION: There was a significant discordance between LDL and non-HDL cholesterol levels in diabetes patients with high triglycerides or the MS. This might explain patients' high residual CV risk despite having achieved their desirable LDL cholesterol levels. Thus, treating both non-HDL and LDL cholesterol to achieve target values should be considered to reduce residual CV risk in patients with diabetes.
Authors:
I Idris; F Al-Ubaidi
Publication Detail:
Type:  Journal Article     Date:  2010-05-27
Journal Detail:
Title:  Diabetes & metabolism     Volume:  36     ISSN:  1878-1780     ISO Abbreviation:  Diabetes Metab.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-24     Completed Date:  2010-11-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607599     Medline TA:  Diabetes Metab     Country:  France    
Other Details:
Languages:  eng     Pagination:  299-304     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Masson SAS. All rights reserved.
Affiliation:
Department of Diabetes and Endocrinology, Sherwood Forest Hospitals Foundation Trust, Nottinghamshire, UK. iidris@aol.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Biological Markers / blood
Blood Pressure
Cardiovascular Diseases / blood,  diagnosis*
Cholesterol, HDL / blood*
Cholesterol, LDL / blood*
Databases, Factual
Diabetes Mellitus / blood*
Female
Great Britain
Humans
Male
Metabolic Syndrome X / blood,  diagnosis*
Middle Aged
Primary Health Care
Risk Assessment
Risk Factors
Triglycerides / blood
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Triglycerides

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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