Abstract
OBJECTIVE To evaluate whether low HDL cholesterol (HDL-c) levels are a risk factor for cardiovascular disease and mortality in patients with type 2 diabetes and whether it remains a residual risk factor when attaining low LDL cholesterol (LDL-c) treatment goals or when LDL-c is treated with intensive lipid-lowering therapy.
RESEARCH DESIGN AND METHODS We performed a prospective cohort study of 1,829 patients with type 2 diabetes included in the Second Manifestations of ARTerial disease (SMART) cohort. Cox proportional hazard models were used to evaluate the risk of HDL-c on cardiovascular events and all-cause mortality. Analyses were performed in strata of LDL-c levels (<2.0, 2.0–2.5, and >2.5 mmol/L) and lipid-lowering therapy intensity and were adjusted for age, sex, BMI, smoking, alcohol, LDL-c, triglycerides, systolic blood pressure, estimated glomerular filtration rate, glucose, and HbA1c.
RESULTS A total of 335 new cardiovascular events and 385 deaths occurred during a median follow-up of 7.0 years (interquartile range 3.9–10.4). No relation was found between plasma HDL-c and cardiovascular 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). Subgroup analysis supported effect modification by plasma LDL-c levels. In patients with LDL-c levels <2.0 mmol/L, higher HDL-c was related to higher risk for all-cause mortality (HR 1.14, 95% CI 1.07–1.21). Higher HDL-c was also related to higher risk for cardiovascular events in patients with LDL-c levels <2.0 mmol/L (HR 1.10, 95% CI 1.07–1.21) in contrast to patients with LDL-c levels between 2.0 and 2.5 mmol/L (HR 0.85, 95% CI 0.75–0.95) and >2.5 mmol/L (HR 0.96, 95% CI 0.91–1.00).
CONCLUSIONS In high-risk patients with type 2 diabetes with LDL-c levels <2.0 mmol/L, higher HDL-c at baseline is unexpectedly related to a higher risk for cardiovascular events and all-cause mortality in contrast to high-risk patients with type 2 diabetes with LDL-c levels between 2.0 and 2.5 mmol/L.
http://care.diabetesjournals.org/
No matter how good your lipid profile is as diabetics the guidelines state LDL <2.0 mmol/L, so to attain that level statins are touted, as my HDL is always high thanks to LC according to his study following the prescribed cholesterol guidelines would put me and many others at a higher risk of CV
Graham
Please check out our website www.lowcarbdiabetic.co.uk We created and maintain this site without any help from anyone else. In doing so, we do not receive direct or indirect funding from anyone. We do not accept money or favours to manipulate the evidence in any way. Please visit our Low Carb food and recipe blog www.lowcarbdietsandrecipes.blogspot.com
Very informative thanks
ReplyDeleteUm artigo muito interessante.
ReplyDeleteContinuação de uma boa semana.
Hello Missy, many thanks for your comment.
ReplyDeleteGlad you found this article was informative.
All the best Jan
Translation for Francisco's comment
ReplyDeleteUm artigo muito interessante. A very interesting article
Continuação de uma boa semana. Continuation of a good week
Hello Francisco, many thanks for your comment.
Olá Francisco, muito obrigado pelo seu comentário
All the best Jan
Cheese rolling, only at Gloucester.
ReplyDeleteEveryone who low carbs knows cholesterol is meaningless :)
ReplyDeleteHello Bob Bushell
ReplyDeleteIt's always lovely to receive a comment from you thank you.
It refers to this post here
http://thelowcarbdiabetic.blogspot.co.uk/2016/06/cheese-rolling-fun-and-more.html
Hope your week is going well
All the best Jan
Hello Bob
ReplyDeleteMany will agree with your comment here
"Everyone who low carbs knows cholesterol is meaningless :)"
All the best Jan
Bob said...
ReplyDeleteEveryone who low carbs knows cholesterol is meaningless :)
Agreed Bob but as an aside given the dire warnings of the effects of saturated fats on LDL after eight years I'm still waiting for this to materialise mine is lower now than when I naively followed the low fat diet when first diagnosed
Go figure !!!!
Cheers
Graham
Hello Graham! Can I just clarify that in LCHF cholesterol levels are not important? In your research and reading is there any acceptable/desired levels to aim for with LDL and HDL? Am new to LCHF and am confused.com!
ReplyDelete