Low HDL Cholesterol and the Risk of Diabetic Nephropathy and Retinopathy Results of the ADVANCE study

Jamie Morton; Sophia Zoungas; Qiang Li; Anushka A. Patel; John Chalmers; Mark Woodward; David S. Celermajer; Joline W. J. Beulens; Ronald P. Stolk; Paul Glasziou; Martin K. C. Ng; ADVANCE Collaborative Grp

doi:10.2337/dc12-0306

Low HDL Cholesterol and the Risk of Diabetic Nephropathy and Retinopathy Results of the ADVANCE study

Jamie Morton, Sophia Zoungas^*, Qiang Li, Anushka A. Patel, John Chalmers, Mark Woodward, David S. Celermajer, Joline W. J. Beulens, Ronald P. Stolk, Paul Glasziou, Martin K. C. Ng, ADVANCE Collaborative Grp

^*Corresponding author for this work

Life Course Epidemiology (LCE)

Research output: Contribution to journal › Article › Academic › peer-review

93 Citations (Scopus)

27 Downloads (Pure)

Abstract

OBJECTIVE-Although low HDL cholesterol (HDL-C) is an established risk factor for atherosclerosis, data on HDL-C and the risk of microvascular disease are limited. We tested the association between HDL-C and microvascular disease in a cohort of patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS-A total of 11,140 patients with type 2 diabetes and at least one additional vascular risk factor were followed a median of 5 years. Cox proportional hazards models were used to assess the association between baseline HDL-C and the development of new or worsening microvascular disease, defined prospectively as a composite of renal and retinal events.

RESULTS-The mean baseline HDL-C level was 1.3 mmol/L (SD 0.45mmol/L [range 0.1-4.0]). During follow-up, 32% of patients developed new or worsening microvascular disease, with 28% experiencing a renal event and 6% a retinal event. Compared with patients in the highest third, those in the lowest third had a 17% higher risk of microvascular disease (adjusted hazard ratio 1.17 [95% CI 1.06-1.28], P = 0.001) after adjustment for potential confounders and regression dilution. This was driven by a 19% higher risk of renal events (1.19 [1.08-1.32], P = 0.0005). There was no association between thirds of HDL-C and retinal events (1.01 [0.82-1.25], P = 0.9).

CONCLUSIONS-In patients with type 2 diabetes, HDL-C level is an independent risk factor for the development of microvascular disease affecting the kidney but not the retina. Diabetes Care 35: 2201-2206, 2012

Original language	English
Pages (from-to)	2201-2206
Number of pages	6
Journal	Diabetes Care
Volume	35
Issue number	11
DOIs	https://doi.org/10.2337/dc12-0306
Publication status	Published - Nov-2012

Keywords

RANDOMIZED CONTROLLED-TRIAL
ATHEROSCLEROSIS RISK
BLOOD-PRESSURE
RENAL DYSFUNCTION
PLASMA-LIPIDS
MELLITUS
PROGRESSION
DISEASE
COMMUNITIES
MICROALBUMINURIA

Access to Document

10.2337/dc12-0306

Handle.net

Persistent link

Embargoed Document

Morton_2012_Diab_Care.pdf
Final publisher's version, 125 KB

Cite this

@article{93049092cd404691964d1dea646655d9,

title = "Low HDL Cholesterol and the Risk of Diabetic Nephropathy and Retinopathy Results of the ADVANCE study",

abstract = "OBJECTIVE-Although low HDL cholesterol (HDL-C) is an established risk factor for atherosclerosis, data on HDL-C and the risk of microvascular disease are limited. We tested the association between HDL-C and microvascular disease in a cohort of patients with type 2 diabetes.RESEARCH DESIGN AND METHODS-A total of 11,140 patients with type 2 diabetes and at least one additional vascular risk factor were followed a median of 5 years. Cox proportional hazards models were used to assess the association between baseline HDL-C and the development of new or worsening microvascular disease, defined prospectively as a composite of renal and retinal events.RESULTS-The mean baseline HDL-C level was 1.3 mmol/L (SD 0.45mmol/L [range 0.1-4.0]). During follow-up, 32% of patients developed new or worsening microvascular disease, with 28% experiencing a renal event and 6% a retinal event. Compared with patients in the highest third, those in the lowest third had a 17% higher risk of microvascular disease (adjusted hazard ratio 1.17 [95% CI 1.06-1.28], P = 0.001) after adjustment for potential confounders and regression dilution. This was driven by a 19% higher risk of renal events (1.19 [1.08-1.32], P = 0.0005). There was no association between thirds of HDL-C and retinal events (1.01 [0.82-1.25], P = 0.9).CONCLUSIONS-In patients with type 2 diabetes, HDL-C level is an independent risk factor for the development of microvascular disease affecting the kidney but not the retina. Diabetes Care 35: 2201-2206, 2012",

keywords = "RANDOMIZED CONTROLLED-TRIAL, ATHEROSCLEROSIS RISK, BLOOD-PRESSURE, RENAL DYSFUNCTION, PLASMA-LIPIDS, MELLITUS, PROGRESSION, DISEASE, COMMUNITIES, MICROALBUMINURIA",

author = "Jamie Morton and Sophia Zoungas and Qiang Li and Patel, {Anushka A.} and John Chalmers and Mark Woodward and Celermajer, {David S.} and Beulens, {Joline W. J.} and Stolk, {Ronald P.} and Paul Glasziou and Ng, {Martin K. C.} and {ADVANCE Collaborative Grp}",

year = "2012",

month = nov,

doi = "10.2337/dc12-0306",

language = "English",

volume = "35",

pages = "2201--2206",

journal = "Diabetes Care",

issn = "0149-5992",

publisher = "AMER DIABETES ASSOC",

number = "11",

}

TY - JOUR

T1 - Low HDL Cholesterol and the Risk of Diabetic Nephropathy and Retinopathy Results of the ADVANCE study

AU - Morton, Jamie

AU - Zoungas, Sophia

AU - Li, Qiang

AU - Patel, Anushka A.

AU - Chalmers, John

AU - Woodward, Mark

AU - Celermajer, David S.

AU - Beulens, Joline W. J.

AU - Stolk, Ronald P.

AU - Glasziou, Paul

AU - Ng, Martin K. C.

AU - ADVANCE Collaborative Grp

PY - 2012/11

Y1 - 2012/11

N2 - OBJECTIVE-Although low HDL cholesterol (HDL-C) is an established risk factor for atherosclerosis, data on HDL-C and the risk of microvascular disease are limited. We tested the association between HDL-C and microvascular disease in a cohort of patients with type 2 diabetes.RESEARCH DESIGN AND METHODS-A total of 11,140 patients with type 2 diabetes and at least one additional vascular risk factor were followed a median of 5 years. Cox proportional hazards models were used to assess the association between baseline HDL-C and the development of new or worsening microvascular disease, defined prospectively as a composite of renal and retinal events.RESULTS-The mean baseline HDL-C level was 1.3 mmol/L (SD 0.45mmol/L [range 0.1-4.0]). During follow-up, 32% of patients developed new or worsening microvascular disease, with 28% experiencing a renal event and 6% a retinal event. Compared with patients in the highest third, those in the lowest third had a 17% higher risk of microvascular disease (adjusted hazard ratio 1.17 [95% CI 1.06-1.28], P = 0.001) after adjustment for potential confounders and regression dilution. This was driven by a 19% higher risk of renal events (1.19 [1.08-1.32], P = 0.0005). There was no association between thirds of HDL-C and retinal events (1.01 [0.82-1.25], P = 0.9).CONCLUSIONS-In patients with type 2 diabetes, HDL-C level is an independent risk factor for the development of microvascular disease affecting the kidney but not the retina. Diabetes Care 35: 2201-2206, 2012

AB - OBJECTIVE-Although low HDL cholesterol (HDL-C) is an established risk factor for atherosclerosis, data on HDL-C and the risk of microvascular disease are limited. We tested the association between HDL-C and microvascular disease in a cohort of patients with type 2 diabetes.RESEARCH DESIGN AND METHODS-A total of 11,140 patients with type 2 diabetes and at least one additional vascular risk factor were followed a median of 5 years. Cox proportional hazards models were used to assess the association between baseline HDL-C and the development of new or worsening microvascular disease, defined prospectively as a composite of renal and retinal events.RESULTS-The mean baseline HDL-C level was 1.3 mmol/L (SD 0.45mmol/L [range 0.1-4.0]). During follow-up, 32% of patients developed new or worsening microvascular disease, with 28% experiencing a renal event and 6% a retinal event. Compared with patients in the highest third, those in the lowest third had a 17% higher risk of microvascular disease (adjusted hazard ratio 1.17 [95% CI 1.06-1.28], P = 0.001) after adjustment for potential confounders and regression dilution. This was driven by a 19% higher risk of renal events (1.19 [1.08-1.32], P = 0.0005). There was no association between thirds of HDL-C and retinal events (1.01 [0.82-1.25], P = 0.9).CONCLUSIONS-In patients with type 2 diabetes, HDL-C level is an independent risk factor for the development of microvascular disease affecting the kidney but not the retina. Diabetes Care 35: 2201-2206, 2012

KW - RANDOMIZED CONTROLLED-TRIAL

KW - ATHEROSCLEROSIS RISK

KW - BLOOD-PRESSURE

KW - RENAL DYSFUNCTION

KW - PLASMA-LIPIDS

KW - MELLITUS

KW - PROGRESSION

KW - DISEASE

KW - COMMUNITIES

KW - MICROALBUMINURIA

U2 - 10.2337/dc12-0306

DO - 10.2337/dc12-0306

M3 - Article

SN - 0149-5992

VL - 35

SP - 2201

EP - 2206

JO - Diabetes Care

JF - Diabetes Care

IS - 11

ER -

Low HDL Cholesterol and the Risk of Diabetic Nephropathy and Retinopathy Results of the ADVANCE study

Abstract

Keywords

Access to Document

Handle.net

Embargoed Document

Fingerprint

Cite this