Lipid control and use of lipid-regulating drugs for prevention of cardiovascular events in Chinese type 2 diabetic patients: a prospective cohort study

Autor: Andrea O.Y. Luk, Peter C.Y. Tong, Juliana C.N. Chan, Xilin Yang, Alice P.S. Kong, Linda W.L. Yu, Wing-Yee So, Rose Z.W. Ting, Ronald C.W. Ma
Rok vydání: 2010
Předmět:
Adult
Male
China
lcsh:Diseases of the circulatory (Cardiovascular) system
medicine.medical_specialty
Time Factors
medicine.drug_class
Endocrinology
Diabetes and Metabolism
Type 2 diabetes
Fibrate
Risk Assessment
Asian People
Risk Factors
Internal medicine
Diabetes mellitus
medicine
Humans
Prospective Studies
Registries
cardiovascular diseases
Risk factor
Prospective cohort study
Triglycerides
Original Investigation
Aged
Dyslipidemias
Proportional Hazards Models
Aged
80 and over
Fenofibrate
business.industry
Cholesterol
HDL
Hazard ratio
Cholesterol
LDL
Middle Aged
medicine.disease
Lipids
Treatment Outcome
Diabetes Mellitus
Type 2
Cardiovascular Diseases
lcsh:RC666-701
Female
lipids (amino acids
peptides
and proteins)
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Metabolic syndrome
Cardiology and Cardiovascular Medicine
business
Biomarkers
medicine.drug
Zdroj: Cardiovascular Diabetology, Vol 9, Iss 1, p 77 (2010)
Cardiovascular Diabetology
ISSN: 1475-2840
Popis: Background Dyslipidaemia is an important but modifiable risk factor of cardiovascular disease (CVD) in type 2 diabetes. Yet, the effectiveness of lipid regulating drugs in Asians is lacking. We examined the effects of lipid control and treatment with lipid regulating drugs on new onset of CVD in Chinese type 2 diabetic patients. Methods In this prospective cohort consisting of 4521 type 2 diabetic patients without history of CVD and naïve for lipid regulating treatment recruited consecutively from 1996 to 2005, 371 developed CVD after a median follow-up of 4.9 years. We used Cox proportional hazard regression to obtain the hazard ratios (HR) of lipids and use of lipid regulating drugs for risk of CVD. Results The multivariate-adjusted HR (95% confidence interval) of CVD in patients with high LDL-cholesterol (≥ 3.0 mmol/L) was 1.36 (1.08 - 1.71), compared with lower values. Using the whole range value of HDL-cholesterol, the risk of CVD was reduced by 41% with every 1 mmol/L increase in HDL-cholesterol. Plasma triglyceride did not predict CVD. Statins use was associated with lower CVD risk [HR = 0.66 (0.50 - 0.88)]. In sub-cohort analysis, statins use was associated with a HR of 0.60 (0.44 - 0.82) in patients with high LDL-cholesterol (≥ 3.0 mmol/L) and 0.49 (0.28 - 0.88) in patients with low HDL-cholesterol. In patients with LDL-cholesterol < 3.0 mmol/L, use of fibrate was associated with HR of 0.34 (0.12 - 1.00). Only statins were effective in reducing incident CVD in patients with metabolic syndrome [(HR = 0.58(0.42--0.80)]. Conclusions In Chinese type 2 diabetic patients, high LDL-cholesterol and low HDL-cholesterol predicted incident CVD. Overall, patients treated with statins had 40-50% risk reduction in CVD compared to non-users.
Databáze: OpenAIRE
Externí odkaz: