High-density lipoprotein subclasses and cardiovascular disease and mortality in type 2 diabetes: analysis from the Hong Kong Diabetes Biobank
Year: 2022
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: High-density lipoproteins (HDL) comprise particles of different size, density and composition and their vasoprotective functions may differ. Diabetes modifies the composition and function of HDL. We assessed associations of HDL size-based subclasses with incident cardiovascular disease (CVD) and mortality and their prognostic utility. RESEARCH DESIGN AND METHODS: HDL subclasses by nuclear magnetic resonance spectroscopy were determined in sera from 1991 fasted adults with type 2 diabetes (T2D) consecutively recruited from March 2014 to February 2015 in Hong Kong. HDL was divided into small, medium, large and very large subclasses. Associations (per SD increment) with outcomes were evaluated using multivariate Cox proportional hazards models. C-statistic, integrated discrimination index (IDI), and categorial and continuous net reclassification improvement (NRI) were used to assess predictive value. RESULTS: Over median (IQR) 5.2 (5.0-5.4) years, 125 participants developed incident CVD and 90 participants died. Small HDL particles (HDL-P) were inversely associated with incident CVD [hazard ratio (HR) 0.65 (95% CI 0.52, 0.81)] and all-cause mortality [0.47 (0.38, 0.59)] (false discovery rate < 0.05). Very large HDL-P were positively associated with all-cause mortality [1.75 (1.19, 2.58)]. Small HDL-P improved prediction of mortality [C-statistic 0.034 (0.013, 0.055), IDI 0.052 (0.014, 0.103), categorical NRI 0.156 (0.006, 0.252), and continuous NRI 0.571 (0.246, 0.851)] and CVD [IDI 0.017 (0.003, 0.038) and continuous NRI 0.282 (0.088, 0.486)] over the RECODe model. CONCLUSION: Small HDL-P were inversely associated with incident CVD and all-cause mortality and improved risk stratification for adverse outcomes in people with T2D. HDL-P may be used as markers for residual risk in people with T2D.
Source: Cardiovascular Diabetology
Authors: Qiao Jin, Eric S. H. Lau, Andrea O. Luk, Claudia H. T. Tam, Risa Ozaki, Cadmon K. P. Lim, Hongjiang Wu, Elaine Y. K. Chow, Alice P. S. Kong, Heung Man Lee, Baoqi Fan, Alex C. W. Ng, Guozhi Jiang, Ka Fai Lee, Shing Chung Siu, Grace Hui, Chiu Chi Tsang, Kam Piu Lau, Jenny Y. Leung, Man-wo Tsang, Elaine Y. N. Cheung, Grace Kam, Ip Tim Lau, June K. Li, Vincent T. Yeung, Emmy Lau, Stanley Lo, Samuel Fung, Yuk Lun Cheng, Chun Chung Chow, Weichuan Yu, Stephen K. W. Tsui, Yu Huang, Hui-yao Lan, Cheuk Chun Szeto, Wing Yee So, Alicia J. Jenkins, Juliana C. N. Chan, Ronald C. W. Ma, the Hong Kong Diabetes Biobank Study Group
Institutions: Chinese University of Hong Kong, Prince of Wales Hospital, Pamela Youde Nethersole Eastern Hospital, Sun Yat-sen University, Kwong Wah Hospital, Tung Wah Hospital, Tung Wah Eastern Hospital, Alice Ho Miu Ling Nethersole Hospital, North District Hospital, Ruttonjee Hospital, United Christian Hospital, Tseung Kwan O Hospital, Yan Chai Hospital, Our Lady of Maryknoll Hospital, Princess Margaret Hospital, Hong Kong University of Science and Technology, City University of Hong Kong, The University of Sydney
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,590
Awards: G1548419927, G1788675745, G920538808
OpenAlex ID: W4313395888