Year: 2025
Type: article
Study design: Observational Study
Abstract: Objective: The association of lipid parameters with cardiovascular disease (CVD) and the impact of kidney function on this association have not been thoroughly evaluated in patients with type 2 diabetes mellitus (T2DM).Methods: Using the Korean National Health Insurance Service Cohort database, we identified 2,343,882 subjects with T2DM in 2015-2016.Baseline lipid levels and kidney function were evaluated and followed up until December 2020.Subjects were classified into three groups according to their estimated glomerular filtration rate (eGFR): ≥60, 30-59, or <30 mL/min/ 1.73 m 2 .We analyzed the diabetes group with eGFR ≥60 and low-density lipoprotein cholesterol (LDL-C) <70 mg/dL as a reference group.Results: The risk of CVD began to increase at LDL-C ≥100 mg/dL in the eGFR ≥60 mL/min/m 2 group.The risk of CVD in the eGFR 30-59 mL/min/m 2 group was increased by 43%, even in the LDL-C <70 mg/dL, and the risk increased progressively with LDL-C category.Among subjects with eGFR 30-59 mL/min/m 2 , LDL-C 70-99, 100-129, 130-159, and ≥160 mg/ dL were significantly associated with the risk of CVD, with hazard ratio (95% confidence interval) of 1.48 (1.43-1.53),1.54 (1.49-1.60),1.55 (1.48-1.63),and 1.88 (1.77-2.00),respectively.In the eGFR <30 mL/min/m 2 group, a 3.3-fold increased risk of CVD was seen, even at LDL-C <70 mg/dL.Conclusion: The cutoff levels of LDL-C that increase CVD risk in patients with T2DM depend on kidney function, which influences the relationship between LDL-C and CVD risk in patients with T2DM.
Authors: Ji-Hyun Kim, Seung-Hwan Lee, Kyu Na Lee, Kyungdo Han, Mee Kyoung Kim
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
Award: G6502490659
OpenAlex ID: W4410700273