Joint control of inflammation, cholesterol, and lipoprotein(a) with incident cardiovascular events in people with type 2 diabetes
Year: 2026
Type: other
Abstract: OBJECTIVE | We aimed to investigate the joint associations of high-sensitivity C-reactive protein (hsCRP), low-density lipoprotein cholesterol (LDL-C), and lipoprotein(a) [Lp(a)] with cardiovascular disease (CVD) among patients with type 2 diabetes. RESEARCH DESIGN AND METHODS | This prospective cohort study identified patients with type 2 diabetes from the UK Biobank. Baseline hsCRP, LDL-C, and Lp(a) were dichotomized according to guideline-recommended target levels. Patients were followed for incident atherosclerotic cardiovascular disease (ASCVD), total CVD (ASCVD plus heart failure), death, or study end. Competing risk models adjusted for important covariates were used. RESULTS | There were 29,658 patients with type 2 diabetes who were followed for a median of 15 years. Those with all three biomarkers above target had significantly increased risks compared with those with all at target: fatal and nonfatal ASCVD (adjusted hazard ratio 1.59, 95% CI 1.24–2.03) and total CVD (adjusted hazard ratio 1.44, 95% CI 1.13–1.83). Cardiovascular risk increased progressively as fewer biomarkers achieved target levels (all Ptrend<0.001), with stronger associations in patients with shorter diabetes duration (<2 years vs ≥2 years). CONCLUSIONS | Elevated hsCRP, LDL-C, and Lp(a) showed dose-dependent associations with cardiovascular risk in patients with type 2 diabetes, supporting their control in cardiovascular risk prevention. Keywords: Cardiovascular disease, Cholesterol, Inflammation, Lipoprotein(a), Type 2 diabetes ARTICLE HIGHLIGHTS l Why did we undertake this study? Knowledge gaps exist concerning the joint associations of hsCRP, LDL-C, and Lp(a) on cardiovascular disease risk in patients with type 2 diabetes. l What is the specific questions we wanted to answer? Do hsCRP, LDL-C, and Lp(a) demonstrate joint associations with cardiovascular outcomes in patients with type 2 diabetes? l What did we find? Elevated levels of hsCRP, LDL-C, and Lp(a) above guideline-recommended targets were strongly and dose-dependently associated with increased cardiovascular risk in patients with type 2 diabetes, particularly among patients with a diabetes duration less than 2 years. l What are the implications of our findings? Healthcare providers should consider hsCRP, LDL-C, and Lp(a) together when assessing cardiovascular risk in patients with type 2 diabetes, particularly in those with early-stage disease.
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W7169578529