Remnant cholesterol tied to CVD death in patients with T2D, CKD, diabetic nephropathy

29 Nov 2021
Remnant cholesterol tied to CVD death in patients with T2D, CKD, diabetic nephropathy

Remnant cholesterol (C) appears predictive of mortality due to cardiovascular disease (CVD) among patients with type 2 diabetes (T2D), chronic kidney disease (CKD) stage 3 to 5, and incident diabetic nephropathy (DN), suggests a study.

In addition, the interaction of remnant-C and low-density lipoprotein (LDL)-C correlates with the highest risk of CVD mortality.

In the study, the authors determine the baseline lipid profile and searched for deaths with CVD within 2 years of baseline among 2,282 adults enrolled between 1 January 2015 and 31 December 2016, who had T2D, CKD stage 3 to 5, and newly diagnosed DN.

The associations between lipids, particularly remnant-C concentration (either as continuous or categorical variables), and CVD mortality risk were analysed using adjusted logistic regression models.

Multivariable-adjusted analyses revealed the association of LDL-C (odds ratio [OR] per 10 mg/dL, 1.022, 95 percent confidence interval [CI], 1.017–1.026), high-density lipoprotein (HDL)-C (OR, 0.929 per 5 mg/dL, 95 percent CI, 0.922–0.936), non–HDL-C (OR, 1.024 per 10 mg/dL, 95 percent CI, 1.021–1.028), and remnant-C (OR, 1.115 per 10 mg/dL, 95 percent CI, 1.103–1.127), but not triglycerides, with CVD mortality.

Atherogenic dyslipidaemia (triglycerides >150 mg/dL [1.69 mmol/L] and HDL-C <40 mg/dL in men or <50 mg/dL in women) also correlated with CVD mortality (OR, 1.073, 95 percent CI, 1.031–1.116).

Notably, remnant-C 30 mg/dL differentiated patients at greater risk of CVD mortality from those with lower concentrations, particularly for interaction with LDL-C level >100 mg/dL. Patients with higher levels of both remnant-C and LDL-C (OR, 1.696, 95 percent CI, 1.613–1.783) were at greatest risk of death with CVD.

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