Lipid variability and risk of microvascular complications in Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial: A post hoc analysis

Hukportie，Daniel Nyarko1; Li，Fu Rong1,2; Zhou，Rui1; Zheng，Jia Zhen1; Wu，Xiao Xiang3; Zou，Meng Chen4; Wu，Xian Bo1

2022

10.1111/1753-0407.13273

Journal of Diabetes   影响因子和分区

1753-0393

1753-0407

Background: Greater lipid variability may cause adverse health events among diabetic patients. We aimed to examine the effect of lipid variability on the risk of diabetic microvascular outcomes among type 2 diabetes mellitus patients. Methods: We assessed the association between visit-to-visit variability (measured by variability independent of mean) in high-density lipoprotein (HDL) cholesterol, low-density lipoprotein-cholesterol (LDL), triglyceride, and remnant cholesterol (RC) measurements among participants involved in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study and the risk of incident microvascular outcomes, including nephropathy, neuropathy, and retinopathy. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs), adjusted for potential confounders. Results: There were 2400, 2470, and 2468 cases of nephropathy, neuropathy, and retinopathy during a follow-up period of 22 600, 21 542, and 26 701 person-years, respectively. Higher levels of HDL, triglyceride, and RC variability were associated with an increased risk of incident nephropathy and neuropathy. Compared with the lowest quartile, the fully adjusted HRs (95% CI) for the highest quartile of HDL, triglyceride, and RC variability for nephropathy risk were 1.57 (1.22, 2.01), 1.50 (1.18, 1.92), and 1.40 (1.09, 1.80), respectively; and for neuropathy, the corresponding risks were 1.36 (1.05, 1.75), 1.47 (1.14, 1.91), and 1.35 (1.04, 1.74), respectively. Null association was observed between LDL variability and all microvascular complications. Additionally, all associations of variability in the other lipids with retinopathy risk were null. Conclusion: Among individuals with type 2 diabetes mellitus, HDL, triglyceride, and RC variability were associated with increased risks of nephropathy and neuropathy but not retinopathy. Trial registration: ClinicalTrials.gov., no. NCT00000620.

high-density lipoprotein low-density lipoprotein microvascular complications remnant cholesterol triglyceride

SCI

英语

其他

WOS:000806589600001

2-s2.0-85131332633

Scopus

1.Department of Epidemiology,School of Public Health,Southern Medical University,Guangzhou,China
2.School of Public Health and Emergency Management,Southern University of Science and Technology,Shenzhen,China
3.Department of General Surgery,157th Hospital,General Hospital of Guangzhou Military Command,Guangzhou,China
4.Department of Endocrinology and Metabolism,Nanfang Hospital,Southern Medical University,Guangzhou,China

Hukportie，Daniel Nyarko,Li，Fu Rong,Zhou，Rui,et al. Lipid variability and risk of microvascular complications in Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial: A post hoc analysis[J]. Journal of Diabetes,2022.

Hukportie，Daniel Nyarko.,Li，Fu Rong.,Zhou，Rui.,Zheng，Jia Zhen.,Wu，Xiao Xiang.,...&Wu，Xian Bo.(2022).Lipid variability and risk of microvascular complications in Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial: A post hoc analysis.Journal of Diabetes.

Hukportie，Daniel Nyarko,et al."Lipid variability and risk of microvascular complications in Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial: A post hoc analysis".Journal of Diabetes (2022).