Total/high density lipoprotein cholesterol and cardiovascular disease (re)hospitalization nadir in type 2 diabetes
Total cholesterol to HDL cholesterol ratio (TC/HDL) is an important prognostic factor for CVD. This study used restricted cubic spline modeling to investigate the dose-response associations between TC/HDL and both CVD hospitalization and CVD rehospitalization in two independent prospective cohorts....
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2018-09-01
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| Series: | Journal of Lipid Research |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0022227520335434 |
| _version_ | 1819097190446923776 |
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| author | Dahai Yu Yamei Cai Rui Qin Jonathan Graffy Daniel Holman Zhanzheng Zhao David Simmons |
| author_facet | Dahai Yu Yamei Cai Rui Qin Jonathan Graffy Daniel Holman Zhanzheng Zhao David Simmons |
| author_sort | Dahai Yu |
| collection | DOAJ |
| description | Total cholesterol to HDL cholesterol ratio (TC/HDL) is an important prognostic factor for CVD. This study used restricted cubic spline modeling to investigate the dose-response associations between TC/HDL and both CVD hospitalization and CVD rehospitalization in two independent prospective cohorts. The East Cambridgeshire and Fenland cohort includes 4,704 patients with T2D from 18 general practices in Cambridgeshire. The Randomized controlled trial of Peer Support In type 2 Diabetes cohort comprises 1,121 patients with T2D with posttrial follow-up data. TC/HDL and other demographic and clinical measurements were measured at baseline. Outcomes were CVD hospitalization over 2 years and CVD rehospitalization after 90 days of the prior CVD hospitalization. Modeling showed nonlinear relationships between TC/HDL and risks of CVD hospitalization and rehospitalization consistently in both cohorts (all P < 0.001 for linear tests). The lowest risks of CVD hospitalization and rehospitalization were consistently found for TC/HDL at 2.8 (95% CI: 2.6–3.0) in both cohorts and both overall and by gender. This is lower than the current lipid control target, 4.0 of TC/HDL. Reducing the TC/HDL target to 2.8 would include a further 33–44% patients with TC/HDL in the 2.8–4.0 range. Studies are required to assess the effectiveness and cost-effectiveness of the earlier introduction of, and more intensive, lipid-lowering treatment needed to achieve this new lower TC/HDL target. |
| first_indexed | 2024-12-22T00:11:09Z |
| format | Article |
| id | doaj.art-5ea83ab8a6ef408aa250584002a4a0f1 |
| institution | Directory Open Access Journal |
| issn | 0022-2275 |
| language | English |
| last_indexed | 2024-12-22T00:11:09Z |
| publishDate | 2018-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Lipid Research |
| spelling | doaj.art-5ea83ab8a6ef408aa250584002a4a0f12022-12-21T18:45:27ZengElsevierJournal of Lipid Research0022-22752018-09-0159917451750Total/high density lipoprotein cholesterol and cardiovascular disease (re)hospitalization nadir in type 2 diabetesDahai Yu0Yamei Cai1Rui Qin2Jonathan Graffy3Daniel Holman4Zhanzheng Zhao5David Simmons6Department of Nephrology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China; Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele ST5 5BG, United KingdomDepartment of Nephrology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, ChinaDepartment of Nephrology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, ChinaPrimary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, Cambridgeshire CB2 0SR, United KingdomDepartment of Sociological Studies, University of Sheffield, Sheffield S10 2TU, United KingdomTo whom correspondence should be addressed.; Department of Nephrology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, ChinaTo whom correspondence should be addressed.; Western Sydney University, Campbelltown, Sydney NSW 2751, AustraliaTotal cholesterol to HDL cholesterol ratio (TC/HDL) is an important prognostic factor for CVD. This study used restricted cubic spline modeling to investigate the dose-response associations between TC/HDL and both CVD hospitalization and CVD rehospitalization in two independent prospective cohorts. The East Cambridgeshire and Fenland cohort includes 4,704 patients with T2D from 18 general practices in Cambridgeshire. The Randomized controlled trial of Peer Support In type 2 Diabetes cohort comprises 1,121 patients with T2D with posttrial follow-up data. TC/HDL and other demographic and clinical measurements were measured at baseline. Outcomes were CVD hospitalization over 2 years and CVD rehospitalization after 90 days of the prior CVD hospitalization. Modeling showed nonlinear relationships between TC/HDL and risks of CVD hospitalization and rehospitalization consistently in both cohorts (all P < 0.001 for linear tests). The lowest risks of CVD hospitalization and rehospitalization were consistently found for TC/HDL at 2.8 (95% CI: 2.6–3.0) in both cohorts and both overall and by gender. This is lower than the current lipid control target, 4.0 of TC/HDL. Reducing the TC/HDL target to 2.8 would include a further 33–44% patients with TC/HDL in the 2.8–4.0 range. Studies are required to assess the effectiveness and cost-effectiveness of the earlier introduction of, and more intensive, lipid-lowering treatment needed to achieve this new lower TC/HDL target.http://www.sciencedirect.com/science/article/pii/S0022227520335434diabetes populationrehospitalizationlipid |
| spellingShingle | Dahai Yu Yamei Cai Rui Qin Jonathan Graffy Daniel Holman Zhanzheng Zhao David Simmons Total/high density lipoprotein cholesterol and cardiovascular disease (re)hospitalization nadir in type 2 diabetes Journal of Lipid Research diabetes population rehospitalization lipid |
| title | Total/high density lipoprotein cholesterol and cardiovascular disease (re)hospitalization nadir in type 2 diabetes |
| title_full | Total/high density lipoprotein cholesterol and cardiovascular disease (re)hospitalization nadir in type 2 diabetes |
| title_fullStr | Total/high density lipoprotein cholesterol and cardiovascular disease (re)hospitalization nadir in type 2 diabetes |
| title_full_unstemmed | Total/high density lipoprotein cholesterol and cardiovascular disease (re)hospitalization nadir in type 2 diabetes |
| title_short | Total/high density lipoprotein cholesterol and cardiovascular disease (re)hospitalization nadir in type 2 diabetes |
| title_sort | total high density lipoprotein cholesterol and cardiovascular disease re hospitalization nadir in type 2 diabetes |
| topic | diabetes population rehospitalization lipid |
| url | http://www.sciencedirect.com/science/article/pii/S0022227520335434 |
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