Comparison of the effects of triglyceride variability and exposure estimate on clinical prognosis in diabetic patients
Abstract Background Hypertriglyceridemia is an important feature of dyslipidemia in type 1 and type 2 diabetic patients and associated with the development of atherosclerotic cardiovascular disease. Recently, variability of lipid profile has been suggested as a residual risk factor for cardiovascula...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12933-022-01681-8 |
| _version_ | 1811189460359970816 |
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| author | Sung Min Koh Se Hwa Chung Yun Jin Yum Se Jun Park Hyung Joon Joo Yong-Hyun Kim Eung Ju Kim |
| author_facet | Sung Min Koh Se Hwa Chung Yun Jin Yum Se Jun Park Hyung Joon Joo Yong-Hyun Kim Eung Ju Kim |
| author_sort | Sung Min Koh |
| collection | DOAJ |
| description | Abstract Background Hypertriglyceridemia is an important feature of dyslipidemia in type 1 and type 2 diabetic patients and associated with the development of atherosclerotic cardiovascular disease. Recently, variability of lipid profile has been suggested as a residual risk factor for cardiovascular disease. This study compared the clinical impact of serum triglyceride variability, and their cumulative exposure estimates on cardiovascular prognosis in diabetic patients. Methods A total of 25,933 diabetic patients who had serum triglyceride levels measured at least 3 times and did not have underlying malignancy, myocardial infarction (MI), and stroke during the initial 3 years (modeling phase) were selected from three tertiary hospitals. They were divided into a high/low group depending on their coefficient of variation (CV) and cumulative exposure estimate (CEE). Incidence of major adverse event (MAE), a composite of all-cause death, MI, and stroke during the following 5 years were compared between groups by multivariable analysis after propensity score matching. Results Although there was a slight difference, both the high CV group and the high CEE group had a higher cardiovascular risk profile including male-dominance, smoking, alcohol, dyslipidemia, and chronic kidney disease compared to the low groups. After the propensity score matching, the high CV group showed higher MAE incidence compared to the low CV group (9.1% vs 7.7%, p = 0.01). In contrast, there was no significant difference of MAE incidence between the high CEE group and the low CEE group (8.6% vs 9.1%, p = 0.44). After the multivariable analysis with further adjustment for potential residual confounding factors, the high CV was suggested as an independent risk predictor for MAE (HR 1.19 [95% CI 1.03–1.37]). Conclusion Visit-to-visit variability of triglyceride rather than their cumulative exposure is more strongly related to the incidence of MAE in diabetic patients. |
| first_indexed | 2024-04-11T14:35:10Z |
| format | Article |
| id | doaj.art-66ab2858fe2c4f72a092d8375baf24a7 |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-04-11T14:35:10Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-66ab2858fe2c4f72a092d8375baf24a72022-12-22T04:18:20ZengBMCCardiovascular Diabetology1475-28402022-11-0121111110.1186/s12933-022-01681-8Comparison of the effects of triglyceride variability and exposure estimate on clinical prognosis in diabetic patientsSung Min Koh0Se Hwa Chung1Yun Jin Yum2Se Jun Park3Hyung Joon Joo4Yong-Hyun Kim5Eung Ju Kim6Department of Internal Medicine, Korea University Anam HospitalDepartment of Biostatistics, Korea University College of MedicineDepartment of Biostatistics, Korea University College of MedicineDepartment of Internal Medicine, Korea University Anam HospitalDivision of Cardiology, Department of Internal Medicine, Korea University Anam HospitalDivision of Cardiology, Department of Internal Medicine, Korea University Ansan HospitalDivision of Cardiology, Department of Internal Medicine, Korea University Guro HospitalAbstract Background Hypertriglyceridemia is an important feature of dyslipidemia in type 1 and type 2 diabetic patients and associated with the development of atherosclerotic cardiovascular disease. Recently, variability of lipid profile has been suggested as a residual risk factor for cardiovascular disease. This study compared the clinical impact of serum triglyceride variability, and their cumulative exposure estimates on cardiovascular prognosis in diabetic patients. Methods A total of 25,933 diabetic patients who had serum triglyceride levels measured at least 3 times and did not have underlying malignancy, myocardial infarction (MI), and stroke during the initial 3 years (modeling phase) were selected from three tertiary hospitals. They were divided into a high/low group depending on their coefficient of variation (CV) and cumulative exposure estimate (CEE). Incidence of major adverse event (MAE), a composite of all-cause death, MI, and stroke during the following 5 years were compared between groups by multivariable analysis after propensity score matching. Results Although there was a slight difference, both the high CV group and the high CEE group had a higher cardiovascular risk profile including male-dominance, smoking, alcohol, dyslipidemia, and chronic kidney disease compared to the low groups. After the propensity score matching, the high CV group showed higher MAE incidence compared to the low CV group (9.1% vs 7.7%, p = 0.01). In contrast, there was no significant difference of MAE incidence between the high CEE group and the low CEE group (8.6% vs 9.1%, p = 0.44). After the multivariable analysis with further adjustment for potential residual confounding factors, the high CV was suggested as an independent risk predictor for MAE (HR 1.19 [95% CI 1.03–1.37]). Conclusion Visit-to-visit variability of triglyceride rather than their cumulative exposure is more strongly related to the incidence of MAE in diabetic patients.https://doi.org/10.1186/s12933-022-01681-8TriglycerideVariabilityCumulative exposureMajor adverse event |
| spellingShingle | Sung Min Koh Se Hwa Chung Yun Jin Yum Se Jun Park Hyung Joon Joo Yong-Hyun Kim Eung Ju Kim Comparison of the effects of triglyceride variability and exposure estimate on clinical prognosis in diabetic patients Cardiovascular Diabetology Triglyceride Variability Cumulative exposure Major adverse event |
| title | Comparison of the effects of triglyceride variability and exposure estimate on clinical prognosis in diabetic patients |
| title_full | Comparison of the effects of triglyceride variability and exposure estimate on clinical prognosis in diabetic patients |
| title_fullStr | Comparison of the effects of triglyceride variability and exposure estimate on clinical prognosis in diabetic patients |
| title_full_unstemmed | Comparison of the effects of triglyceride variability and exposure estimate on clinical prognosis in diabetic patients |
| title_short | Comparison of the effects of triglyceride variability and exposure estimate on clinical prognosis in diabetic patients |
| title_sort | comparison of the effects of triglyceride variability and exposure estimate on clinical prognosis in diabetic patients |
| topic | Triglyceride Variability Cumulative exposure Major adverse event |
| url | https://doi.org/10.1186/s12933-022-01681-8 |
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