Impact of Severe Hypercholesterolemia on Cardiovascular Risk in Individuals With or Without Diabetes Mellitus
10.12997/jla.2022.11.3.299
- Author:
Chan Joo LEE
1
;
Sanghyun PARK
;
Kyungdo HAN
;
Sang-Hak LEE
Author Information
1. Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Publication Type:Brief Report
- From:Journal of Lipid and Atherosclerosis
2022;11(3):299-307
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objective:The aim of the current study was to investigate whether the impact of low-density lipoprotein-cholesterol (LDL-C) levels on cardiovascular risk is different between individuals with severe hypercholesterolemia and diabetes mellitus (DM) and those without DM.
Methods:This study used the database of a National Health Insurance Service cohort of Korea. Among individuals who underwent health check-up, 2,261,332 were included and categorized into 3 groups with severe hypercholesterolemia, >260, 225–259, and 190–224 mg/dL groups, and a control group (<160 mg/dL). Risks of composite events (myocardial infarction [MI], coronary revascularization, and ischemic stroke) and total mortality were analyzed, according to the presence of DM.
Results:Of the study population, 5.2% had DM. During median follow-up of 6.1 years, the rates of composite events (/1,000 person-year) in non-DM and DM subjects were up to 5.66 and 8.92, respectively. Adjusted hazard ratios (aHRs) of the composite events ranged up to 3.11 and 1.44 in non-DM and DM groups, respectively (p<0.0001 between LDL-C categories in both groups). Dependency of aHR on LDL-C levels was more prominent in the non-DM group. aHRs of MI and coronary revascularization showed similar tendency to the composite events. Although aHRs of ischemic stroke (p<0.0001) and total mortality (p=0.002) were different according to LDL-C categories in the non-DM group, these relations were not observed in DM group.
Conclusion:Although individuals with severe hypercholesterolemia had high cardiovascular risk when DM was present, the impact of LDL-C on the risk was attenuated in this population.
