Lipids and lipoproteins as risk factors for coronary heart disease in men with abnormal glucose tolerance: the Honolulu Heart Program.
OBJECTIVE
To evaluate lipids and lipoproteins as risk factors for coronary heart disease (CHD) in older men with non-insulin-dependent diabetes (NIDDM) or abnormal glucose tolerance compared with normoglycaemic men.


METHODS
A prospective, population-based cohort study based on the lipoprotein examination (1970-72) of the Honolulu Heart Program. Follow-up was through to December 1988.


METHODS
Honolulu, Hawaii.


METHODS
Japanese-American men, ages 51-72 at baseline: 2042 with 1 h glucose < 12.5 mmol l-1 (normal group); 376 on oral hypoglycaemic agents or with 1 h glucose > or = 12.5 mmol l-1 after 50 g oral glucose challenge (abnormal glucose tolerance group). None had prevalent coronary heart disease (CHD) or stroke at baseline.


METHODS
Incident CHD: definite non-fatal myocardial infarction (MI) or fatal CHD.


RESULTS
There were 221 incident cases in the normal group, and 65 in the abnormal glucose tolerance group. Total and high-density lipoprotein (HDL) cholesterol were significant predictors of incident CHD in men with NIDDM or abnormal glucose tolerance after controlling for age, body-mass index, systolic blood pressure, pack-years of cigarettes and alcohol consumption (P < 0.05). Total, low-density lipoprotein (LDL) and very-low-density lipoprotein (VLDL) cholesterol were significant predictors in normal men, and HDL cholesterol was of borderline significance.


CONCLUSIONS
Abnormal lipids and lipoproteins are significant, independent predictors of CHD in subjects with NIDDM or abnormal glucose tolerance. Attention to lipid and lipoproteins as CHD risk factors should be part of clinical management of these patients.
Laws
A
A
Honolulu Heart Program, HI.
Marcus
E B
EB
Grove
J S
JS
Curb
J D
JD
D000368:Aged; D001213:Asian / Q000706:statistics & numerical data; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005951:Glucose Tolerance Test; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D007564:Japan / Q000208:ethnology; D008055:Lipids / Q000097:blood*; D008074:Lipoproteins / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000150:complications / Q000208:ethnology / Q000401:mortality; D011446:Prospective Studies; D012307:Risk Factors
D008055:Lipids; D008074:Lipoproteins