Importance of lipid levels in elderly diabetic individuals: baseline characteristics and 1-year survey of cardiovascular events.
BACKGROUND
The respective incidences of ischemic heart and cerebrovascular disease (IHD, CVD) are high in diabetic individuals. Complications of dyslipidemia increase the risk, but direct evidence is limited, so a cohort prospective study (Japan-CDM) was conducted.


RESULTS
The study group comprised 4,014 subjects with type 2 diabetes (1,936 women, 2,078 men; mean age 67.4+/-9.5 years) who were divided into dyslipidemic patients (79.1%) with or without medication (medicated, 50.9%; not medicated, 28.2%) and normo-lipidemic patients (20.9%). The incidence of IHD, CVD, arteriosclerosis obliterans (ASO), congestive heart failure (CHF) and death was assessed. IHD and CVD occurred in 0.82 and 0.67%, respectively, during the first year following registration. CHF, ASO and sudden death occurred in 0.27%, 0.12% and 0.12%, respectively. There was a significant statistical difference in the relation of elevated levels of high-density lipoprotein-cholesterol to lower rates of IHD and CVD. IHD and CVD in males were dependent on the level of low-density lipoprotein-cholesterol (LDL-C): 0.45%, 1.56%, 1.78%, 1.91% and 2.34% were observed in less than 2.11, 2.11-2.62, 2.63-3.15, 3.16-3.67, and more than 3.68 mol/L of LDL-C. In the lowest LDL-C group, death other than from vascular diseases was increased. Age, sex (male) and complicated hypertension increased the risk of events. Patients who were prescribed antihyperlipidemic agents suffered less events than patients who were not being treated, which suggests direct effects of therapy.


CONCLUSIONS
Strict lipid control may be effective for reducing the incidence of vascular events in Japanese diabetic individuals.
Hayashi
Toshio
T
Department of Geriatrics, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho,Showa-ku, Nagoya 466-8550, Japan. hayashi@med.nagoya-u.ac.jp
Kawashima
Seinosuke
S
Itoh
Hideki
H
Yamada
Nobuhiro
N
Sone
Hirohito
H
Watanabe
Hiroshi
H
Hattori
Yoshiyuki
Y
Ohrui
Takashi
T
Yoshizumi
Masashi
M
Yokote
Koutaro
K
Kubota
Kiyoshi
K
Nomura
Hideki
H
Umegaki
Hiroyuki
H
Iguchi
Akihisa
A
D000367:Age Factors; D000368:Aged; D044466:Asian People; D002561:Cerebrovascular Disorders / Q000097:blood* / Q000209:etiology / Q000517:prevention & control; D008078:Cholesterol, LDL / Q000097:blood*; D003625:Data Collection; D048909:Diabetes Complications / Q000097:blood* / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan; D050356:Lipid Metabolism; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood* / Q000209:etiology / Q000517:prevention & control; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors
D008078:Cholesterol, LDL