title: Importance of lipid levels in elderly diabetic individuals: baseline characteristics and 1-year survey of cardiovascular events.
abstract: 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.
authors.affiliation: Department of Geriatrics, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho,Showa-ku, Nagoya 466-8550, Japan. hayashi@med.nagoya-u.ac.jp
authors.forename: Toshio
authors.initials: T
authors.lastname: Hayashi
authors.forename: Seinosuke
authors.initials: S
authors.lastname: Kawashima
authors.forename: Hideki
authors.initials: H
authors.lastname: Itoh
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Yamada
authors.forename: Hirohito
authors.initials: H
authors.lastname: Sone
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Watanabe
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Hattori
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohrui
authors.forename: Masashi
authors.initials: M
authors.lastname: Yoshizumi
authors.forename: Koutaro
authors.initials: K
authors.lastname: Yokote
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Kubota
authors.forename: Hideki
authors.initials: H
authors.lastname: Nomura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Umegaki
authors.forename: Akihisa
authors.initials: A
authors.lastname: Iguchi
mesh_terms: 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
chemical_list: D008078:Cholesterol, LDL