title: Serum level of triglycerides is a potent risk factor comparable to LDL cholesterol for coronary heart disease in Japanese patients with type 2 diabetes: subanalysis of the Japan Diabetes Complications Study (JDCS).
abstract: BACKGROUND
  Risk factors for cardiovascular complications in Japanese patients with diabetes have not been fully elucidated.
  
  
  OBJECTIVE
  Our objective was to determine incidence of and risk factors for coronary heart disease (CHD) and stroke in Japanese diabetic patients.
  
  
  METHODS
  We conducted a prospective study at 59 hospitals throughout Japan.
  
  
  METHODS
  Patients included 940 men and 831 women with type 2 diabetes (mean age, 58.2 yr) without a history of cardiovascular complications who were followed for a median of 7.86 yr.
  
  
  METHODS
  This was an observational study.
  
  
  METHODS
  Incidence of CHD and stroke was evaluated.
  
  
  RESULTS
  Incidences of CHD and stroke per 1000 person-years were 9.59 and 7.45, respectively, whereas those of myocardial and brain infarctions were 3.84 and 6.29, respectively. Multivariate Cox analysis revealed that the serum log-transformed triglyceride level was a potent and independent predictor of CHD [hazard ratio (HR) = 1.54; 95% confidence interval (CI) = 1.22-1.94 per 1 sd increase), comparable to low-density lipoprotein (LDL) cholesterol (HR = 1.49; 95% CI = 1.25-1.78 per 1 sd increase). Triglycerides and LDL cholesterol linearly and continuously increased CHD risk, and subjects in the top third for both had markedly high risks of CHD, and their effects were possibly additive. However, serum triglycerides worked independently of blood pressure levels. Systolic blood pressure was the only significant predictor for stroke except for age (HR = 1.31; 95% CI = 1.04-1.65, per 1 sd increase).
  
  
  CONCLUSIONS
  In Japanese patients with type 2 diabetes, the serum triglyceride level was a leading predictor of CHD, comparable to LDL cholesterol. Because the serum triglyceride level is not a leading predictor of CHD in diabetic subjects in Western countries, ethnic group-specific strategies for prevention of diabetic macroangiopathy may be indicated.
authors.affiliation: Department of Internal Medicine, University of Tsukuba Institute of Clinical Medicine, 3-2-7 Miyamachi, Mito, Ibaraki, Japan 310-0015. jdcstudy@md.tsukuba.ac.jp
authors.forename: Hirohito
authors.initials: H
authors.lastname: Sone
authors.forename: Sachiko
authors.initials: S
authors.lastname: Tanaka
authors.forename: Shiro
authors.initials: S
authors.lastname: Tanaka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Iimuro
authors.forename: Koji
authors.initials: K
authors.lastname: Oida
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Yamasaki
authors.forename: Shinichi
authors.initials: S
authors.lastname: Oikawa
authors.forename: Shun
authors.initials: S
authors.lastname: Ishibashi
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Katayama
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohashi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Akanuma
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Yamada
mesh_terms: D000368:Aged; D008078:Cholesterol, LDL / Q000097:blood*; D003327:Coronary Disease / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D014280:Triglycerides / Q000097:blood*
chemical_list: D008078:Cholesterol, LDL; D014280:Triglycerides