Impact of low-density lipoprotein cholesterol on cardiovascular outcomes in people with type 2 diabetes: a meta-analysis of prospective cohort studies.
OBJECTIVE
To estimate the prospective association of low-density lipoprotein (LDL) cholesterol on cardiovascular disease (CVD) risk among people with type 2 diabetes.


METHODS
We used extensive literature searching strategies to locate prospective cohort studies that reported LDL cholesterol levels as a risk factor for cardiovascular events. We conducted meta-analytic procedures for two outcomes: incident CVD and CVD mortality.


RESULTS
A total of 16 studies were included in this analysis with a mean follow-up range of 4.8-11 years. The pooled relative risk associated with a 1mmol/L increase in LDL cholesterol in people with type 2 diabetes was 1.30 (95% confidence interval [CI], 1.19-1.43) for incident CVD, and 1.50 (95% CI, 1.25-1.80) for CVD mortality, respectively. Subgroup analyses showed that for incident CVD, the pooled relative risk was 1.28 (95% CI, 1.17-1.41) for 7 studies adjusted for blood pressure and/or glucose concentration (or insulin concentration, glycated hemoglobin) and 1.40 (95% CI, 1.05-1.86) for 3 studies that did not adjust for these variables.


CONCLUSIONS
Our study demonstrates that LDL cholesterol was associated with an increased risk for cardiovascular outcomes in people with type 2 diabetes, independent of other conventional risk factor.
Pennington Biomedical Research Center, Baton Rouge, LA, United States; School of Human Ecology, Louisiana State University AgCenter, Baton Rouge, LA, United States; Department of Experimental Statistics, Louisiana State University, Baton Rouge, LA, United States.
Yujie
Y
Wang
Carol J
CJ
Lammi-Keefe
Lifang
L
Hou
Gang
G
Hu
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality*; D008078:Cholesterol, LDL / Q000097:blood*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
D008078:Cholesterol, LDL
Cardiovascular outcomes; Low-density lipoprotein cholesterol; Meta-analysis; Type 2 diabetes