Importance of high-density lipoprotein cholesterol levels in elderly diabetic individuals with type IIb dyslipidemia: A 2-year survey of cardiovascular events.
OBJECTIVE
The risk factors for ischemic heart disease (IHD) or cerebrovascular accident (CVA) in elderly diabetic individuals with type IIb dyslipidemia are not fully known. Therefore, we investigated the relationship between lipid levels and IHD and CVA in diabetic individuals with type IIb dyslipidemia.


METHODS
The Japan Cholesterol and Diabetes Mellitus Study is a prospective cohort study of 4014 type 2 diabetic patients (1936 women; age 67.4 ± 9.5 years). The primary end-points were the onset of IHD or CVA. Lipid and glucose levels, and other factors were investigated in relation to the occurrence of IHD or CVA. A total of 462 participants were included in the group of patients with type IIb dyslipidemia.


RESULTS
The 462 diabetic participants with type IIb dyslipidemia were divided into those who were aged <65 years, 65-74 years and >75 years (n=168, 190 and 104, respectively). High-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol/HDL-C were significantly associated with the risk of cardiovascular events in diabetic individuals with type IIb dyslipidemia who were aged <65 years, and HDL-C and diastolic blood pressure was significantly associated with cardiovascular events in patients aged 65-74 years. Non-HDL-C was not significantly associated with the risk of cardiovascular events. Multiple regression analysis showed that lower HDL-C was significantly associated with the risk of cardiovascular events in diabetic individuals with type IIb dyslipidemia who were aged <65 years and 65-74 years.


CONCLUSIONS
Lower HDL-C was an important risk factor for cardiovascular events in diabetic individuals with type IIb dyslipidemia who were aged <75 years.
Department of Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Koichiro
K
Ina
Toshio
T
Hayashi
Atsushi
A
Araki
Seinosuke
S
Kawashima
Hirohito
H
Sone
Hiroshi
H
Watanabe
Takashi
T
Ohrui
Koutaro
K
Yokote
Minoru
M
Takemoto
Kiyoshi
K
Kubota
Mitsuhiko
M
Noda
Hiroshi
H
Noto
Qun-Fang
QF
Ding
Jie
J
Zhang
Ze-Yun
ZY
Yu
Byung-Koo
BK
Yoon
Hideki
H
Nomura
Masafumi
M
Kuzuya
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D008076:Cholesterol, HDL / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D050171:Dyslipidemias / Q000097:blood* / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D011159:Population Surveillance; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D013997:Time Factors
D008076:Cholesterol, HDL
cerebrovascular accident; elderly type 2 diabetes; high-density lipoprotein cholesterol; ischemic heart disease; type IIb dyslipidemia